瘀热病机在出血性中风发病中的作用

摘要

Objective To investigate the distribution and dynamic changs of pattern elements,especially the role of static heat pattern in the occurrence of cerebral hemorrhage in acute stage.Methods Based on Pattern Element Scale for Hemorrhagic Stroke at Acute Stage,we collected clinical manifestation data of 1 028 patients with acute hemorrhagic stroke.Distribution and dynamic changs of eight pattern ele-ments (Static heat,Wind,Fire,Phlegm heat,Phlegm dampness,Blood stasis,Qi deficiency and Yin deficiency)at five different timing points after admission (upon adaission Day 3,7,14,and 21 ). Results The distribution of pattern elements in hemorrhagic stroke patients at the acute stage presented with a specific rule.Proportion of Static-heat pattern was the highest at each time point followed by Wind and Fire patterns.There was statistical longitudinal difference in the number of pattern elements (P <0.05)at different time points.Conclusion Static heat pattern seems to be the fundamental mechanism and play a leading role in the occurrence of the disease while wind,fire,and phlegm seems to derive from Static heat.%目的：临床调查出血性中风急性期患者病机证素的分布、演变情况，揭示“瘀热”病机在发病过程中的重要作用。方法按照“出血性中风急性期病机证素诊断量表”，采用多时点临床流行病学调查方法对1028例出血性中风急性期患者进行现场调查，统计分析5个时间点（入院时，病程第3、7、14、21天）8个病机证素（瘀热、风阳、火热、痰热、痰湿、瘀血、气虚、阴虚）的分布、演变情况。结果出血性中风急性期证候分布呈现一定的规律性，不同时间点瘀热比例均高于其他病机证素，风阳、火热居前位。将各病机证素例数按时间点进行纵向比较，差异有统计学意义（P ＜0．01）。结论瘀热为病理本质，在发病中起主导作用，风、火、痰源于瘀热搏结。