多发性硬化患者特殊治疗后中医证候学变化的横断面调查研究

Cross-sectional Investigation of Change of TCM syndromes on Multiple Sclerosis Patients after Special Treatment

目的探讨多发性硬化(MS)患者特殊治疗(血浆置换、免疫球蛋白)后的中医证候学变化。方法将MS患者随机分为常规组(常规的营养神经治疗和/或中医药治疗)48例,血浆置换组64例和免疫球蛋白组47例。采用横断面调查,填写问卷及中医四诊信息表,分组整合病历,运用WF文锋一Ⅲ中医(辅助)诊疗系统获得各组证素积分,对Ⅱ、Ⅲ级各组证素积分进行系统聚类分析。结果常规组与血浆置换组病位证素比较,肺、经络、肝、肾差异有统计学意义(P<0.05);病性证素比较,表、阳虚、湿、痰、风、阴虚、津亏差异有显著统计学意义(P<0.01)。常规组与免疫球蛋白组病位证素比较,肺、脾、肾差异有统计学意义(P<0.05);病性证素比较,表、寒、气虚、阳虚、湿、痰、风、毒、血瘀差异有显著统计学意义(P<0.01)。结论主要证名常规组为肺脾气虚证、痰阻经络证、寒湿阻络证,血浆置换组为脾阳虚证、脾气虚证,免疫球蛋白组为脾肾阳虚证。

Objective To investigate change of TCM syndrome on patients of multiple sclerosis （MS） after special treatment （immune globulin, plasma exchange）. Methods The MS patients were randomly divided into the convention group with 48 cases （neurotrophic drug and or TCM treatment）, plasma exchange group with 64 cases, and immune globulin group with 47 cases. A cross-sectional survey was adopted to fill with the questionnaire and the four diagnostic methods of TCM information table, grouping and integrating medical records. The syndrome score in each group was evaluated by using WF Wen Feng Ⅲ Chinese-（aided） diagnosis system. The accumulated points on level Ⅱ and Ⅲ groups were determined by systematic cluster analysis. Results Comparing the convention group with plasma exchange group, the symptom factors of disease location in lung, meridian, liver and kidney have statistically significance （P〈0.05）; The symptom factors of disease＇s quality in exterior, yang-deficiency, dampness, phlegm, wind, yang-deficiency, body fluid deficiency are statistically significant （P〈0.01）. Comparing the convention group with immune globulin group, the symptom factors of disease location in lung, spleen and kidney are statistically significant （P〈0.05）; The symptom factors of disease＇s quality in exterior, cold, qi-deficiency, yang-deficiency, dampness, phlegm, wind, toxicity and blood stasis are statistically significant （P〈0.01）. Conclusion The syndrome names of convention group are mainly called lung-spleen qi-deficiency, stagnation of phlegm and cold dampness of meridian collaterals. The syndromes in plasma exchange group are mainly spleen-yang-deficiency, spleen-qi-deficiency. The Immune globulin group is mainly spleen-kidney-yang deficiency syndrome.