闽东地区缺血性中风痰瘀互结证患者中医体质及治疗分析

An exploration of the TCM constitution and treatment of ischemic stroke patients with the syndrome of intermin-gled phlegm and blood stasis in eastern Fujian

目的 通过了解闽东地区缺血性中风痰瘀互结证患者中医湿热体质特点,旨在探讨影响湿热体质相关因素,加深对缺血性中风之痰瘀互结证的认识,并结合临床医案分析中风康复汤的运用.方法 本研究通过系统抽样方法 ,选取2017年1月-2019年12月福建中医药大学附属福州中医院脑病科缺血性中风痰瘀互结证的住院患者68例进行研究,运用《中医体质分类与判定》,分为湿热质组与非湿热质组,分析缺血性中风痰瘀互结证患者中医湿热体质特点.结果 缺血性中风痰瘀互结证患者湿热质较常见,占有比例较高(67.6%).缺血性中风痰瘀互结证患者有饮食嗜好、有饮酒史湿热体质比较,差异有统计学意义(P<0.05),其中湿热体质与饮食嗜好(如辛辣、甜食、油腻、煎炸等)、饮酒史比较,差异有统计学意义(P<0.05).湿热质组运用中风康复汤占有比例较高(71.8%),湿热质组运用率与非湿热质组比较,差异有统计学意义(P<0.05).结论 闽东地区除气候湿热外,存在饮食嗜好、饮酒等因素,催生湿热体质,影响缺血性中风痰瘀互结的形成,临床应结合闽东地区湿、热特点,讲求痰瘀并治的治法及思路,以期为临床方药运用提供依据.

Objective To understand the characteristics of damp-heat constitution of TCM in ischemic stroke patients with the syndrome of intermin-gled phlegm and blood stasis in eastern Fujian,so as to explore the relevant factors affecting damp-heat constitution,deepen the understanding of the syndrome of intermin-gled phlegm and blood stasis of ischemic stroke,and analyze the application of apoplexy rehabilitation decoction with reference to clinical medical cases. Methods Through systematic sampling method,68 ischemic stroke patients with the syndrome of intermin-gled phlegm and blood stasis hospitalized in the Department of Encephalopathy of Fuzhou Traditional Chinese Medicine Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2017 to December 2019 were selected for research.The patients were divided into the damp-heat group and the non dampheat group according to Classification and Determination of Constitution in TCM,and the characteristics of TCM damp-heat constitution of ischemic stroke patients with the syndrome of intermin-gled phlegm and blood stasis were analyzed. Results Damp-heat constitution was more common in ischemic stroke patients with the syndrome of intermin-gled phlegm and blood stasis,accounting for a higher proportion(67.6%).There were statistically significant differences in damp-heat constitution between ischemic stroke patients with the syndrome of intermin-gled phlegm and blood stasis who had dietary habits and drinking history(P < 0.05),among which damp-heat constitution had statistically significant correlation with dietary habits(such as spicy,sweet,greasy,fried,etc.preference) and drinking history(P < 0.05).The application rate of apoplexy rehabilitation decoction in the damp-heat group was higher(71.8%),and when compared with that in the non damp-heat group,it showed statistically significant difference(P < 0.05). Conclusion In addition to humid and hot climate in eastern Fujian,there are factors such as dietary preference and drinking,which have increased damp-heat constitution and affected the formation of intermin-gled phlegm and blood stasis in ischemic stroke.Clinically,the treatment method and thinking of phlegm and blood stasis combined treatment should be emphasized with reference to the characteristics of humid and hot climate in eastern Fujian,so as to provide basis for clinical application of prescriptions.