难治性血小板减少性紫癜中医学四诊信息回顾性调查.doc

难治性血小板减少性紫癜中医学四诊信息回顾性调查
【摘要】目的采用因子分析的方法,探讨难治性血小板减少性紫癜(RITP)中医临床证候特征,为中医药合理规范地治疗RITP提供思路。方法对75例RITP患者临床证候进行回顾性调查,统计患者症状、体征、舌脉的发生频率,并对发生频率在10%以上的症状或体征进行因子分析。结果气虚血瘀是RITP主要的证候类型,其代表症状为神疲乏力、气短、皮下紫斑、面唇紫黯、经血色黑有血块,代表舌脉为舌质黯淡、苔白,脉细弱或细涩;阴虚为其次的证候类型,代表症状为五心烦热、潮热盗汗、口干,代表舌脉为舌红少津、脉细数。结论气虚血瘀是RITP最主要中医证型,益气活血法为RITP最基本的中医治则。
【关键词】难治性血小板减少性紫癜;中医证候;因子分析;回顾性调查

Abstract:Objective To support a reasonable and standard TCM treatment principle for refractory idiopathic thrombocytopenic purpura (RITP) by exploring TCM syndrome features in RITP patients with factor analysis. Methods Seventy-five patients with RITP were studied retrospectively with their TCM syndrome features. The incidence rates of their various symptoms, body signs, tongue figures and pulse figures were calculated. The symptoms or body signs which incidence higher than 10% were analyzed by factor analysis. Results According to analysis and synthesis of tongue, pulse and symptoms, Qi deficiency and blood stasis was the major syndrome, of which the main signs were fatigue, shortness of breath, purple plague, plexion, dark menstrual blood, dark tongue body, write tongue coating, weak thready pulse or unsmooth thready pulse. And Yin deficiency was the secondary syndrome, of which main signs were burning sensation of five centers, hectic fever, night sweating, dry mouth, red tongue, shortness of tongue fluid and coating, rapid weak pulse. Conclusion For Qi deficiency and blood stasis being the major syndrome, one of TCM intervention treat
ment principles for RITP is invigorating Qi and promoting blood circulation.

Key words:refractory idiopathic thrombocytopenic purpura;TCM syndrome;factor analysis;retrospective clinical study

特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)是以出血、外周血小板减少、骨髓巨核细胞数正常或增多,伴有成熟障碍为主要表现的出血性疾病。应用糖皮质激素和脾脏切除术可使70%以上的患者血小板数量稳定在安全水平,约30%患者使用这些措施无效,归属于难治性特发性血小板减少性紫癜(refractory idiopathic thrombocytopenic purpura, RITP)范畴[1-3]。本研究通过长期临床观察,提出RITP是以
“气虚血瘀”为主要病机变化的难治性血液病,并对75例RITP患者的中医四诊信息进行回