缺血性中风的急性期患者阴阳类证中医证候特点的多中心临床研究

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1、缺血性中风急性期患者阴阳类证中医证候特点的多中心临床研究【摘要】目的：通过对缺血性中风急性期患者发病不同时点证候特点的研究，探讨缺血性中风阴、阳类证中医证候组成特征。方法：采用“中风病辨证诊断标准”对1246例缺血性中风急性期患者发病后1～3d、4～10d、11～30d3个时点的中医证候特点进行了调查，分析缺血性中风急性期中医证候在3个时点的变化特点及阴、阳类证患者中6个基本证候分布的差异。结果：缺血性中风急性期患者风证的比率由1～3d的87.1％降到11～30d的79.3％（P0.01）；火热证患者比率由1～3d的52.1％降到11～30d的38.7％（P0.01

2、）；患者痰证的比率由1～3d的67.1％降到11～30d的57.4％（P0.01）；血瘀证、气虚证和阴虚阳亢证患者比率在3个调查时点差异无统计学意义（P0.05）。缺血性中风急性期3个时点阴、阳类证分布比较差异无统计学意义（P0.05）。阳类证患者中，风证、火证、痰证、阴虚阳亢证出现频率高于阴类证患者（P0.01），血瘀证、气虚证出现频率低于阴类证患者（P0.05，P0.01）。缺血性中风急性期证候组合在3个调查时点均以3个证候组合为主。阳类证患者中出现4、5个证候组合的频率高于阴类证患者，出现单证和两证组合的频率低于阴类证患者（P0.05，P0.01）。阴类证患者

3、中证候组合出现频率最高的为风＋痰＋血瘀＋气虚组合和风＋痰＋气虚组合。阳类证患者中证候组合出现频率最高的为风＋火＋痰＋气虚组合和风＋火＋痰组合。结论：阳类证和阴类证证候组合最主要的区别为阳类证具有火热证特征，痰证、气虚证、血瘀证与阴阳分类的证候诊断无关。【关键词】中风;证候;阴证;阳证;临床试验,多中心　　Objective:ToexplorethecompositioncharacteristicsoftraditionalChinesemedicine(TCM)syndromesinpatientswithacuteischemicstrokeofyinoryan

4、gsyndromebyinvestigatingthecharacteristicsofTCMsyndromesatdifferentperiodsafteronset.Methods:Onethousandtwohundredandfortysixpatientswithacuteischemicstrokewereadmittedintwentyhospitals.Accordingtothe“diagnosticcriteriaofsyndromedifferentiationofstroke”,thecharacteristicsofsyndromesin

5、thepatientswereinvestigatedattheperiodsof13days,410daysand1130daysaftertheyhadischemicstroke.Generaldistributionofsixbasicsyndromeswascomparedbetweenthepatientswithyinsyndromeandthepatientswithyangsyndromeatthethreeperiods.Thesixbasicsyndromeswerewindsyndrome,pathogenicfiresyndrome,

6、phlegmsyndrome,bloodstasissyndrome,qideficiencysyndrome,andsyndromeofyindeficiencyandyanghyperactivity.Results:Thepercentagesofwind,pathogenicfire,andphlegmsyndromesinthepatientsweredecreasedattheperiodof1130daysascomparedwiththeperiodof13days(87.1%vs79.3%,52.1%vs38.7%and67.1%vs57.4%

7、respectively,P0.01).However,thepercentagesofthesyndromesofbloodstasis,qideficiency,andyindeficiencyandyanghyperactivityweresimilaratthethreeperiods(P0.05).Therewerenodifferencesinthedistributionofyinandyangsyndromesamongthethreeperiods(P0.05).Thepercentagesofsyndromesofwind,pathogeni