中风先兆证临床特征专家问卷调查结果分析

Analysis of clinical characteristics of precedent sign of stroke based on expert questionnaire investigation results

关键词:  中风先兆证  问卷调查  临床特征  证候  辨证论治

Key words:  precedent sign of stroke  questionnaire investigation  syndrome  treatment based on syndrome differentiation

摘要:

[目的] 研究中风先兆证临床特征表现.[方法] 在文献系统评价的基础上,建立专家调查问卷,预调查信度(Cronbach α系数):0.96和效度(累积方差贡献率)82.22%,分半信度 (Guttman Split-half): 0.90、分半相关系数:0.87.对资料进行主成分分析降维处理,经球形检验(KMO and Bartlett's Test),提示可以进行因子分析.[结果] 专家问卷调查发放问卷600份,收回问卷588份,失访12份,失访率2%(小于<15%),总体信度0.97和效度73.11%,分半信度0.92、分半相关系数0.91.中风先兆证的临床特征表现如下:病史为冠心病和糖尿病;危险因素为高血压病、年老、环境污染、微循环异常;病因病机为年老体衰、体质不良、气血津液紊乱、脏腑功能失调、腑实壅塞、气候变化、房事不节;证候为气虚血瘀证、痰瘀证、肝风内动证、肝阳上亢证、肾精不足证;症状有倦怠乏力、语言不利、肢体麻木、头昏/头晕/目眩、感觉异常/感觉减退、黑蒙、头胀痛、口角流涎/流涎;舌象有舌淡、舌暗/舌黯/舌暗红/舌暗淡、舌绛红/舌红绛、苔薄白、苔白腻、无苔、苔白;脉象有脉弦滑、脉涩/脉细涩、脉细/脉细弱、脉虚/弱. [结论] 以上研究进一步完善了前期文献系统评价的结果,对学会标准的修订具有一定的借鉴价值.

Abstract:

[Objective] To study the clinical characteristics of precedent sign of stroke. [Methods] To establish the expert questionnaire based on literature of system evaluation. Pre-survey: reliability(Cronbach alpha)=0.96, validity(cumulative %)=82.22%. Guttman Split-half:0.90, correlation between forms:0.87. Data reduction by principal component analysis and factor analysis, KMO and Bartlett's test. [Results] Formal investigation 600 questionnaires, lost 12 parts, dropout rate of 2%, Reliability(Cronbach alpha)=0.97, validity(cumulative %)=73.11%. Guttman Split-half: 0.90, correlation between forms: 0.91. Clinical features on premonitory syndromes of stroke: the risk factors included hypertension, age, environment pollution, abnormal microcirculation; etiology and pathogenesis: body failure in elder person, poor physical constitution, turbulence of gas, blood and body fluid, maladjustment of Zang-Fu function climate change; the symptoms: gas deficiency and blood stasis, phlegm stagnation symptom, wind phlegm symptom, internal moving of liver wind, kidney essence deficiency syndrome; main clinical symptoms for high to low occurrence: dizziness/giddiness/blurred vision, numbness of extremities, lassitude, barylalia, headache, optic atrophy; tongue picture: pale tongue, tongue Black/dark tongue/dark red tongue/tongue, tongue dark crimson/bright red tongue, thin white fur, white greasy moss; pulse picture: taut and slippery pulse, pulse astringent/thready pulse astringent, pulse fine/thready pulse, weak pulse. [Conclusion] The above research will improve the results of literature system evaluation and have some reference value to the standards of academic committee.