主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2018, Vol. 41 ›› Issue (1): 83-88.doi: 10.3969/j.issn.1006-2157.2018.01.014

• 临床研究 • 上一篇    

中风急性期中经络与中脏腑痰热腑实证临床特点对比研究*

陈婷婷1, 任晋婷2, 任丽娜1, 贺忠延1, 孙畅1, 王冬慧1, 孙明广1, 王芳1, 谢颖桢1#   

  1. 1 北京中医药大学东直门医院 北京 100007;
    2 中国中医科学院广安门医院;
  • 收稿日期:2017-07-17 出版日期:2018-01-30 发布日期:2018-01-30
  • 通讯作者: 谢颖桢,女,博士,教授,博士生导师,研究方向:中医药防治脑血管病,E-mail: xyz_3191@aliyun.com
  • 作者简介:陈婷婷,女,在读博士生
  • 基金资助:
    *国家自然科学基金资助项目(No.81273693)

Comparative study on clinical characteristics of pattern of phlegm heat and bowel excess in acute stage of stroke involving meridians-collaterals or involving zang-fu organs*

Chen Tingting1, Ren Jinting2, Ren Lina1, He Zhongyan1, Sun Chang1, Wang Donghui1, Sun Mingguang1, Wang Fang1, Xie Yingzhen1#   

  1. 1 Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100007, China;
    2 Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China;
  • Received:2017-07-17 Online:2018-01-30 Published:2018-01-30
  • Supported by:
    National Natural Science Foundation of China (No.81273693)

摘要: 目的 探索中风病急性期中经络痰热腑实证与中脏腑痰热腑实证在神经功能缺损程度、不同时点中医证候分布、腑实持续时间等方面的临床特点。方法 采用病历回顾研究的分析方法,对204例中经络痰热腑实证(以下简称中经络组)与217例中脏腑痰热腑实证(以下简称中脏腑组)的基本信息、发病时美国国立卫生院卒中量表(NIHSS)评分、腑气通畅与否及腑实持续时间、不同时段(发病1~3 d、发病4~7 d、发病8~14 d)中医证候分布进行数据结构化录入,对数据所得临床特点对比分析研究。结果 中脏腑组患者NIHSS评分中除意识状态以外的神经功能缺损程度明显高于中经络组(P<0.01);中脏腑组患者平均腑气通畅时间明显长于中经络组(P<0.01),且急性期内中脏腑组腑气始终未通的比例明显高于中经络组;中经络组中痰热腑实证在发病1~14 d呈现逐渐递减趋势,中脏腑组痰热腑实证在发病1~7 d呈现递增趋势,发病8~14 d呈现递减趋势;中经络组气虚血瘀、风痰瘀血闭阻脉络证在4~14 d的出现例数明显高于1~3 d,中脏腑组阴虚风动、痰热瘀血、风痰瘀血在8~14 d出现例数明显高于1~3 d。结论 痰热腑实证的持续时间与中风病病情严重程度呈正相关,即中脏腑痰热腑实证神经功能缺损重、持续时间长。

关键词: 中风病, 痰热腑实证, 中经络, 中脏腑, 回顾性分析

Abstract: Objective To explore the clinical characteristics of pattern of phlegm heat and bowel excess in acute stage of stroke involving meridian-collateral or involving zang-fu organs from the aspects of severity of neurological impairment, pattern distribution at different time points and duration of bowel excess. Methods The basic information, scores of National Institute of Health Stroke Scale (NIHSS), whether bowel qi being unobstructed or not, duration of bowel excess, and pattern distribution at different time points (onset for 1 d to 3 d, onset for 4 d to 7 d and onset for 8 d to 14 d) were inputted based on structured data by using retrospective analysis of medical records in 204 cases of pattern of phlegm heat and bowel excess of stroke involving meridian-collateral (meridian-collateral group) and 217 cases of pattern of phlegm heat and bowel excess of stroke involving zang-fu organs (zang-fu organ group). The clinical characteristics from the data were compared, analyzed and studied. Results The severity of neurological impairment except of conscious state was significantly higher in zang-fu organ group than that in meridian-collateral group (P<0.01). The average duration of unobstructed bowel qi was significantly longer in zang-fu organ group than that in meridian-collateral group (P<0.01), and the percentage of patients with throughout obstructed bowel qi was significantly higher in zang-fu organ group than that in meridian-collateral group in acute stage of stroke. The pattern of phlegm heat and bowel excess showed a decline trend after stroke onset for 1 d to 14 d in meridian-collateral group, and showed an ascending trend after stroke onset for 1 d to 7 d and a decling trend after stroke onset for 8 d to 14 d in zang-fu organ group. The cases of pattern of qi deficiency with blood stasis or pattern of collaterals blocked by wind-phlegm and static blood were significantly higher in meridian-collateral group at 4-14 d than those at 1-3 d, and cases of pattern of wind stirring due to yin deficiency, pattern of phlegm heat and blood stasis or pattern of wind phlegm and blood stasis were significantly higher in zang-fu organ group at 8-14 d than those at time point 1. Conclusion The duration of pattern of phlegm heat and bowel excess is positively correlated to the severity of stroke, that is, neurological impairment is more serious and duration is longer in patients with pattern of phlegm heat and bowel excess of stroke involving zang-fu organs.

Key words: stroke, pattern of phlegm heat and bowel excess, stroke involving meridians-collaterals, stroke involving zang-fu organs, retrospective analysis

中图分类号: 

  • R255.5