94例重症肌无力患者中医证型分析

Analysis on Chinese Medicine Syndrome Types of 94 Cases of Myasthenia Gravis

目的:针对重症肌无力西医症状分型明确的情况下进行中医辨证分型分布规律调查,以期在辨证分型基础上指导治疗。方法:选取于2016年6月—2018年6月在西安市中医医院王晓燕主任医师门诊就诊或经门诊收入住院的94例重症肌无力患者作为研究对象,对患者的一般资料、临床表现及中医四诊资料进行辨证分析,总结中医证型分布规律。结果:重症肌无力患者Osserman分型的分布依次为Ⅰ型(76.6%)>Ⅱa型(18.1%)>Ⅱb型(5.3%)。重症肌无力的发病率女性(55.3%)>男性(44.7%)。重症肌无力患者的中医证型分布依次为脾胃亏虚、水湿内停型(34.0%)>脾肾阳虚、寒湿内陷型(30.9%)>元气亏虚、升提无力型(19.1%)>中气亏虚、气虚气陷型(16.0%)。结论:在重症肌无力患者病因病机、中医辨证分型研究与分析的基础上提出,治疗重症肌无力时采用"补肾健脾、益气升提、培元固本"之法。

Objective:To investigate the distribution rule of Chinese medicine syndrome types of myasthenia gravis on the basis of definite symptom typing of western medicine,so as to guide its treatment. Methods:A total of 94 cases of patients with myasthenia gravis visiting in the chief physician WANG Xiaoyan’s clinic or hospitalized in Xi’an Hospital of Chinese Medicine from June 2016 to June 2018 were selected as the study subjects. The analysis of syndrome differentiation was carried out based on general information, clinical manifestations and information from four examinations of Chinese medicine of patients, and then the distribution rule of Chinese medicine syndrome types was summarized. Results: The proportion of different Osserman types of myasthenia gravis was type Ⅰ(76.6%),type Ⅱ a(18.1%) and type Ⅱ b(5.3%). The incidence of myasthenia gravis in female was 55.3%,higher than that of 44.7% in male. The Chinese medicine syndrome types of myasthenia gravis were successively the spleen-stomach deficiency and water-dampness retention type(34%),spleen-kidney yang deficiency and inward invasion of cold-dampness type(30.9%),original qi deficiency and the middle qi failing to upraise type(19.1%) as well as middle qi deficiency,qi deficiency and qi fall type(16.0%). Conclusion:Based on the research and analysis of etiology and pathogenesis as well as Chinese medicine syndrome differentiation and typing of patients with myasthenia gravis,it is proposed to adopt the method of supplementing the kidney and fortifying the spleen,boosting and upraising qi,as well as strengthening and consolidating the source qi.