老年人头晕常见病因的中医证型分布探讨

Distribution of TCM syndrome types among the common causes of dizziness in the elderly

目的:以病证结合模式探讨老年人头晕常见病因的中医证型分布规律。方法:选择433例老年头晕患者,按照西医的诊断标准明确梅尼埃病、良性发作性位置性眩晕、前庭神经炎、中枢性眩晕、慢性主观性头晕、直立性低血压和高血压急症等头晕常见的7种病因,对上述病因的头晕患者予以中医辨证分型。结果:直立性低血压患者的平均年龄显著高于其他各组;梅尼埃病患者的平均年龄显著低于其他各组;中枢性眩晕患者的主要证型为肝阳上亢型、痰湿中阻型,高血压急症患者的主要证型为肝阳上亢型,直立性低血压患者的主要证型为肾精不足型;肝气郁结型在慢性主观性头晕患者中,及肝阳上亢型在高血压急症患者的比例均显著高于其他病因(均P<0.01);直立性低血压和良性发作性位置性眩晕患者的主要证型为肾精不足型(P<0.01,P=0.015)。慢性主观性头晕与其他6种病因的证型构成差异显著(P<0.01);梅尼埃病和良性发作性位置性眩晕之间、前庭神经炎和高血压急症之间的证型构成最为相似。结论:老年人头晕的常见病因的中医证型构成存在一定的规律性。

Objective:To explore the distribution of TCM syndrome types among the common causes of dizziness in the elderly.Methods:433 elderly patients with dizziness were selected and seven common causes of dizziness were identified according to the diagnostic criteria,including Meniere’s disease,benign paroxysmal positional vertigo,vestibular neuritis,central vertigo,chronic subjective dizziness,orthostatic hypotension and hypertensive emergency,and all patients were given TCM syndrome differentiation respectively.Results:The average age of patients with orthostatic hypotension was significantly higher than that in other groups.The average age of patients with Meniere’s disease was significantly lower than that in other groups.The main types among patients with central vertigo were liver Yang(阳)hyperactivity and stagnation of phlegm-dampness,the main syndrome type in hypertensive emergency and orthostatic hypotension patients were liver Yang hyperactivity and kidney essence deficiency,respectively.The type of liver Qi(气)stagnation among chronic subjective dizziness patients and liver Yang hyperactivity among hypertensive emergency patients were significantly higher(P<0.01),The main type among patients with orthostatic hypotension and benign paroxysmal positional vertigo was renal sperm deficiency(P<0.01,P=0.015).There was a significant difference in syndrome types between chronic subjective dizziness and other six causes(P<0.01),the syndrome types in benign paroxysmal positional vertigo and Meniere’s disease,vestibular neuritis and hypertensive emergency were the most similar.Conclusion:There was some certain regularity in the distribution of TCM syndrome types among the common causes of senile dizziness.