54例视神经脊髓炎谱系疾病患者的临床特点分析及中医证素研究

目的:探讨54例视神经脊髓炎谱系疾病(NMOSD)患者的临床特点及证素证候分析,为阐明该病的中西医病因、诊断和证候间关系提供依据.方法:按照2015年国际视神经脊髓炎诊断小组(IPND)的诊断标准招募54例NMOSD患者,收集资料进行统计分析.四诊信息根据病位和病性证素予以整理并分析其特征.结果:研究对象男女比例为1:...

Analysis of Clinical Characteristics of 54 Patients with Neuromyelitis Optic Spectrum Disease and Traditional Chinese Medicine Syndrome Elements Research

Objective:To explore the clinical characteristics and syndrome analysis of 54 patients with neuromyelitis optica spectrum disease(NMOSD),and to provide evidence for elucidating the relationship between the etiology,diagnosis and syndromes of the disease.Methods:According to the 2015 International Optic Neuromyelitis Diagnostic Group(IPND)diagnostic criteria,a total of 54 patients with NMOSD were recruited,and data were collected for statistical analysis.The information of the 4 clinics was sorted and analyzed according to the location of the disease and the symptoms of the disease.Results:The male to female ratio of the study subjects was 1∶6.7,the average age of onset(40.13±12.14)years old,49 cases of AQP4-IgG positive,19 cases of autoimmune disease antibody positive;family history distribution,tumor family history accounted for 9.3%,autoimmune disease family accounted for 5.6%;the average course of disease was(3.91±4.60)years,and the average number of attacks was(5.91±4.56);the most common involved sites were the optic nerve and cervical thoracic spinal cord;18 cases of abnormal neuroelectrophysiological examination.The results of TCM syndrome elements show that the distribution of disease location syndrome elements:spleen>liver>kidney>three Jiao>stomach;the distribution of disease symptoms was:wet>phlegm>blood stasis>qi stagnation>cold;the distribution of deficiency is:qi deficiency>yin deficiency>yang Deficiency>blood deficiency>yang hyperactivity.Conclusion:The incidence of NMOSD patients in remission is mainly young and middle-aged women,which may be associated with autoimmune diseases.The nervous system is most commonly affected by the optic nerve,optic chiasm,cervical spinal cord,and thoracic spinal cord.The positive rate of AQP4-IgG detection in peripheral blood is high,and neuroelectrophysiological induction potential is abnormal.The analysis of TCM syndrome elements indicates that the pathological factors of this disease are in the spleen,liver,and kidney.The deficiency syndrome factors of this disease are mostly qi deficiency,yin deficiency,and Yang deficiency,and the solid syndrome factors are mostly dampness,phlegm,and stasis;the main deficiency is summarized as the deficiency of qi in the middle Jiao,the deficiency of yin in the liver and kidney,and the deficiency of Yang in the spleen and kidney,etc.,which are the basis of the pathogenesis of the disease.In fact,most of the sex syndromes include phlegm-dampness,blood stasis,and qi stagnation.