500例耳鸣患者中医证型分析

Analysis on TCM syndrome patterns in 500 tinnitus participants

目的总结刘大新教授诊治的500例耳鸣患者辨证分型特点,探讨耳鸣证型分布规律,为耳鸣的中医辨证提供参考。方法整理分析刘大新主任诊疗的第一主诉为耳鸣的患者500例,经四诊合参、辨证分型,结合问卷调查进行中医证候归纳,应用计算机隐结构模型为证型分类的客观性提供依据。结果 500例耳鸣患者一般资料符合正态分布;其中脾胃虚弱型314例(63%)、肝火上扰型94例(19%)、肾精亏损型47例(9%)、痰火郁结型31例(6%)、风热侵袭型14例(3%);证候分布为脉缓45%,倦怠乏力75%,便溏82%,纳呆64%,胸闷脘满68%,苔白69%,苔薄95%。结论脾胃虚弱证是耳鸣的主要临床证型,应重视耳鸣脾胃虚弱证及兼证的治疗研究。

Objective To summarize the Professor LIU Da-xin＇ s characteristics on syndrome differentiation for 500 tinnitus participants, to explore the syndrome pattern of tinnitus, and to provide references for the TCM syndrome differentiation and treatment of tinnitus. Methods 500 participants with tinnitus as the first chief complaint, who were treated by Professor LIU, were determined with four diagnostic methods and syndrome differentiation, combined with questionnaires to conclude TCM syndromes, and a computer latent structure model was applied to provide statistical data to ensure the objectivity of syndrome classification. Results The general information of 500 tinnitus participants fitted normal distribution; there are 314 （63%） of weakness of the spleen and the stomach, 94 （19%） of liver fire flaring up, 47 （9%） of kidney essence insufficiency, 31 （6%） of stagnation of phlegm-fire and 14 （3%） of wind-heat invasion. The symptoms distribution was 45% of moderate pulse, 75% of tiredness and weakness, 82% of loose stool, 64% of indigestion and loss of appetite, 68% of chest congestion and abdominal fullness, 69% of white fur, and 95% of thin fur. Conclusion The syndrome of weakness of the spleen and the stomach is the major clinical syndrome pattern of tinnitus. Great importance should be attached to studies on treatment for syndrome of weakness of the spleen and the stomach and its accompanied symptoms in tinnitus.