化痰通腑法治疗217例中风中脏腑痰热腑实证的回顾性研究

摘要

Object:Study the affect through relieving phlegm and relaxing bowel method for stroke in patients with disturbance of consciousness of the viscera,neurologic deficits and phlegm heat relieving empirical related syndrome.Method:Retrieve dongzhimen hospital information center from 1975 to 2005 medical record number,a stroke,the original medical record was obtained from the record room,strictly comply with stroke and phlegm heat relieving empirical diagnostic criteria and the research including and exclusion criteria,follow the principle of double cross check the record,structured paper-based medical records can be converted to electronic data,using frequency statistics and t test to analyze on relieving patients before and after in the state of consciousness,neurologic deficits and the change of heat syndrome,phlegm syndrome.Results:Phlegm heat stroke in the viscera of relieving real medical record of 217 cases were received.72.81％ of the syndrome appear within 72 hours of the onset.Through relieving method can make the 83.41％ of patients relieving FuQi obstructed.58.5％ patients turn conscious,while the method promotes the speed of consciousness recovery,shorten the duration of disturbance of consciousness,reduce the degree of heat syndrome,phlegm syndrome,prompt neural functional recovery.Conclusion:Phlegm heat relieving empirical associated with stroke severity.Phlegm and relieving method prompted by relieving Qi flow,material detoxified,reduce phlegm heat and phlegm fire certificate at the same time,which can also have a positive effect on improving the awareness of stroke and neural function defect illness.Relieving Qi flow has an important role in the stroke,which can be used as a criterion of illness weight standard,playing an important role to the prognosis of stroke outcome.%目的:通过化痰通腑法对中风中脏腑痰热腑实证患者意识障碍、神经功能缺损及相关证候影响的分析,研究痰热腑实证及化痰通腑法在中风病病势转归中的作用.方法:检索东直门医院信息中心1975年至2005年中风病案号从病案室获取原始病案,严格遵照中风病和痰热腑实证的诊断标准及本研究的纳入和排除标准,遵循双人双录交叉核对原则,将纸质病案转化为结构化电子数据,运用频次统计和t检验分析通腑前后患者在意识状态、神经功能缺损及火热证、痰证的改变情况.结果:共得到中风中脏腑痰热腑实病案217例72.81％的患者,其证候在发病72 h内出现,化痰通腑法可使83.41％的患者腑气通畅,58.5％的患者神志转清,同时促进了意识恢复的速度,缩短了意识障碍持续时间,降低了火热证、痰证程度,促使神经功能恢复.结论:痰热腑实证出现与中风病严重程度相关,化痰通腑法促使腑气通畅、降浊解毒,减轻痰热、痰火证的同时,对改善中风病意识及神经功能缺损的病情有积极作用.腑气通畅在中风病中占据重要地位,痰热腑实证及化痰通腑使腑气通畅对中风病预后转归有重要作用,提示中风病发生发展过程中脑与肠存在密切关联.