216例中风病急性期痰热腑实证患者症状分析

目的探讨中风病急性期痰热腑实证的证候特点,确定其主要的症状表现,指导通腑法的临床应用。方法回顾性分析216例中风病急性期痰热腑实证患者的症状表现,对症状进行频次、因子、聚类分析。结果中风病急性期痰热腑实证前46位高频症状经因子分析后提取出19个关键症状。特异性症状聚类分析结果为:鼻鼾、痰鸣、气促、声高气粗、口臭、头痛、腹胀、胸闷、心烦易怒、躁扰不宁、虚烦不眠聚为第一类,咽干、口渴、口苦、口干聚为第二类,倦怠乏力、气短聚为一类,咳嗽、大便秘结各单列一类;舌苔脉象聚类分析结果为:沉脉、舌生瘀斑、厚苔、白苔、红舌、数脉、紫舌、少苔、细脉聚为第一类,腻苔、滑脉、弦脉、黄苔聚为第二类,淡红舌单列一类;黄腻苔、弦滑脉是临床中常见的组合。结论中风病急性期痰热腑实证属本虚标实,实性证候要素以痰、热、瘀、腑实为主,虚性证候要素以气阴两虚为主。通腑法在中风病急性期要动态地辨证应用,同时注意与扶正法的联用。

Analysis on symptoms of 216 patients with heat-phlegm and sthenic-fu syndrome in the acute stage of apoplexy

Objective To exploring the syndrome characteristics of the heat-phlegm and sthenic-fu syndrome of apoplexy to guide the clinical application of the therapy of purging fu-organ in the acute stage of apoplexy.Methods The symptoms of 216 selected patients with the heat-phlegm and sthenic-fu syndrome in the acute stage of apoplexy were inquired.The symptoms with high appearance were classified by frequencies,factor and classify analysis to explore the inner relation of them.Results Nineteen key symptoms were extracted from 46 high appearance symptoms after factor analysis.Through classify analysis of specific symptoms,snore,phlegm rale,hasty breathing,rough voice and breathing,halitosis,headache,abdominal distension,oppression in the chest,vexation,agitation,vacuity vexation and insomnia were classified into the frist category;dry throat,thirst,bitterness of mouth,dry mouth were the second category;fatigue and lack of strength,shortness of breath were classified into one category;cough,constipation were single.Through classify analysis of tongue coating and pulse pattern,deep pulse,stasis macula on the tongue,thick tongue fur,pale tongue fur,red tongue,rapid pulse,purple tongue,little tongue fur,fine pulse were classified into one category;slimy tongue fur,slippery pulse,wiry pulse,yellow tongue fur were another category;pale tongue was single;yellow and slimy tongue fur,wiry and rapid pulse were clinical familiar combination.Conclusion Symptoms' factor and classify analysis shows that the nature of the pathological mechanism is the deficient root and excessive branch syndrome.The excessive branch includes heat-phlegm,blood stasis and sthenic-fu,and the deficient root includes both deficiency of qi and yin.When the method of purging fu-organ is used,supporting right and banking up the root is also very important.