香港地区慢性疲劳综合征的初步调查与中医病机探讨c

香港地区慢性疲劳综合征的初步调查与中医病机探讨c 【关键词】 慢性疲劳综合征 ［摘要］目的：调查香港地区20～50岁人群疲劳与慢性疲劳综合征（chronic fatigue syndrome, CFS）的发病情况及其中医证型与症状，探讨CFS的病机。：按流行病学方法，参照英国Chalder等制订的疲劳量、美国疾病控制中心1994年制定的CFS诊断及按《中药新药临床研究指导原则》中医证候指导原则的要求制定调查表，对香港地区20～50岁的普通公民进行非随机抽样调查。研究疲劳症状、CFS及常见的中医证型与症状。结果：1 013位公民中，有疲劳症状的为585人，占57.8%；符合CFS诊断标准的65人，患病率为6.4%。在中医证型中，以气虚血瘀较为多见，占35.7%。在调查的54种中医症状中，出现频率最高的前8位症状依次为腰膝酸软、神疲、乏力、疼痛、失眠、健忘、脉络瘀血及头晕眼花。舌象多见舌质淡胖、淡暗，舌苔薄白、薄腻；脉象则多见沉细。结论：CFS在香港地区20～50岁人群中的患病率为6.4%。中医证型以气虚血瘀证为主。CFS的病机主要为本虚标实，以气虚、肾虚为本，血瘀为标。 　　［关键词］慢性疲劳综合征; 证候; 气虚血瘀 　　A preliminary epidemiological study and discussion on traditional Chinese medicine pathogenesis of chronic fatigue syndrome in Hong Kong 　　ABSTRACT Objective: Our purpose is to conduct an epidemiological study of chronic fatigue syndrome (CFS) and its syndrome types and symptoms of traditional Chinese medicine (TCM) among adults (2050 years old) in Hong Kong, and to discuss the TCM pathogenesis. Methods: Design: Crosssectional questionnaire survey. Measures: Demographic data, CDC (1994) CFS diagnostic criteria, Trudie Chalder fatigue scale, and China national standard for TCM syndrome types criteria. Subjects: Twenty to fifty years old adults by convenient sampling. Results: One thousand and thirteen subjects were successfully interviewed. Five hundred and eightyfive subjects (57.8%) had different levels of fatigue. Sixtyfive subjects (6.4%) met CFS diagnostic criteria. In terms of TCM syndrome types, blood stasis due to qi deficiency had the highest prevalence (35.7%) among CFS. In the 54 symptoms investigated in total, the first eight symptoms in order of appearing rates were soreness of loins and weakness in knees, poor spirit, lassitude, pain, insomnia, forgetting, vessels blood stasis, vertigo and dazzle. The mostly appeared tongue figures were pale and corpulent or pale dim tongue proper, white and white greasy tongue coating, and the mostly appeared pulse figure was sunkenthin. Conclusion: The point prevalence of CFS among adults of 20 to 50 years old was found to be 6.4%. The most prevalent TCM syndrome type was blood stasis due to qi deficiency. The TCM pathogenesis of CFS was deficiency of origin, mainly deficiency of qi and kidney, with excess of superficiality. 　　KEY WORDS chronic fatigue syndrome; symptom complex; blood stasis due to qi deficiency 　　慢性疲劳综合征（chronic fatigue syndrome, CFS）是一组以持续或反复发作的疲劳，伴有多种神经、精神症状，但无器质性及精神性疾病为特点的症候群。香港是一个高速发展的现代化大都市，香港人工作生活的节奏很快，人们的心理及生理负荷大，因此本病的发病率也相应较高。2004年3月～2004年6月，我们对香港地区20～50岁的普通公民进行了非随机抽样调查，调查表的制定参照了英国Chalder等［1］制订的疲劳量表、美国疾病控制中心1994年制定的CFS诊断标准［2］及按《中药新药临床研究指导原则》中医证候指导原则［3］的要求，以气虚、血虚、肝郁脾虚、湿热壅盛、肾阴虚、肾阳虚、血瘀等为主要中医证型，共涉及中医症状54项及舌、脉象。现将结果报道如下。