摘要
目的提取股骨头坏死的证素,分析证素组合规律,为该病的临床治疗提供新的辨证思路。方法设计股骨头坏死的证候量表。运用WF文锋-Ⅲ中医辅助诊疗软件对231例股骨头坏死患者进行辨证,确立病位、病性证素;采用聚类、频数分析法探讨证素组合规律及疾病不同分期证素分布特征。结果股骨头坏死的病位证素主要有筋骨、肾、脾、肝,筋骨在Ⅱ期、Ⅲ期、Ⅳ期出现频率均超过90%,肾在Ⅲ期、Ⅳ期出现频率较高,脾在Ⅰ期、Ⅱ期出现频率相对较高,肝在Ⅳ期出现频率较高;主要病性证素有痰(湿)、血瘀(气滞)、阳虚、寒、气虚、阴虚、血虚,痰(湿)在Ⅰ期、Ⅱ期、Ⅲ期的出现频率均超过70%,血瘀(气滞)在各期出现频率均超过50%,阳虚在Ⅲ期、Ⅳ期出现频率超过50%,寒在Ⅲ期、Ⅳ期出现频率接近50%,阴虚在Ⅳ期出现频率超过50%,气虚、血虚在各期的出现频率均在50%以下。证素寒、痰、肾、阳虚等多相兼,脾、气虚、湿、血虚等多相兼,肝、阴虚、精亏等多相兼,气滞、血瘀多相兼。证素组合形式有24种,其中2项、3项、4项、5项组合者较多。结论股骨头坏死的病位证素以筋骨、肾、脾、肝为主,早期以筋骨、脾为主,中期以筋骨、脾、肾为主,晚期以筋骨、肝、肾为主。病性证素以痰(湿)、血瘀(气滞)、寒、阳虚、阴虚、气虚为主;痰(湿)、血瘀(气滞)是贯穿于疾病全过程的病机关键;痰、或湿、或血瘀兼其他证素是该病的病性证素组合特征。
Objective To collect the syndrome factors of femoral head necrosis, analyze the laws of syndrome factor combination, and provide a new idea of syndrome differentiation in the treatment of this disease in clinic. Methods A syndrome scale of femoral head necrosis was designed. The patients （n = 231 ） with femoral head necrosis were given syndrome differentiation to determine the disease-location factors and disease-natures factors by using WF-Wenfeng-]]I TCM assistant diagnosis-treatment software. The laws of syndrome factor combination and syndrome factor distribution at different disease stages were discussed by applying the methods of clustering and frequency analysis. Results The location factors of femoral head necrosis were mainly sinew and bone, kidney, spleen and liver. The occurrence frequency of sinew and bone was over 90% at stage II, III and IV, kidney, higher at stage III and IV, spleen, higher at stage I and II , and liver, higher at stage IV. The major nature factors included phlegm （dampness）, blood stasis （qi stagnation）, yang deficiency, cold, qi deficiency, yin deficiency and blood deficiency. The occurrence frequency of phlegm （dampness） was over 70% at stage I , II and III, blood stasis （qi stagnation）, over 50% at all stages, yang deficiency, over 50% at stage III and IV, cold, over 50% at stage III and IV, yin deficiency, over 50% at stage IV, and qi deficiency and blood deficiency, below 50% at all stages. The syndrome factors of cold, phlegm, kidney and yang deficiency combined commonly, spleen, qi deficiency, dampness and blood deficiency combined commonly, liver, yin deficiency and essence deficiency combined commonly, and qi stagnation and blood stasis combined commonly. There were 24 types of syndrome factor combination, mainly 2-factor combination, 3-factor combination, 4-factor combination and 5-factor combination. Conclusion The syndrome factors of disease location mainly include sinew and bone, kidney, spleen and liver, and sinew and bone and spleen are common at early stage, sinew and bone, spleen and kidney, at middle stage, and sinew and bone, liver and kidney, at later stage. The syndrome factors of disease nature mainly include phlegm （dampness）, blood stasis （qi stagnation）, cold, yang deficiency, yin deficiency and qi deficiency. Phlegm （dampness） and blood stasis （qi stagnation） are the key pathogenesis throughout the whole disease course. The combination characteristics of factors of disease nature show as phlegm or dampness or blood stasis combining other syndrome factors.
出处
《北京中医药大学学报》
CAS
CSCD
北大核心
2011年第7期495-499,共5页
Journal of Beijing University of Traditional Chinese Medicine
基金
"十一五"国家科技支撑计划资助项目(No.2007AI20B035)
中国博士后科学基金资助项目(No.20100480432)
关键词
股骨头坏死
证候
证素
辨证
femoral head necrosis
syndromes
syndrome factors
syndrome differentiation
