带状疱疹患者中医证型相关性因素分析

Analysis of Correlation Factors of TCM Syndromes in Patients with Herpes Zoster

摘要: 目的：探讨蛇串疮患者的中医证型分布规律，分析中医证型同各影响因素以及方剂之间的关系。方法：选取广西中医药大学2020年1月到2024年1月蛇串疮住院患者的临床资料进行统计和分析。结果：本次研究共纳入符合条件的病例159份，在蛇串疮的中医证型分布中，气滞血瘀证比例最高，达到44%，其次是肝经郁热证，占34%，而脾虚湿蕴证的比例最低，仅为22%；在年龄范围为60至69岁的老年人群中，蛇串疮的发病率最高，且气滞血瘀证患者的年龄平均值高于了肝经郁热证和脾虚湿蕴证；独活寄生汤在蛇串疮治疗时使用频数最高，累计达到38次；不同证型患者在不同年龄段的分布差异具有统计学意义(P < 0.05)；不同证型患者的性别、发病季节统计学差异不显著(P > 0.05)。结论：气滞血瘀证是蛇串疮中最多见的证型，蛇串疮的中医证型与年龄具有相关性，多见于中老年人群。在临床诊疗中，应当重视老年人群脏腑功能失调、正气逐渐衰退的特点，并在治疗蛇串疮的整个过程中，贯彻活血化瘀、理气通络的原则，以最大限度地避免带状疱疹后遗神经痛的发生。

Abstract: Purpose: To the distribution patterns of Traditional Chinese Medicine (TCM) syndrome types in patients with herpes zoster, analyzing the relationships between TCM syndrome types, various influencing factors, and the application of herbal prescriptions. Method: Clinical data of inpatients with herpes zoster from Guangxi University of Chinese Medicine from January 2020 to January 2024 were selected for statistical analysis. Results: This study included a total of 159 eligible cases. Among the TCM syndrome types in herpes zoster, the highest proportion was Qi stagnation and blood stasis syndrome, reaching 44%, followed by liver meridian depression and heat syndrome, accounting for 34%, while the proportion of spleen deficiency and dampness retention syndrome was the lowest at 22%. In the age group of 60 to 69 years, the incidence of herpes zoster was the highest, and the average age of patients with Qi stagnation and blood stasis syndrome exceeded those with liver meridian depression and heat syndrome and spleen deficiency and dampness retention syndrome. Duhuo Jisheng Tang was the most frequently used prescription in the treatment of herpes zoster, accumulating to 38 times. The distribution differences of different syndromes among different age groups in patients were statistically significant (P < 0.05), while there was no significant statistical difference in gender and onset season among patients with different syndromes (P > 0.05). Conclusion: The stagnation of qi and blood stasis pattern is most common in herpes zoster, especially in middle-aged and elderly patients. Therefore, in the clinical diagnosis and treatment process, we should pay attention to the characteristics of organ dysfunction and the gradual decline of positive energy in the elderly population. Throughout the treatment of herpes zoster, it is crucial to consistently follow the principles of promoting blood circulation, removing blood stasis, regulating qi, and unblocking meridians. This approach aims to minimize the occurrence of postherpetic neuralgia in herpes zoster patients.