视神经炎的中医证候学研究

Research on TCM syndromes of optic neuritis

目的了解目系暴盲(视神经炎)的证候诊断,以及辨证分型与年龄、性别之间的关系,为深入研究目系暴盲的中医辨证论治提供客观依据。方法选择2010年11月1日至2013年10月31日就诊于北京中医药大学东方医院眼科门诊、急诊和住院的目系暴盲患者,采用问卷调查的方法进行病例回顾和病例监测。以证候学研究为核心,采用临床流行病学的设计方法,收集固定时间段内目系暴盲患者的中医证候表现,对中医证型的性别分布、年龄分布进行分析。结果共收集病例109例,包括病例回顾61例,病例监测48例。统计结果显示:1.男、女患者的各证型构成具有统计学意义的差异(P=0.031<0.05)。女性患者的证型分布比较集中,主要分布在肝肾阴虚证、肝郁气滞证和气血两虚证,男性患者的证型分布则比较分散,以肝肾阴虚证、肝郁气滞证最为多见,且肝经实热证和阴虚火旺证的比例高于女性患者。2.不同年龄段目系暴盲患者的证型分布差异无统计学意义(P=0.054>0.05)。结论目系暴盲的中医证候类型分布与性别有关,女性患者的证型分布比较集中,以肝肾阴虚证、肝郁气滞证和气血两虚证多见。要获得更为客观全面的结论,尚需开放证型、增加样本、长期随访,做进一步研究。

OBJECTIVE To understand the relationship between age, gender and syndrome differentiation type of sudden blindness, and to provide an objective basis for syndrome diagnosis. METHODS Patients were chosen from outpatient, emergency and inpatient ophthalmology department, Dongfang Hospital of Beijing University of TCM from November 1, 2010 to October 31, 2013. The source objects of study included review and monitor of cases. Taking the research of symptomatology as the center, we collected the syndromatology of TCM during the periods by using a design method of clinical epidemiology. RESULTS 1. In the correlation analysis of gender and type of syn- drome, there were statistically significant differences in the various syndromes constituted of male and female pa- tients （P=0.031 〈0.05）. The syndrome type distribution of female patients was more concentrated, mainly in liver and kidney yin deficiency, liver depression and qi stagnation and deficiency of both qi and blood. Meanwhile, the syn- drome type distribution of male patients was more dispersed, with liver and kidney syndrome, the most common liver qi stagnation, and the ratio was higher than female patients between excess heat syndrome of the liver and hyperac- tivity of fire due to yin deficiency; 2, In the correlation analysis of age and type of syndrome, there was not a statisti- cally significant difference among different ages of patients with optic neuritis in the distribution of syndrome （P= 0.054〉0.05）. CONCLUSIONA The characteristics of TCM syndrome type distribution of eye system sudden visual loss was related to gender, and the syndrome type distribution of female patients was more concentrated, mainly in liver and kidney yin deficiency, liver depression and qi stagnation and deficiency of both qi and blood. In order to obtain more objective and comprehensive conclusion, we still need to open the TCM syndrome type, increase the sample, long-term follow-up and further study.