基于现代文献和临床信息的缺血性中风病恢复期证候诊断量表条目筛选与优化

发布时间：2018-07-10 01:09

本文选题：缺血性中风病恢复期 + 证候　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:筛选并优化《缺血性中风病恢复期证候诊断量表》的条目。方法:本研究基于现代文献和专家经验选取缺血性中风病恢复期常见证候及四诊信息,形成量表条目池。利用前瞻性、多中心的临床调查采集缺血性中风病恢复期患者的临床表现,筛选并优化缺血性中风病恢复期证候诊断量表的条目。结果:1.气虚证:条目:神疲、乏力、气短、语声低微、懒言、头晕目眩、面色fD白、自汗、便溏、舌质淡、舌体胖大、舌边有齿痕、脉细、脉沉、脉弱。参考条目:脉结、脉代、脉虚。2.血虚证:条目:心悸、多梦、手足发麻、爪甲色淡、头晕眼花、面色淡白、面色萎黄、舌质淡、舌边有齿痕、脉细、脉弱、脉结、脉虚。参考条目:月经量少、脉代。3.阳虚证:条目:畏冷、四肢不温、口淡不渴、渴喜热饮、自汗、小便清长、尿少浮肿、大便溏薄、面色白、舌淡胖、舌暗、苔白滑、脉沉迟、脉细、脉沉弱、脉沉细、脉沉缓、脉虚。4.阴虚证:条目:腰酸、膝软、目涩、目眩、耳鸣、咽干、五心烦热、两颧潮红、消瘦、胁痛、盗汗、小便短黄、舌质红、舌瘦而干、舌红少津、苔少、脉细数、脉细、脉数。参考条目:低热、无苔、脉虚。5.痰湿证:条目:胸脘痞闷、肥胖、头闷痛、头重、头晕、口黏腻、渴不欲饮、呕吐痰涎、纳呆、便溏、痰多、身体困重、痰质粘稠、恶心、舌质淡、舌胖大、舌边有齿痕、苔滑、苔腻、苔厚腻、脉滑、脉弦滑、脉濡缓。参考条目:苔滑腻。条目:面色晦暗、面色黧黑、皮肤粗糙、痛有定处、口唇青紫、肢体强硬、肢体疼痛、暗舌、舌紫暗、舌有瘀斑瘀点、舌下脉络青紫、舌下脉络曲张、脉涩、脉结、脉代、脉细涩。参考条目:紫舌。7.风证:条目:头晕目眩、口眼歪斜、肢体震颤、肢体强直、手足麻木、头痛、语言謇涩、偏身不遂、颈项强直、忽然昏仆,不醒人事、舌颤、舌红、舌红绛、苔白、脉弦、脉细、脉弦数、脉弦细。参考条目:抽搐、脉数。8.火热证:条目:满面通红、目赤、口干、口渴喜冷饮、口唇焦裂、口苦、口臭、痰色黄、心烦、烦躁、小便黄赤、大便干、发热、汗多、舌质红、舌质绛、黄苔、脉数、脉弦、脉滑、脉弦数、脉滑数。参考条目:躁苔、脉洪数。6.血瘀证:结论:1.通过文献研究、专家经验、临床流行病学调查筛选出《缺血性中风病恢复期证候诊断量表》条目,较适用于缺血性中风病恢复期患者,临床辨证准确,操作便捷。2.文献研究结合专家经验使《缺血性中风病恢复期证候诊断量表》条目全面、广泛,具有专家指导性,保证了量表条目的独立性和代表性。3.临床流行病学调查保证了量表条目的客观性,临床操作性强,辨证便捷。4.文献研究和临床流行病学调查共同筛选的条目具有较重要的诊断地位。5.文献研究、专家经验、流行病学调查相互结合是筛选中医证候诊断量表条目行之有效的方法,为证候诊断量表的构建提供参考。
[Abstract]:Objective: to select and optimize the item of Ischemic Stroke recovery Syndrome Diagnostic scale. Methods: based on the modern literature and expert experience, the common syndromes and four diagnoses of ischemic stroke in convalescence were selected to form a pool of items. A prospective, multicenter clinical survey was conducted to collect the clinical manifestations of patients with ischemic apoplexy in convalescent stage, and to select and optimize the items of the scale for diagnosis of ischemic apoplexy in convalescent stage. The result is 1: 1. Qi-deficiency syndrome: item: fatigue, shortness of breath, low voice, lazy speech, dizziness, facial color fD white, self sweat, loose stool, light tongue, big tongue body, teeth mark on tongue edge, fine pulse, deep vein, weak pulse. Reference items: pulse knot, pulse generation, pulse deficiency. 2. Blood deficiency Syndrome: items: palpitations, dreams, hand and foot tingling, paw color pale, dizziness, pale white, pale complexion, pale tongue, tongue edge teeth mark, pulse fine, weak vein, pulse knot, pulse deficiency. Reference item: less menstrual volume, pulse generation. 3. Yang deficiency Syndrome: items: fear of cold, not warm limbs, dry mouth not thirsty, thirst for hot drinks, self-sweat, urine clear long, urine less swelling, loose stool thin, pale white, tongue pale, tongue dark, white fur, pulse sink late, pulse thin, vein sink weak, pulse sink, pulse sink slowly, the tongue is thin, the tongue is dark, the fur is white, the pulse is late, the pulse is thin, the vein is weak, the vein is deep, the pulse is slow, Pulse deficiency. Yin deficiency syndrome: items: lumbar acid, soft knee, eyes acerbity, dizziness, tinnitus, dry pharynx, five upset hot, two zygomatic flashes, thin, hypochondriac pain, night sweat, short yellow urine, tongue red, tongue thin and dry, tongue red, less fur, pulse fine number, pulse fine, pulse number. Reference item: low fever, no moss, pulse deficiency. 5. Phlegm dampness syndrome: item: chest and epigastric distension, obesity, head pain, head weight, dizziness, gooey mouth, thirst and not wanting to drink, vomiting and sputum salivation, drab, loose stools, sputum, body sleepy, sputum thick, nausea, light tongue, fat tongue, teeth mark on tongue, Moss slippery, moss greasy, moss thick greasy, pulse slippery, pulse string slippery, pulse moisten slowly. Reference entry: moss greasy. Entries: dark complexion, rough skin, fixed place of pain, bluish lips, tough limbs, limb pain, dark tongue, dark tongue with stasis spots, sublingual choroid blue, sublingual choroid varicose, astringent veins, vein knot, pulse generation, The veins are thin. Reference: purple tongue. 7. Wind syndrome: items: dizziness, slanting mouth and eye, limb tremor, ankylosis, numbness of hand and foot, headache, language Jian acerbity, unfavorable side, rigidity of neck, sudden fainting servant, unconscious person, tongue tremble, red crimson tongue, white moss, pulse string, Pulse fineness, pulse string number, pulse string fineness. Reference entry: twitch, pulse number. 8. Hot heat syndrome: item: full face red, eye red, dry mouth, thirsty cold drink, mouth chaff, bitter mouth, bad breath, yellow sputum color, upset, irritable, urinal yellow red, stool dry, fever, sweat much, tongue red, tongue crimson, yellow fur, pulse number, pulse string, Pulse slip, pulse string number, pulse slip number. Reference items: grumpy moss, pulse number. 6. Blood stasis syndrome: conclusion: 1. Through literature research, expert experience and clinical epidemiological investigation, the item of the symptom Diagnostic scale of Ischemic apoplexy during recovery period was selected, which is more suitable for the patients with Ischemic apoplexy in convalescent stage. The clinical differentiation is accurate and the operation is convenient. 2. Literature research combined with expert experience made the items of the scale for diagnosis of Syndrome in convalescent stage of Ischemic Stroke to be comprehensive, extensive and expert guidance, which ensured the independence and representativeness of the items of the scale. 3. The clinical epidemiology investigation ensured the objectivity of the items of the scale, the clinical maneuverability was strong, the differentiation of symptoms and signs was convenient. 4. 4. The items screened jointly by literature research and clinical epidemiology survey have important diagnostic status. The combination of literature research, expert experience and epidemiological investigation is an effective method for screening the items of TCM Syndrome Diagnostic scale, which provides a reference for the construction of TCM Syndrome Diagnostic scale.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R255.2

【参考文献】