脑卒中后抑郁的中医病机和证型研究.pdf

提 要 目的：在导师多年临床经验的基础之上，通过分析脑卒中后抑郁患者的临床资料， 探讨脑卒中后抑郁的中医病机，总结中医证型，为脑卒中后抑郁的防治提供参考和依 据。 方法：建立临床资料调查表，采集脑卒中后抑郁患者的病案信息，采用 SPSS16.0 统计软件，运用频数统计和系统聚类分析的方法，结合中医理论探讨脑卒中后抑郁的 病机，总结中医证型。 结果：128 例脑卒中后抑郁患者的 60 个症状经系统聚类法分析后，结合中医理 论可划分为4类，分别为：瘀阻痰结证；肝脾不调、心虚胆怯证；心肾不交证；心肾 阳虚证。 结论：脑卒中后抑郁见症多端，病程缠绵。中医病机与中风的病机关系密切，病 位主要在心，与肾肝胆密切相关，肾虚是其病理基础，瘀血、痰湿、气滞是其主要病 理因素，心肾相交的正常生理功能失调在脑卒中后抑郁的发病中占有重要地位。 关键词 脑卒中后抑郁；中医病机；聚类分析；心肾相交 TCM Pathogenesis and Syndrome Type Study of Post-stroke Depression Speciality:the clinical study of neuro-medical disease of TCM Author:Zouchao Tutor:Prof. Sun Lijun Abstract Objective: Basing on the clinical experience of the tutor ˊs, through the analysis of post-stroke depression patients ˊs clinical information, this study discusses the pathogenesis of post-stroke depression, summarizes the TCM syndrome type, in order to provide witness for the prevention and therapy of post-stroke depression. Methods: Establish the clinical data questionnaires, then collecte the clinical information of the patients , adopt clustering analysis and frequency statistics by the SPSS16.0 statistical software, discusses the pathogenesis of post-stroke depression and summarizes the TCM syndrome type under the theory of TCM. Results: By clustering analysis and combining the TCM theory,the sixty symptoms of 154 patients are divides into four syndrome types by follows: phlegm and blood stasis,gan-pi disorder and qi asthenia of xin-dan ,Xin-shen abnormal fellowship ,yang asthenia of xin-shen . Conclusion:Post-stroke depression is a complicated and lingering disease.It ˊs pathogenesis have close relations with stroke.The main r