慢性主观性头晕中医证候学特点初步分析

Preliminary Analysis on Traditional Chinese Medicine Syndrome of Chronic Subjective Dizziness

目的:探讨慢性主观性头晕中医临床症状特点和证候分布规律。方法:建立《慢性主观性头晕中医临床表征调查表》,对符合诊断标准的患者采集临床表征元素数据,对症状频率进行统计和分析;对临床表征元素进行聚类分析统计,得到临床证候分类群组,经过诊断学分析判别,获得临床证候类别和分布规律。结果:162例慢性主观性头晕患者进入调查和统计。46个临床症状中有8组症状出现频率在40%以上:头痛/头重/头胀、倦怠乏力、劳累后头晕目眩加重、耳鸣、恶心、易醒、入睡困难、多梦;有16个症状出现频率在30%以上;其余22个临床症状出现率较低。聚类分析聚类出4组临床证候,经过中医证候判别分别为肝肾阴虚型(30.86%)、气血亏虚型(41.98%)、痰浊中阻型(18.52%)、肝气郁结型(8.65%)4种类型,其中虚证多见,实证较少。结论:慢性主观性头晕中医临床症见多样,证候分型以4种常见类型为主,虚证为主,包括气虚血虚、阴虚;实证以气郁、痰湿为主。

Objective ： To probe the traditional Chinese medicine （ TCM ） symptoms and syndromes of chronic subjective dizziness （CSD）. Methods ： Established ＂chronic subjective dizziness TCM clinical manifestation questionnaire＂, collected clinical data, calculated the frequency of symptoms, cluster analysis was applied. Results ： 162 cases with CSD were enrolled in survey. The occurrence rate of 8 groups of manifestations and signs is over 40%, they were headache/front heaviness/fullness in head, fatigue, dizziness after overwork, tinnitus, nausea, easy to wake up, difficulty falling asleep, more dreams. 16 manifestations occurred over 30%, the leftover 22 manifestations occurred occasionally. There were four elinical syndromes which were clustered by statistical calculation, they were deficiency of liver-Yin and kidney-Yin syndrome, deficiency of Qi and blood syndrome, phlegm turbidity obstructing the center syndrome, and stagnation of liver qi syndrome. Deficiency syndromes are common, and empirical are rare. Conclusion ： Clinical manifestations of CSD are varied. CSD has four main syndromes. Deficiency syndromes are common which include deficiency of Qi, blood and Yin, and empirical syndromes are rare.