从脏腑辨证角度分析300例干燥综合征中医证型分布情况

摘要

Objective:In order to objectively collecting and analyzing the TCM syndromes distribution of the common clinical symptoms in patients with primary sjögren syndrome,summarize the syndrome distribution law of the disease,s main symptoms,in order to guide the clinical diagnosis and treatment. Methods:Through the open collection in 300 cases with primary sjögren syndrome,record the general condition of the patient and common symptom integral quantization table and four diagnostic information,then according to the symptoms of summed up the TCM syndrome type,analysis of the data by statistic method,reach the TCM syndrome type distribution of common symptoms with primary sjögren syndrome.Results: ① The onset of a drying of patients with chief complaint up to 65%,the non drying complained about 35%.With or without drying,the main type of syndrome with the top 3 are hyperactivity of liver Yang > Liver blood deifciency > kidney essence deifciency.②Through detailed analysis of different degree of dry mouth,dry eye,nose,throat,skin dry,joint pain,swelling of the parotid gland symptoms found,in the recent 2/3 patients severe dry eye and mild to moderate joint pain,and other symptoms accounted for only about half.Each symptom at different levels of symptoms are the liver yang hyperactivity type was the dominant type of syndrome,other common syndromes are liver blood deifciency,spleen qi deifciency,deifciency of kidney essence deifciency and liver yin type.Conclusion:The main for liver,show that the drying syndrome has close relationship with liver.The major syndromes of the clinical symptoms of various sjögren's syndrome is liver yang hyperactivity. The other common type of syndrome also association with liver,other relevant organs are kidney and spleen,the syndromes associated with lung and blood stasis is relatively less.%目的：为了比较客观地收集并分析原发性干燥综合征患者的临床常见症状的中医证型分布，总结该病主要症状的证型分布规律以指导临床诊治。方法：通过开放性收集原发性干燥综合征患者300例，记录患者一般情况及常见症状的积分量化表及四诊信息，然后根据症状归纳出中医证型，运用统计学方法对数据进行分析，得出原发性干燥综合征患者常见症状的中医证型分布情况。结果：①起病时有干燥主诉的患者达65％，非干燥主诉的患者约35%。无论有无干燥主诉其主要证型前3位均为肝阳上亢型>肝血亏虚型>肾精不足型。②经详细分析不同程度口干、目干、咽干、鼻干、肤干、关节痛、腮腺肿大症状发现，中重度目干和轻中度关节痛在近2/3患者中存在，而其他各项症状仅占一半左右。而各组症状中不同级别症状中均以肝阳上亢型为主要优势证型，其他常见证型有肝血亏虚型、脾气亏虚型、肾精不足型和肝阴不足型。结论：原发性干燥综合征患者中各中医证型的最主要定位脏腑为肝，表明干燥综合征与肝有密切关系。在干燥综合征各临床各种干燥症状中最主要的证型为肝阳上亢型，其他常见证型也与肝有关，其他相关脏腑还有肾与脾，而与肺及瘀血相关的证型相对较少。