摘要
目的 探索老年卒中后抑郁的中医证候要素分布规律.方法 采用回顾性分析法,收集222例老年卒中后抑郁患者的个人基本信息和中医症状相关资料,对提取的36条症状信息进行频数分析,并运用因子分析与聚类分析相结合的方式探索老年卒中后抑郁患者的证候要素分布规律.结果 对提取的36条症状信息进行频数统计,结果表明心情郁闷、急躁易怒、疲倦乏力、心悸多梦、口干咽燥等为老年卒中后抑郁患者常见的临床表现,经因子分析后得出12个公因子,判定结果提示病性类证候要素以气滞、痰湿、血瘀、火热、血虚、阴虚、气虚为主,病位集中在肝、脾、肾、心,基于12个公因子的聚类分析结果显示,常见证型有肝郁脾虚证(38.74％)、肾虚血瘀证(29.73％)、痰热瘀阻证(24.77％)及心肝血虚证(6.76％).结论 老年卒中后抑郁属形神同病,以肝郁脾虚证为主,因此在临床治疗时应强调形神同治,注意补虚泻实,调节气机,在分证论治的基础上侧重疏肝健脾.
Abstract
Objective To explore the distribution of syndrome elements of traditional Chinese medicine(TCM)in elderly patients with post-stroke depression.Methods A retrospective analysis was conducted to collect the basic information and TCM symptoms of 222 elderly patients with post-stroke depression.The frequency of 36 symptoms were analyzed,and the distribution of syndrome elements were explored by factor analysis and cluster analysis.Results The frequency statistics of 36 symptom information extracted showed that depressed mood,irritability,fatigue,palpitations and dreams,dry mouth and dry throat were the common clinical manifestations of elderly patients with post-stroke depression.After factor analysis,it was concluded that 12 common factors,the results suggested the main syndrome elements were qi stagnation,phlegm dampness,blood stasis,heat,blood deficiency,yin deficiency,and qi deficiency.The disease sites were concentrated in the liver,spleen,kidney,and heart.Cluster analysis based on 12 common factors showed that,the common syndromes were liver depression and spleen deficiency(38.74％),kidney deficiency and blood stasis(29.73％),phlegm heat and stasis(24.77％),and heart-liver blood deficiency(6.76％).Conclusion Post-stroke depression in the elderly is a disease of both body and spirit,mainly characterized by liver stagnation and spleen deficiency.Therefore,in clinical treatment,we should emphasize the treatment of both body and spirit,pay attention to toning deficiency and reducing excess,regulating qi apparatus,and focus on soothing the liver and strengthening the spleen on the basis of syndrome analysis and treatment.
基金项目
北京中医药大学重点攻关项目(2020-JYB-ZDGG-130)
维普
万方数据