颈动脉粥样硬化及大动脉粥样硬化性卒中中医证素相关性的研究.pdfVIP

提 要 目的：探讨颈动脉粥样硬化、大动脉粥样硬化性卒中证素的分布与组合规律，初 步阐明颈动脉粥样硬化与颈内动脉系统大动脉粥样硬化性卒中在证素层面上的相关 性；初步揭示颈动脉粥样硬化与颈内动脉系统大动脉粥样硬化性卒中发病可能的病机 联系。方法：共纳入病例169例，标记为A组，单纯颈动脉粥样硬化者135例，标记 为 B 组，颈内动脉系统大动脉粥样硬化性卒中者 34 例，标记为 C 组，对 A、B、C 三 组病例证素构成与组合规律进行分析。结果：共提取 17 个证素，病性证素热出现频 率最高，为23.64%，其次为痰、血瘀等；作用靶点主要位于经络，频率为36.56% ， 其次为脑神、肝、肾等。B组病例中，以两证素、三证素、四证素组合最多，累积构 成比为94.08%，C组病例中，以三证素组合、四证素组合和五证素组合为多，其累积 构成比为76.46%。B组病例组合证型中，以痰热证、气虚血瘀证、阴虚血瘀证；痰热 瘀结证、痰热阻络证、痰热蒙窍证；阴虚血瘀，痰热内蕴证、痰热瘀络证、痰热瘀阻， 清窍失和证等证型为主，诸多证型均以痰、热证素为基础，兼有其他病性或者病位证 素。C组病例组合证型中，以痰热瘀络证；气虚血瘀，痰热阻络证、痰热瘀络，津液 亏虚证等证型为主，诸多证型亦以痰、热、血瘀证素为基础，兼有其他病性或者病位 证素。结论：痰、热、血瘀等病性证素在颈动脉粥样硬化及大动脉粥样硬化性卒中的 发病过程中起重要作用，病性证素（证候靶点）主要以经络、脑神为主，同时肝、肾 二脏的虚损作为本虚固存。 关键词 颈动脉粥样硬化；大动脉粥样硬化性卒中；证素；中医病机 Related Research Between TCM Syndrome Elements of Carotid Atherosclerosis and Aortic Atherosclerotic Stroke Specialty: the study of neuro-medical disease clinical of TCM Author: Qiao Lijun Tutor: Prof. DING Yuanqing Abstract Objective: To explor the distribution and combination rule of the syndrome elements between carotid atherosclerosis and aortic atherosclerotic apoplexy ；preliminary to reveal the pathogenesis contraction between carotid atherosclerosis and aortic atherosclerotic stroke of internal carotid artery system. Methods: 169 examples are included in the case which are marked as A group ；According to the diagnostic criteria of carotid atherosclerosis and those not occurring ischemic stroke，135 cases are suitable and marked as B group ；34 cases are marked as C group，who are suitable for the diagnostic criteria of internal carotid artery system atherosclerotic arteries stroke. On A, B, C three groups about the distribution and combination rule of the syndrome elements between carotid atherosclerosis and aortic atherosclerotic apoplexy are analyzed.Results: 1