中风病发病病机演变的动态研究

Dynamic Research on the Pathogenesis of Apoplexy

目的 :探索解读中风病发病前中医症状所蕴涵病机信息的生物统计方法 ,以期加深对中风病复杂的病机演变规律的认识。方法 :利用DME病因学1 :2病例对照研究 ,分别对中风发病前24小时、24至72小时、72小时至1周、1周至1个月、1个月以上5个时点的症状变量 ,分析克朗巴赫系数α(Cronbachα)和分半信度(split-halfre liability)后 ,进行流行病学和生物统计学分析。结果 :中风病发病前1个月病机以虚瘀为主 ;至发病前1周气阴两伤 ,阴虚阳亢而生热 ;发病前72小时～1周 ,虚瘀、痰壅日盛 ;发病前24～72小时虚瘀、痰结而滋生火热 ,热盛生风 ;发病前24小时见风火相煽 ,肆意攻窜而游荡于血脉、全身 ,使人卒然舌强 ,躁扰不宁而卒中。结论 :虽然每一个时点呈现多样化的临床表现 ,且与时俱变 ,症状和病机之间亦交互影响 。

Objective: To explore the biostatistic method for explaining the implicated informations of some symptoms occurred before apoplexy in order to further understand their rule of pathogenesis evolution. Methods: A 1:2 case-control study of etiology was carried out in five time points. After getting materials of Cronboch α and split-half reliability for all symptoms variables epidemiologic and biostatistic analysis were done for them. Results: The main pathogenesis was weak and blood stasis about one month before apoplexy and it became deficiency of both qi and yin one week before onset. These pathogenesis factors became more and more exuberant in the following days and transformed into pathogenic fire and wind period 24 h-72 h before this disease. While these pathogenic fire and wind stirred up each other in blood and body and apopleoxy onset occurred soon. Conclusions: Although these symptoms were different and varied with time in the disease course and there was an influence between them,the evolution rule and the changing trace could be recognized.