220例慢性再生障碍性贫血中医症状和证型临床特点分析

目的了解慢性再生障碍性贫血（chronicaplasticanemia，CAA）的中医证型及不同性别患者中典型症状的分布特点。方法选取2002年6月_2012年6月浙江省中医院血液内科门诊及住院CAA患者220例。采集患者初次发病时的症状、体征及四诊情况，进行中医辨证分型，并对证型和典型症状进行分析。结果220例CAA患者中肾阳虚型121例（55．00％），肾阴虚型18例（8．18％），肾阴阳两虚型81例（36．82％）；典型症状分布：乏力气短（男77．12％，女73．53％）、面色铣白（男64．41％，女57．84％）、四肢不温（男12．71％，女26．47％）、自汗盗汗（男32．20％，女26．47％）、口干咽燥（男6．78％，女6．86％）、手足心热（男14．41％，女20．59％）、大便稀溏（男6．78％，女2．49％）、瘀点瘀斑（男42．37％，女43．14％）。结论CAA初诊患者的中医辨证分型以肾阳虚为主，其次是肾阴阳两虚，肾阴虚最少；中医症状中，男女患者表现最多的是乏力气短，其次为面色白光白和皮肤瘀点瘀斑。

Analysis of Clinical Features of Traditional Chinese Medicine Symptoms and Syndromes of 220 Patients with Chronic Aplastic Anemia

Objective To study Chinese medicine （CM） syndrome types of chronic aplastic ane- mia （CAA） patients and the distribution laws of typical CM symptoms in different genders. Methods From June 2002 to June 2012, 220 CAA outpatients/inpatients at Department of Hematology, Zhejiang Chinese Medical Hospital were recruited. Patients＇ symptoms and signs, as well as four diagnostic infor- mation at the first onset were collected. CM syndrome differentiation was performed. The syndrome types and typical symptoms were analyzed. Results （1） In the 220 CAA patients, there were 121 cases of Shen yang deficiency syndrome （55.0%）, 18 of Shen yin deficiency syndrome type （8.18%）, 81 cases of Shen yin-yang deficiency syndrome （36.82%）. （2） The distribution of typical symptoms： fatigue and shortness of breath （77.12% males and 73.53% females）, pale complexion （64.41% males and 57.84% females）, low temperature of four limbs （12.71% males and 26.47% females）, spontaneous perspiration and night sweating （32.20% males and 26.47% females）, dry mouth and throat （6.78% males and 6.86% females）, feverish feelings in palms and soles （14.41% males and 20.59% females）, loose stool （6.78% males and 2.94% females）, petechiae and ecchymosis （42.37% males and 43.14% females）. Conclusions Shen yang deficiency syndrome was most often seen in CAA patients at the initial diagnosis, followed by Shen yin-yang deficiency syndrome. Shen yin deficiency syndrome was the least seen. In CM symptoms, fatigue and shortness of breath were most common seen, followed by pale complexion, skin petechia and ecchymosis.