中风急症证候研究与问题探讨

Studies on syndrome and problems of stroke

目的 :探讨中风急症患者的证候分布。方法 :对 2 49例中风急症始发状态患者进行了中风辨证量化诊断调查。结果 :本病急性期证候分布概率以血瘀证最高 (6 4.6 6 % ) ,其次为风证 (6 2 .2 5 % )、痰湿证 (47.79% )、火热证 (30 .12 % )、气虚证 (2 5 .70 % )及阴虚阳亢证 (18.88% )。证型组合形式复杂 ,计 5 4个类型。脑出血者以 3证组合居首 ,2证次之 ;脑梗死则与之相反。证候组合规律以风瘀同时存在最多 (40 .5 6 % ) ,其次为风痰(35 .34 % )、痰瘀 (31.73% )及风火 (16 .47% ) ;3证组合依次为风痰瘀 (19.6 8% )、风火痰 (8.0 3% )和风火瘀(7.2 3% ) ;4证与 5证组合以风火痰瘀最高 ,两者共占 7.2 3%。证候得分均值与疾病性质、病灶大小关系密切。结论 :用统一中医辨证量化诊断标准探讨中风急症病理病机 ,并对重视早期量化诊断问题提出了建议与处理办法。

Objective:To investigate the distributions of syndrome in patients with stroke.Methods:The syndromic quantitative diagnose of 249 patients with stroke in early stage were performed.Results:The highest distribution probability of stroke syndrome was blood stasis(血瘀) and the probabilities of wind syndrome(风证),phlegmdampness(痰湿),firehot(火热),Qideficiency(气虚),floating of Yang due to Yindeficiency(阴虚阳亢) were 64 66%,62 25%,47 79%,30 12%,25 70% and 18 88% respectively.There were 54 types of syndromes.Most cerebral bleeding had three or two syndromes in contrary to cerebral infarction,syndrome had its rule.The proability of windstasis (风瘀) coexisting at the same time was highest(40 56%).And windphlegm(风痰),phlegmstasis(痰瘀),windfire(风火) coexisting at the same time were 35 34%,31 73%,16 47% respectively.The probabilities of three syndromes was windphlegmstasis(风痰瘀,19 68%),windfirephlegm(风火痰,8 03%),and windfirestasis(风火瘀,7 23%).The highest probability of four or five syndromes coexisting in the same patients was windfirephlegmstasis(风火痰瘀,7 23%).Mean of syndrome scores was obviously related to effects of disease′s magnitude.Conclusions:In order to certify the standard of traditional syndrome quantitative diagnosis,investigate the pathogenesis of stroke,and attach important to quantitative diagnosis at early stage,some suggestions and treatment methods are offered,which have important theoretical significance and clinically applicable value.