CAJ | 학술논문

目的：初步探讨脑卒中高危人群的中医症状及舌脉特点,为脑卒中的中医预防提供辨证论治依据,并为脑卒中高危人群辨证体系的建立奠定基础。方法设计前瞻性观察方法,通过多中心大样本筛查选取脑卒中高危人群2536例,分析其中医症状、舌脉、证类分布的频数特征,观察不同性别、年龄脑卒中高危人群中医症状分布特点的差异性。结果检出率前5位的中医症状按出现频率由高到低依次为：视物模糊(1670例,65.9%)、急躁易怒(1458例,57.5%)、腰膝酸软或痛(1445例,57.1%)、头晕(1286例,50.7%)、双目干涩(1274例,50.2%)；检出率前5位的舌脉象按出现频率由高到低依次为：苔白(1401例,55.2%)、苔薄(1260例,49.7%)、脉弦(1201例,47.4%)、舌黯(1168例,46.1%)、舌红(1027例,40.5%)。头晕、失眠、苔白、苔薄等检出率女性显著高于男性(P＜0.01),齿摇、苔腻、苔黄、脉弦等检出率男性显著高于女性(P＜0.01)；齿摇、双目干涩、口渴、舌黯、舌红、脉弦等的检出率老年组明显高于中年组(P＜0.01),急躁易怒、麻木、气短、舌齿痕、苔薄、脉沉等检出率中年组明显高于老年组(P＜0.01)。结论脑卒中高危人群临床表现复杂,既有肝脾肾亏损本虚之象,又有风火痰瘀的标实之征,多属虚实夹杂证。不同性别、年龄脑卒中高危人群症状分布具有一定差异性和规律性。
목적：초보탐토뇌졸중고위인군적중의증상급설맥특점,위뇌졸중적중의예방제공변증론치의거,병위뇌졸중고위인군변증체계적건립전정기출。방법설계전첨성관찰방법,통과다중심대양본사사선취뇌졸중고위인군2536례,분석기중의증상、설맥、증류분포적빈수특정,관찰불동성별、년령뇌졸중고위인군중의증상분포특점적차이성。결과검출솔전5위적중의증상안출현빈솔유고도저의차위：시물모호(1670례,65.9%)、급조역노(1458례,57.5%)、요슬산연혹통(1445례,57.1%)、두훈(1286례,50.7%)、쌍목간삽(1274례,50.2%)；검출솔전5위적설맥상안출현빈솔유고도저의차위：태백(1401례,55.2%)、태박(1260례,49.7%)、맥현(1201례,47.4%)、설암(1168례,46.1%)、설홍(1027례,40.5%)。두훈、실면、태백、태박등검출솔녀성현저고우남성(P＜0.01),치요、태니、태황、맥현등검출솔남성현저고우녀성(P＜0.01)；치요、쌍목간삽、구갈、설암、설홍、맥현등적검출솔노년조명현고우중년조(P＜0.01),급조역노、마목、기단、설치흔、태박、맥침등검출솔중년조명현고우노년조(P＜0.01)。결론뇌졸중고위인군림상표현복잡,기유간비신우손본허지상,우유풍화담어적표실지정,다속허실협잡증。불동성별、년령뇌졸중고위인군증상분포구유일정차이성화규률성。
Objective To investigate characteristics of symptoms, tongue and pulse of high-risk group of stroke, and provide evidence of differential treatment for stroke prevention, diagnosis and treatment of stroke, thus laying a solid foundation on further study of differential treatment system of high-risk groups of stroke. Methods With prospective observational method, 2536 cases of stroke were selected by multi-center screening, and characteristics of TCM symptoms, tongue, pulse and syndrome distribution in different gender and age were observed. Results The top five symptoms were:blurred vision (1670 cases, 65.9%), irritability (1458 cases, 57.5%), limp or pain on waist and knees (1445 cases, 57.1%), dizziness (1286 cases, 50.7%) and dry eyes (1274 cases, 50.2%). The top five tongue and pulse were:white moss (1401 cases, 55.2%), thin moss (1260 cases, 49.7%), string pulse (1201 cases, 47.4%), dark tongue (1168 cases, 46.1%) and red tongue (1027 cases, 40.5%). The detection rate of dizziness, insomnia, white coating, thin coating, etc. were higer in women than that in man (P<0.01). The detection rate of teeth shaking, greasy fur, yellow fur, string pulse, etc. were higher in man than that in woman (P<0.01). The detection rate of teeth shaking, dry eyes, thirst, dark tongue, red tongue, string pulse, etc. in the elderly group were higher than the middle-aged one (P<0.01). The detection rate of irritability, numbness, shortness of breath, scalloped tongue, thin coating, deep pulse, etc. in the middle-aged group was higher than the aged one (P<0.01). Conclusion The clinical manifestations of high-risk group of stroke are complicated. There were root deficiency such as deficiency of spleen and kidney, and branch excess such as wind-fire and phlegm-stasis. Difference and regularity were showed in different gender and different age groups to some extent.