多系统萎缩患者的证候规律(167例)

目的:本研究旨在临床观察并分析多系统萎缩(Multiple System Atrophy,MSA)证候规律。方法:采用横断面分析方法,收集所有符合西医诊断标准的MSA患者一般情况及四诊信息,不设定证候类型,辨别每个病例具体证型,提取证候要素。统计证候要素频次,百分比,归纳证候要素组成分布;采用以类型或平均值为界进行证素的分组比较,探讨证候要素与病程、疾病严重程度、疾病分型的相关性。结果:167例MSA患者总体病机虚多实少,寒多热少。P型热证多见,C+P型寒证多见;气虚最多见于C+P型,血虚多见于P型;气虚常与寒证并见,且多见于疾病中晚期,热证常与血虚并见,且多见于疾病早期。肾虚最多见于C+P型,肝病、心病多见于P型,脾虚及胃病多见于C型。痰、湿多见于C+P型和P型,血瘀多见于C+P型,而气陷只见于C+P型。随着病情加重、混合型的出现,虚证与实证并见,正虚和邪实皆增加。结论:MSA核心病机为肾阳虚,总体治则在于温肾助阳。

Syndrome Law of 167 Cases of Multiple System Atrophy Patients

To observe and analyze syndrome law of multiple system atrophy (MSA). Methods:It was a cross-sectional study. General information and four diagnosis information of MAS patients meeting western medicine criteria were collected. And specific syndrome of each case was differentiated, to extract syndrome elements. Frequency of syndrome elements and percentage were calculated. Distribution of syndrome elements was concluded. Type and mean value were used to compare the group of syndrome elements. And the correlation between syndromes and course of the disease, syndromes and severity, syndromes and type of the disease of all MSA patients were evaluated. Results:The mechanism of MSA was more deficiency and less excess. There were more heat and blood deficiency in MSA-P type, with more cold and qi deficiency in MSA-C+P. Qi deficiency was commonly seen in C+P type, and blood deficiency was frequently seen in P type. Qi deficiency was often together with cold syndrome, and often seen in the middle and advanced stage of disease. Heat syndrome was often together with blood deficiency, and often seen in the early stage of disease. Kidney deficiency was often seen in C+P type, and liver disease, heart disease were often seen in P type. Spleen deficiency and stomach disease were often seen in C type. Phlegm and damp were more frequently seen in P and C+P type. Blood stasis was more frequently in C+P type, and qi collapse only in C+P type. Deficiency and excess were both increased with the progress of MSA. Conclusion:Key mechanism of MSA was Yang deficiency of kidney. TCM treatment principle of MSA was warming kidney and supporting Yang.