中风病先兆证临床特征表现文献系统评价

Systematic evaluation on literature of clinical characteristics of antecedent sign in stroke

关键词:  中风病先兆证  文献评价  证候  辨证论治

Key words:  precedent sign of stroke  literature evaluation  syndrome  treatment based on syndrome differentiation

摘要:

[目的] 文献系统评价中风病先兆证的临床特征。[方法] 运用循证医学文献系统评价方法, 建立“文献信息采集表”,对中风病先兆证文献进行研究。[结果] 共纳入合格文献261篇, 研究表明:1)危险因素:吸烟、饮酒、饮食过咸、冠心病、高血压病、糖尿病、高脂血症、动脉硬化、年龄、环境污染、体质量超重等。2)病因病机:气血津液紊乱、脏腑功能失调、内风旋动、饮食不节、七情失调、起居失调、年老体衰、烦劳过度、气候变化、腑实壅塞、体质不良、房事不节等。3)证候包括:风痰证、痰瘀证、痰湿证、痰热证, 肝胆火旺证、肝风内动证、肝肾阴虚证、肝阳上亢证, 气虚血瘀证、气血亏虚证、气阴两虚证、气滞血瘀证, 肾精不足证, 肾虚证等。4)主要临床症状从高到低依次排列为:头昏/头晕/目眩, 肢体麻木, 倦怠乏力, 语言不利, 头胀痛, 黑蒙, 肢体拘急/筋惕肉(目闰), 烦燥不安/性情易怒、胸闷/心悸、失眠/少寐多梦等。5)舌象:舌红、舌瘀点/舌瘀斑、舌暗/舌黯/舌暗红/舌暗淡、苔薄白等。6)脉象:脉弦、脉弦滑、脉涩/脉细涩等。[结论] 以上结果与学会标准存在差异。

Abstract:

[Objective] To evaluate the clinical characteristics of antecedent sign in stroke with literature system. [Methods] Using systemic evaluation of evidence-based medicine, a “information collection table” was established to study the literature about precedent sign of stroke. [Results] The 261 pieces of qualified research literatures were used in the study altogether. The research showed: 1) the risk factors included smoking, drinking alcohol, super-salt diet, coronary hart disease, hypertension, diabetes, hyperlipemia, atheroma, age, environment pollution and heavy body weight. 2) etiology and pathogenesis: turbulence of gas, blood and body fluid, maladjustment of Zang-Fu function, endogenous wind, improper diet, incoordination of seven emotions, irregularity in daily life, body failure in elder person, physical strain, climate change, obstruction by Fu excess, worse constitution, intemperance in sexal life, etc. 3) The symptom: wind phlegm symptom, phlegm stagnation symptom, phlegm-damp symptom, phlegm-heat syndrome, excessive fire in liver and gallbladder, internal moving of liver wind, Yin deficiency in liver and kidney, excessive rising of liver Yang, gas deficiency and blood stasis, deficiency of gas blood, deficiency of both Qi and Yin, gas stasis and blood stagnation, deficiency of kidney essence, kidney deficiency. 4) main clinical symptoms for high to low occurrence: dizziness/giddiness/blurred vision, numbness of extremities, lassitude, barylalia, headache optic atrophy, contracture of extremities/muscular witching and cramp, dysphoria/being irritable and irascible, oppressive feeling in the chest/palpitation, insomnia/little sleep disturbed by dreams. 5) tongue picture: red tongue, tongue petechia/tongue ecchymosis, dark tongue/dark and red tongue/light red tongue/white and thin fur, etc. 6) pulse picture: stringy pulse, stringy and rolling pulse, hesitant pulse/thready and hesitant pulse, etc. [Conclusion] There is a difference between the results above and the standards of academic committee.