基于临床流行病学方法的不同类型原发性青光眼患者的中医体质类型研究

摘要

目的 了解不同类型原发性青光眼的中医体质特点,为临床辨证施治及体质调节提供参考.方法 选择2014年1月-2015年6月就诊于上海中医药大学附属曙光医院的179例原发性青光眼患者进行中医体质问卷调查,包括急性闭角型青光眼、慢性闭角型青光眼、开角型青光眼,体质分类采用王琦的九型分法.另外选取在本院体检中心进行健康体检的64名健康人作为对照,采用相同问卷,统计分析不同类型青光眼患者的中医体质分布特点.结果 青光眼患者收回有效问卷177份,急性闭角型青光眼52份,慢性闭角型青光眼64份,开角型青光眼61份;对照健康人群收回有效问卷62份.各类型青光眼及健康对照组的中医体质分布明显不同(P＜0.001).急性闭角型青光眼患者体质分布以痰湿质为主(26.9％),其次为湿热质(15.4％)、瘀血质(13.5％)、气郁质(13.5％);慢性闭角型青光眼患者以阳虚质为主(26.6％),其次为气郁质(12.5％)和阴虚质(12.5％);开角型青光眼以气郁质为主(34.4％),其次为瘀血质(14.8％);对照组以平和质为主(29.0％),其次为气虚质(14.5％)及阳虚质(12.9％).结论 不同类型原发性青光眼患者的中医体质分布存在一定的倾向性,急性闭角型青光眼患者多见痰湿质,慢性闭角型青光眼患者多见阳虚质,慢性开角型青光眼多见气郁质,而气郁质是三种青光眼中均较为常见的体质.%OBJECTIVE To investigate the constitution of patients with glaucoma for its physical characteristics as references for clinical treatment based on syndrome differentiation and constitution adjustment.METHODS Between January of 2014 and June of 2015,one hundred and seventy-nine patients with glaucoma,including acute angle-closure glaucoma,chronic angle-closure glaucoma and primary open-angle glaucoma,who received treatment in the Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine were recruited in case group.While sixty-four healthy subjects from hospital medical center for medical examination were included in control group.All subjects were followed up with the same questionnaire consisted of TCM constitution scale and Chinese constitution classification and judgment standard on basis of Prof.Wang Qi's nine constitutional type method.RESULTS A total of 177 valid questionnaires of glaucoma patients were collected,including 52 patients with acute angle-closure glaucoma,64 chronic angle-closure glaucoma,61 primary open-angle glaucoma.The healthy participants yielded 62 valid questionnaires.Constitution of healthy subjects showed an obvious different pattern in contrast to glaucoma patients (P＜0.05).Among acute angle-closure glaucoma patients,phlegm-damp constitution accounted for 26.9％,followed by damp-heat constitution (15.4％),blood stasis constitution (13.5％) and qi stagnation constitution (13.5％);Among patients with chronic angle-closure glaucoma,yang deficiency accounted for 26.6％,followed by yin deficiency and qi stagnation constitution that each made up 12.5％;In open-angle glaucoma patients,tampered constitution was the most common type which accounted for 29.0％,qi deficiency constitution and yang deficiency constitution made up 14.5％ and 12.9％ respectively.CONCLUSIONS There were certain links between traditional Chinese medicine constitution and types of primary glaucoma.Phlegm-dampness constitution was closely related to acute angle-closure glaucoma.Patients with chronic primary angle-closure glaucoma were most commonly in yang-deficiency constitution.Chronic primary open-angle glaucoma patients were more likely with constitution among qi stagnation.And constitution of qi stagnation was the common one among different types of glaucoma patients.