63例视神经脊髓炎患者临床特点和中医证型分布

目的探讨视神经脊髓炎（neuromyelitis optica，NMO）患者的临床特点、中医证型分布及NMO的病机。方法采用临床病例分析统计方法，回顾性分析63例NMO患者的临床特点、舌苔脉象和中医证型分布。结果 63例NMO患者中男女性别比为1∶6.88，平均发病年龄（31.67±12.44）岁，28.57%的患者有明显诱因，以急性起病、复发缓解多见，平均复发4.60次，大多数患者以感觉障碍、视觉障碍和运动障碍为首发和就诊即时症状，中医证型有肝肾阴虚证、痰热瘀阻证等，主要涉及肾、肝两脏。证候要素以肝肾阴虚、痰、血瘀、热为最多。结论 NMO本虚以肝肾阴虚为主，邪实以痰、血瘀、热兼夹为主。其中肝肾阴虚和痰瘀内阻的病理机制在NMO患者中具有普遍性和代表性，这一特点从患者的舌象和脉象上也可以得到佐证。

英文摘要:

Objective To explore the clinical features of neuromyelitis optica （NMO） patients， and to study the distribution of Chinese medical syndrome types and the pathogenesis of NMO. Methods The clinical features， figures of tongue and pulse， Chinese medical syndromes were comprehensively analyzed in 63 NMO patients using statistical methods for clinical data. Results The age ratio of male to female in 63 NMO patients was 1∶6.88. Their average age of first onset was 31.67±12.44 years old， and 28.57% of patients had obvious inducing factor. Urgent onset with relieved recurrence were often seen， with the average recurrence times of 4.60. Most patients complained about sensation disorders， vision disorders， and movement disorders as their first attack and visit. The Chinese medical syndrome types included Gan Shen yin deficiency syndrome and phlegm heat collateral stagnation syndrome， mainly involved Gan and Shen. Gan Shen yin deficiency， sputum， blood stasis， and heat were most often seen syndrome elements. Conclusions Gan Shen yin deficiency was dominated in the deficiency in origin of NMO. Phlegm， blood stasis， mingled heat were main dominant evils. Of them， the pathogenesis of Gan Shen yin deficiency and phlegm heat collateral stagnation had universality and representativeness， which could be verified from patients′ tongue picture and pulse picture.

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