血管性痴呆患者中医证候特点研究

摘要

Objective:Discuss to traditional Chinese medicine syndrome characteristics and distribution regularity of Vascular dementia (VD).Methods:95 cases of VD patients were Collected,and the difference of syndrome gender composition,age distribution,culture degree were statistics compared based on TCM syndrome differentiation scale (SDSVD),and each syndrome occur rate and syndrome combinations were analyzed,syndrome integration were analyzed by the correlation matrix analysis.Result:After statistical analysis,there were no statistical differences between different syndromes of gender,age distribution,degree of culture composition in VD patients,Frequency rate of syndrome of VD patients from big to small in the order was:syndrome of deficiency of kidney essence ＞ Obsessed with the phlegm turbidity resistance syndrome ＞ syndrome of collateral retardation due to blood stasis ＞ Relieving ZhiZhuo leave certificate ＞ Qi deficiency syndrome ＞ Hot card inside ＞ Essence of liver Yang syndrome,and the frequency of which were 86.32％,56.84％,54.74％,45.26％,40.00％,33.68％,32.63％.single syndrome were accounted for 8.42％,and two syndrome combination for 14.74％,three syndrome combination for 25.26％.Two syndrome combination of the kidney essence deficiency and blood stasis resistance collaterals syndrome were appear the most times,and three syndrome combination with essence of kidney deficiency syndrome and phlegm turbidity resistance syndrome and blood stasis resistance winding appears the most times.The result of syndromes for correlation matrix analysis shows that excessive rising of liver-YANG were the largest correlation with fire-heat inside,and followed by Relieving ZhiZhuo leave certificate syndrome and Obsessed with the phlegm turbidity resistance syndrome,which are positively correlated.Conclusion:The syndrome of deficiency of kidney essence,Obsessed with the phlegm turbidity resistance syndrome,blood stasis syndrome is the highest occurrence rate syndromes in VD patients.The characteristic of syndrome combination were inclusion of excess and deficiency.Which showed that Kidney essence deficiency,blood stasis,stagnation of phlegm were the main pathomechanism.The correlation matrix of syndrome score showed that it is helpful for calming the liver and suppress yang to clean hepatic fire,as the same time,it is helpful for cleanning hepatic fire to calm the liver and suppress yang,and it is helpful for dissipating phlegm for resuscitation to clear intestinal tract and descend the turbid.%目的:探讨血管性痴呆(VD)中医证候特点及分布组合规律.方法:采集VD患者95例依据中医辨证量表(SDSVD)进行中医辨证分型,统计比较各证候性别构成、年龄分布、文化程度构成差异,分析各证候出现率及证候组合方式,对证候积分进行相关矩阵分析.结果:VD患者各证候间性别构成、年龄分布、文化程度构成方面比较差异无统计学意义,VD患者证候出现率从大到小依次为肾精亏虚证＞痰浊阻窍证＞瘀血阻络证＞腑滞浊留证＞气血亏虚证＞火热内盛证＞肝阳上亢证,出现率分别为86.32％、56.84％、54.74％、45.26％、40.00％、33.68％、32.63％.其中单证占8.42％,两证组合占14.74％,三证组合占25.26％,两证组合以肾精亏虚证+瘀血阻络证出现最多,三证组合中以肾精亏虚证+痰浊阻窍证+瘀血阻络证出现最多.证候相关矩阵分析显示,火热内盛证与肝阳上亢证相关性最大,其次为腑滞浊留证与痰浊阻窍证均呈正相关.结论:VD的证候主要以肾精亏虚证、痰浊阻窍证、瘀血阻络证最为常见,证候组合以虚实夹杂为其主要特点,肾虚血瘀痰阻为其基本病理机制;证候积分相关矩阵分析提示,清肝泻火有助于平肝潜阳,合理采用通腑降浊法有助于化痰开窍醒神.