You Jin-song, Huang Yan, Cai Ye-feng, Guo Jian-wen, Liang Wei-xiong, Huang Pei-xin, Liu Mao-cai
First Department of Neurology, Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong Province 510120, China.
Zhong Xi Yi Jie He Xue Bao. 2008 Apr;6(4):346-51. doi: 10.3736/jcim20080404.
To explore the composition characteristics of traditional Chinese medicine (TCM) syndromes in patients with acute ischemic stroke of yin or yang syndrome by investigating the characteristics of TCM syndromes at different periods after onset.
One thousand two hundred and forty-six patients with acute ischemic stroke were admitted in twenty hospitals. According to the "diagnostic criteria of syndrome differentiation of stroke", the characteristics of syndromes in the patients were investigated at the periods of 1-3 days, 4-10 days and 11-30 days after they had ischemic stroke. General distribution of six basic syndromes was compared between the patients with yin syndrome and the patients with yang syndrome at the three periods. The six basic syndromes were wind syndrome, pathogenic fire syndrome, phlegm syndrome, blood stasis syndrome, qi deficiency syndrome, and syndrome of yin deficiency and yang hyperactivity.
The percentages of wind, pathogenic fire, and phlegm syndromes in the patients were decreased at the period of 11-30 days as compared with the period of 1-3 days (87.1% vs 79.3%, 52.1% vs 38.7% and 67.1% vs 57.4% respectively, P<0.01). However, the percentages of the syndromes of blood stasis, qi deficiency, and yin deficiency and yang hyperactivity were similar at the three periods (P>0.05). There were no differences in the distribution of yin and yang syndromes among the three periods (P>0.05). The percentages of syndromes of wind, pathogenic fire, phlegm, and yin deficiency and yang hyperactivity were higher (P<0.01), and the percentages of syndromes of blood stasis and qi deficiency were lower (P<0.05, P<0.01) in patients with yang syndrome than in patients with yin syndrome. The complex of three syndromes was the most frequent composition pattern in the patients at the three periods. The percentages of complex syndromes of four or five syndromes were higher, and the percentages of single-syndromes and complex syndromes of two syndromes were lower in patients with yang syndrome than in patients with yin syndrome (P<0.05, P<0.01). The most frequent complex syndromes in patients with yin syndrome were complex syndrome of wind, phlegm, blood stasis and qi deficiency, and complex syndrome of wind, phlegm and qi deficiency; while the most frequent complex syndromes in patients with yang syndrome were complex syndrome of wind, pathogenic fire, phlegm and qi deficiency, and complex syndrome of wind, pathogenic fire and phlegm.
The main discrimination between the yin and yang syndromes is that the yang syndrome is characterized by pathogenic fire. The syndromes of phlegm, qi deficiency, and blood stasis are not associated with the diagnosis of yin or yang syndrome.
通过调查急性缺血性中风患者发病后不同时期的中医证候特点，探讨急性缺血性中风阴证或阳证患者的中医证候组成特征。
20家医院共收治1246例急性缺血性中风患者。依据“中风病辨证诊断标准”，对患者在缺血性中风后1 - 3天、4 - 10天和11 - 30天这三个时期的证候特点进行调查。比较阴证患者和阳证患者在这三个时期六种基本证候的总体分布情况。六种基本证候为风证、火热证、痰证、血瘀证、气虚证、阴虚阳亢证。
与1 - 3天相比，11 - 30天时患者中风证、火热证、痰证的比例下降（分别为87.1%对79.3%、52.1%对38.7%、67.1%对57.4%，P<0.01）。然而，血瘀证、气虚证、阴虚阳亢证在三个时期的比例相似（P>0.05）。三个时期阴阳证分布无差异（P>0.05）。阳证患者风证、火热证、痰证、阴虚阳亢证的比例较高（P<0.01），血瘀证、气虚证的比例较低（P<0.05，P<0.01）。三个时期患者中三种证候组合是最常见的证候构成形式。阳证患者四证或五证组合的比例高于阴证患者，单证和两证组合的比例低于阴证患者（P<0.05，P<0.01）。阴证患者最常见的复合证候是风痰瘀气虚证和风痰气虚证；阳证患者最常见的复合证候是风火痰气虚证和风火痰证。
阴阳证的主要鉴别在于阳证以火热为特征。痰证、气虚证、血瘀证与阴证或阳证的诊断无关。
