1. 首都医科大学附属北京天坛医院中医科
2. 北京中医药大学东直门医院脑病一科
3. 首都医科大学附属北京天坛医院中医科北京中医药大学东直门医院脑病一科
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樊永平, 仝延萍, 王静文, 等. 慢性硬膜下血肿的临床特点与辨证论治[J]. 北京中医药, 2019,38(7):627-630.
FAN Yong-ping, TONG Yan-ping, WANG Jing-wen, et al. Clinical characteristics and traditional Chinese medicine treatment based on pattern differentiation for chronic subdural hematoma[J]. Beijing Journal of Traditional Chinese Medicine, 2019,38(7):627-630.
樊永平, 仝延萍, 王静文, 等. 慢性硬膜下血肿的临床特点与辨证论治[J]. 北京中医药, 2019,38(7):627-630. DOI: 10.16025/j.1674-1307.2019.07.001.
FAN Yong-ping, TONG Yan-ping, WANG Jing-wen, et al. Clinical characteristics and traditional Chinese medicine treatment based on pattern differentiation for chronic subdural hematoma[J]. Beijing Journal of Traditional Chinese Medicine, 2019,38(7):627-630. DOI: 10.16025/j.1674-1307.2019.07.001.
目的探讨慢性硬膜下血肿(chronic subdural hematoma,CSDH)患者的临床特点、中医证型分布、病机及方药选择。方法采用横断面调查方法,记录并分析106例CSDH患者的临床特点、中医证型分布、病机与辨证论治。结果 106例CSDH患者的男女比例为4∶1,平均年龄为(67. 34±1. 38)岁,其中69. 8%的患者发病前有明确头部外伤史,23. 6%的患者有抗凝或抗血小板聚集药物服用史,32. 1%的患者为钻孔引流术后血肿复发。临床症状主要表现为头部不适、肢体轻瘫、言语不利等。中医证候以血瘀兼见气虚、痰湿和肾虚为主。结论 CSDH以老年人多见,术后易复发,核心病机是血瘀水停,主要证型有气虚血瘀、痰瘀内阻和肾(阴)虚血瘀,基本治则是活血利水,基础方剂是桃红四物汤合抵当汤加益母草。
Objective To discuss the clinical characteristics, traditional Chinese medicine( TCM) pattern distribution,pathogenesis and prescriptions for chronic subdural hematoma( CSDH). Methods The clinical characteristics, TCM pattern distribution,pathogenesis,and TCM treatment based on pattern differentiation of 106 CSDH patients were recorded and analyzed by using cross-sectional study. Results The ratio of male to female in 106 CSDH patients was 4 ∶1. The average age of the enrolled patients was 67. 34 ± 1. 38 years old. Among them,69. 8 % of them had a history of traumatic brain injury,23. 6 % had a history of taking anticoagulant or antiplatelet aggregation drugs, and 32. 1 % had recurrent hematoma after drainage operation. The common clinical symptoms of CSDH were manifested as headache, limb paralysis or glossolalia, etc. The main patterns included blood stasis with qi deficiency,phlegm and fluid,and kidney deficiency. Conclusion CSDH is more commonly seen in the elderly with postoperative recurrence. The essential pathogenesis of CSDH is blood stasis and fluid stagnation, the main patterns include qi deficiency and blood stasis,phlegm and blood stasis,and kidney yin deficiency and blood stasis,the basic principles of treatment are to activate blood circulation and eliminate water, and the basic prescription is Taohong Siwu Tang modified with Didang Tang and Yimucao.
慢性硬膜下血肿中医证型辨证论治病机
chronic subdural hematomaTCM syndromeTCM treatment based on syndrome differentiationpathogenesis
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