摘要
目的研究额颞顶脑梗死中医证候特征、中药用药特点及神经认知学特征,为此类患者辨证用药、预后评估等提供数据支持。方法收集2011年1月至2020年12月北京中医药大学东直门医院脑病科收治的脑梗死患者病历资料428例,其中额颞顶脑梗死172例、非额颞顶脑梗死256例。利用因子、聚类分析方法对额颞顶脑梗死中医证候分布进行回顾性分析,同时挖掘其中药用药特点;对比额颞顶脑梗死与非额颞顶脑梗死认知损伤情况,观察额颞顶脑梗死神经认知学特征。结果归纳得到额颞顶脑梗死中医证候4类,分别为脾肾气虚证、肝肾阴虚证、脾虚痰阻证、气虚血瘀证;挖掘其常用中药组合6类,功效以平肝潜阳、补益肝肾、益气活血通络、滋补阴液、化痰健脾、化痰活血、疏肝理气为主;额颞顶脑梗死较非额颞顶脑梗死认知损伤发生率更高,语言功能、执行功能、视空间功能损伤发生率更高,差异具有统计学意义(P<0.05)。结论额颞顶脑梗死脾肾气虚更为显著;中药用药强调脾肾肝同调,兼顾理气祛痰散瘀之法;神经认知学表现以语言功能、执行功能、视空间功能损伤为甚,可为其临床诊疗提供客观参考。
Objective To explore the distribution of TCM syndrome types,medication rules of TCM and neurocognitive features in patients with frontal lobe,temporal lobe or parietal lobe infarction,and provide data support for the treatment of such patients based on syndrome differentiation and prognosis evaluation.Methods From January 2011 to December 2020,172 cerebral infarction(CI)patients with frontal/temporal/parietal lobe infarction(FTP)and 256 CI patients without frontal/temporal/parietal lobe infarction(NFTP)were selected as research subjects.The distribution of TCM syndrome types and medication rules of FTP was analyzed by factor and cluster analysis.Compared the cognitive impairment of FTP and NFTP,and observed the neurocognitive characteristics of FTP.Results There are 4 types syndromes of FTP,including spleen and kidney Qi deficiency,liver and kidney Yin deficiency,spleen deficiency and phlegm obstruction,Qi deficiency and blood stasis.Exploited 6 kinds of common Chinese medicine combinations,with the main functions of calming the liver,tonifying the liver and kidney,invigorating Qi and dredging collateral,nourishing Yin fluid,eliminating phlegm and strengthening the spleen,removing phlegm and activating blood circulation,soothing the liver and regulating the circulation of Qi.Compared with the incidence of NFTP,the FTP has a higher cognitive impairment,higher incidence of language deficits,executive dysfunctions and visuospatial dysfunction(P<0.05).Conclusion FTP has more obvious deficiency of spleen and kidney.Traditional Chinese medicine treatment emphasizes regulating spleen,kidney and liver together,taking into account the method of regulating Qi,eliminating phlegm and removing blood stasis.Neurocognitive manifestations are mainly the decline of language function,executive function and visuospatial function.
作者
雷筱菁
徐敏杰
谭中建
黄佳钦
张家成
陈健
包炜玮
常静玲
LEI Xiaojing;XU Minjie;TAN Zhongjian;HUANG Jiaqin;ZHANG Jiacheng;CHEN Jian;BAO Weiwei;CHANG Jingling(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《环球中医药》
CAS
2023年第5期881-888,共8页
Global Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81973790)
中央高校校级重点攻关项目(2020-JYB-ZDGG-110-2)。
关键词
脑梗死
额叶
颞叶
顶叶
中医证候
中药
神经认知
因子分析
聚类分析
Cerebral infarction
Frontal lobe
Temporal lobe
Parietal lobe
TCM syndrome
Chinese herb
Neurocognitive
Factor analysis
Cluster analysis
