从临床流行病学调查探析肝气郁结辨证标准.docVIP

从临床流行病学调查探析肝气郁结辨证标准（湖南中医药大学,湖南 长沙 410208） 摘 要：目的：通过临床流行病学调查，探讨肝气郁结辨证标准。方法：采用流行病学整群抽样法，从湖南中医药大学第一附属医院第二附属医院及第三附属医院2000年1月-2001年12月所有住院病例中，查找临床中医证候诊断属肝气郁结及其兼证者，填写调查表格，运用SPSS软件进行统计分析。结果：本组612例肝气郁结及相兼证候病例的常见症状中，胸胁、乳房、少腹胀痛481例，占78.59%；纳差450例，占73.53%；神疲乏力407例，占66.50%。纳差及神疲乏力分别排在肝气郁结及相兼证侯常见症状的第2位及第3位。而出现咽有梗阻感症状及巅顶头痛症状的病例分别仅2例，出现痛经、闭经或月经先后不定期症状的病例16例，且主要存在于妇科疾病中，三项分别仅占总例数的0.33%、0.16%和2.61%。结论：纳差及神疲乏力症状应纳入肝气郁结辨证标准，咽有梗阻感、巅顶头痛及痛经、闭经或月经先后不定期等特征性症状应归于兼症之列。本法为中医证侯学规范化研究的有效方法,比较客观、真实,符合临床实际情况。 关键词：临床流行病学调查；肝气郁结；辨证标准 中图分类号：R256.4文献标识码：A文章编号：1673-7717（2011）03-0610-03 Study of Diagnostic Criteriaof Hepatic Depression Syndrome through Clinical Epidemiologic Survey XIE Yu-xia,WU Run-qiu （Hunan University of TCM, Changsha410208，Hunan,China） Abstract:Objective: To study the diagnostic criteria ofhepatic depression syndrome（HDS）through clinical epidemiologic survey.Methods: By using the method of epidemiologic cluster sampling ,we should find the cases complicated with HDS from aii the hospitalized cases of January 2000 to December 2001 of Hunan University of TCM First Affiliated Hospital, Second Affiliated Hospital and the ThirdAffiliated Hospital and fill out survey forms ,count and analyze the datas by using SPSS statistical analysis software. Result: Among the common symptoms of 612 cases complicated with HDS，distending pain in the chest and hypochondrium，breast and lateral lower abdomen were 481 cases（78.59%）,lack of appetite were 450 cases（73.53%）,fatigue were 407 cases（66.50%）and the latter two were ranked the second and third. But among all the cases,the symptoms of sense of pharyngeal obstruction（0.33%） and top of headache pain（0.16%） were only 2 cases and the symptoms of dysmenorrhoea, amenorrhea or irregular menstrual cycle mainly in gynecological diseases（2.61%）were 16 cases. Conclusion: the symptoms of lack of appetite and fatigue should be the main symptoms and included in the diagnostic criteria of HDS, but the symptoms of sense of pharyngeal obstr