143例社区老年期痴呆患者的中医证候分析

Traditional Chinese medicine syndrome of 143 patients with senile dementia

目的研究社区老年期痴呆患者的中医证候特点。方法对纳入病例的143例痴呆患者进行问卷调查,采用描述性分析的方法进行统计学分析。结果 143例痴呆患者中,中医基本证候以肾虚髓减证最为多见,其后依次是心肝阴虚证、痰浊阻窍证、心脾两虚证、气滞血瘀证。其中仅属虚证者77例,实证者17例,虚实夹杂者49例。单一证候70例,证候类型由多至少依次为肾虚髓减证、痰浊阻窍证、心肝阴虚证、心脾两虚证、气滞血瘀证。复合证候73例,证候类型由多至少依次为肾虚髓减证、心肝阴虚证、痰浊阻窍证、心脾两虚证、气滞血瘀证。结论老年期痴呆的病机较为复杂,为多种病理因素相互作用而致病,单纯的病机比较少见。本虚标实是老年期痴呆的基本病机,本虚证中,以肾虚髓减最为显著。标实证中,痰浊阻窍占有重要地位。

Objective To study traditional Chinese medicine syndromes of the patients with senile dementia in the community. Methods The 143 patients with senile dementia in the community health service center and conrnunity station were given questionnaires and the data were analyzed by descriptive analysis. Results Among the 143 patients with senile dementia,the most basic traditional Chinese medicine syndromes were kidney deficient and encephala reduction, followed by heart and liver deficiency, sputum turbid blocking aperture, heart-spleen deficiency, qi-stagnancy and blood stasis, of which 77 cases were totally deficiency syndromes, 17 cases were totally excessive syndromes and 49 cases were deficiency-excess complications. There were 70 cases of single syndrome, and the types were ordered from more to less as follows：kidney deficient and encephala reduction, sputum turbid blocking aperture, heart and liver deficiency, heart-spleen deficiency, qi-stagnancy and blood stasis. There were 73 cases of composite syndromes, and the types were ordered from more to less as follows： kidney deficient and encephala reduction, heart and liver deficiency, sputum turbid blocking aperture, heart-spleen deficiency, qi- stagnancy and blood stasis. Conclusion The mechanism of senile dementia was complex and was induced by the interplay of many pathological factors. It was rare to be induced by a single mechanism. The basic mechanism of senile dementia was deficiency in origin and enrichment in symptom. For deficiency in origin, kidney deficient and encephala reduction were the most outstanding; for enrichment in symptom, sputum turbid blocking aperture played an important part.