158例重症肌无力患者中医证候和临床特点相关性探讨

Discussion on Correlation between TCM Syndromes and Clinical Characteristics of Patients with Myasthenia Gravis for 158 Cases

目的探讨重症肌无力中医证候分布与西医临床特点的相关性。方法回顾性分析2012年1月—2016年4月门诊及住院的158例重症肌无力患者的中医证候和西医临床特点。结果重症肌无力中医证型以脾肾亏虚(46.8%)和脾气虚弱(41.2%)多见;<20岁以脾气虚弱为主(84.6%),21~40岁以脾气虚弱多见(65.4%),41岁~60岁脾气虚弱(40.0%)和脾肾亏虚(52.0%)相当,>60岁以脾肾亏虚多见(65.9%);I型以脾气虚弱为主(67.3%),IIa型脾气虚弱多见(47.6%),脾肾亏虚次之(38.1%),Ⅱb型以脾肾亏虚多见(81.6%);在舌质分布上,淡白舌最多(64.6%),舌形分布上,舌体胖大最多(59.5%)。在舌苔分布上,白腻苔最多(46.8%);病程<1年、病程1~3年、病程3~10年、病程>10年其淡白舌所占比重分别为52.6%、66.7%、72.3%和64.0%,其舌体胖大所占比重分别为36.8%、50.0%、74.5%和84.0%,其白腻苔所占比重分别为28.9%、45.8%、48.9%和72.0%。结论重症肌无力证型以脾肾亏虚和脾气虚弱多见,其中医证型与年龄、西医分型相关;重症肌无力为虚实夹杂之病,可合并湿邪。

Objective To explore the correlation of myasthenia gravis（MG） between TCM syndrome distribution and the clinical characteristics of Western medicine. Methods Retrospective analysis of the clinical characteristics of 158 patients with MG which includes outpatient and in-patient from January 2012 to April 2016 were carried out. Results Deficiency of the spleen and the kidney（46.8%）, deficiency of spleen-qi（41.2%） are the major TCM syndrome of MG. Deficiency of spleen-qi（84.6%） is the major TCM syndrome of the patients who are less than 20 years old, deficiency of spleen-qi（65.4%） is the major TCM syndrome of the patients between the age of 21 to 40, deficiency of the spleen and the kidney（40.0%）, deficiency of spleen-qi（52.0%） are the major TCM syndrome of the patients between the age of 41 to 60, deficiency of the spleen and the kidney（65.9%） are the major TCM syndrome of the patients who are older than 60 years old. Deficiency of spleen-qi（67.3%） are the major TCM syndrome of I type, deficiency of spleen-qi（47.6%） are the major TCM syndrome of IIa type, and the rate of deficiency of the spleen and the kidney is 38.1%; deficiency of the spleen and the kidney（81.6%） are the major TCM syndrome of Ⅱb type. In the distribution of the tongue, pale tongue is the most（64.6%）. In the distribution of the tongue shape, swollen tongue is the most（59.5%）. In the distribution of tongue coating, white and greasy fur is the most（46.8%）. The proportion of pale white tongue was 52.6 %, 66.7 %,72.3 % and 64.0%, in disease course of less than 1 year, 1 to 3 years, 3 to 10 years and more than 10 years. The proportion of swollen tongue is 36.8%, 50.0%, 74.5% and 84.0%. The proportion of white and greasy fur is 28.9%. 45.8%. 48.9% and 72.0%.Conclusion Deficiency of the spleen and the kidney, deficiency of spleen-qi are the major TCM syndrome of MG, the TCM syndrome is related to age and western medicine classification. MG is the disease of deficiency syndrome accompanied with excess syndrome,and combined with pathogenic dampness.