老年多系统疾病患者中医证候要素初探?

目的初步探讨老年多系统疾病并见的证候要素特征。方法将124例老年多系统疾病患者病例资料按照格式化的信息录入SPSS软件表格,其中计数资料以原有数据表示,计量资料以1或0表示,所有的数据进行格式化设置;中医证候要素按照病性及病位分别录入,有则计为1,无则计为0;计数资料分析采用t检验,计量资料分析采用χ2检验。结果病性类证候要素分布:阴虚65.3%、气虚58.1%、火热41.1%、血瘀37.9%、气滞36.3%;病位类证候要素分布:脾54.8%、肾49.2%、肝24.2%、肺23.4%。80岁以上年龄组气虚证发生率达75%,80岁以下组气虚证发生率为50%。气虚证组平均年龄最大(77.65±9.98)岁,火热证组平均年龄偏低(73.14±8.44)岁;气虚证较无气虚证患者年龄偏大,火热证患者较无火热证患者年龄偏小,均有统计学意义,其他证候要素的有无与平均年龄间无明显统计学差异。痰证多系统疾病并见组的疾病数目最多(6.00±1.83),与无痰证组比较有统计学差异,其他证候要素的有无与老年患者多系统疾病数目之间无明显统计学差异。既往疾病中合并糖尿病、冠心病、慢性肺病的老年多系统疾病患者复合证素的数目更多,证候更加复杂;患有慢性胃炎的老年多系统疾病患者复合证素数目较少,证候相对简单。结论老年多系统疾病中医证候要素具有复杂性、不确定性、特殊性的特点。

TCM syndrome elements of 124 elderly patients with multi-system dis-ease

Objective To make a preliminary exploration on TCM syndrome elements of elderly patients with multi-system diseases. Methods A total 124 medical records of elderly patients with multi-system diseases were analyzed using SPSS software, of which count data were represented by the raw data and analyzed using Student’ s test and the measurement data were represented by figure “0”or “1”and ana-lyzed using Chi-square test . And TCM syndrome were input separately according to disease nature or dis-ease location-“0”for none, otherwise“1”. Results The frequency of disease nature elements from high to low was listed as the following: yin deficiency syndrome ( 65 . 3%) , qi deficiency syndrome (58. 1%), heat syndrome ( 41. 1%), blood stasis syndrome ( 37. 9%), qi stagnation syndrome (36. 3%);that of disease location elements was listed as: spleen(54. 8%), kidney (49. 2%), liver (24. 2%) and lung (23. 4%). 75% patients over 80 years suffered form qi deficiency, higher than 50% patients less than 80 years old. The mean age of patients with qi deficiency syndrome was 77. 65 ± 9 . 98 , while that of heat syndrome patients was 73 . 14 ± 8 . 44 . The patients with qi deficiency syndrome were older than those without qi deficiency syndrome, and the patients with heat syndrome were younger than those without heat syndrome. The quantity of the disease in phlegm syndrome group was the most (6. 00 ± 1. 83), and there was a significant difference compared with other groups. The elderly patients suffered from diabetes, coronary heart disease or chronic lung disease had more TCM syndrome elements and more complicated syndromes, and the patients with chronic gastritis had less TCM syndrome elements and less complicated syndromes. Conclusion The rule of TCM syndrome elements of elderly patients with multi-system disease is characterized by complexity, uncertainty and particularity.