Development And Epidemiological Investigation On The Distribution And Combination Rule Of The Element Of Pathogenesis And Syndrome Diagnosis Scale For Internal Injury Headache

Objective:The clinical pathogenesis of internal injury headache is complex and its performance is diverse. So its syndrome diagnosis is affected by many factors. After thousands of years, traditional syndrome method of TCM is enduring.However, it is difficult to adapt to the objective and standardized requirement of modern Chinese medicine.The research is to explore an new dialectical ideas of internal injury headache from the height of pathogenesis.Using the differentiation and diagnosis method of elements of syndrome and pathogenesis,developing the scale,the research attempts to reveal the distribution and combination rule of elements of pathogenesis and syndrome of internal injury headache as well as the correlation of various factors,to deepen this concept of dialectical diagnosis.In addition,the research can offer examples and evidence based medicine for constructing a new system of TCM.Method:A summary reviews ancient and modern doctors of internal injury headache study on the etiology,pathogenesis and syndrome classification.The research preliminary develops a internal injury headache differentiation and diagnosis scale of elements of pathogenesis and syndrome.By collecting clinical data of 324 outpatients,using the scale to make the diagnostics,then analyzing and processing the data,the research find the distribution and association rule about each elements of pathogenesis and syndrome,also with age, gender, influence factor relevance.Results:Firstly, the distribution rule is as follows.324 cases in order of frequency is:liver yang>liver fire>blood deficiency>turbid phlegm>blood stasis>congealing cold>qi deficiency>yin deficiency>qi depression.Of all, liver yang(199 cases,61.42%) and liver fire(194 cases,59.88%) are the most in sthenia syndrome while blood deficiency(85cases,26.23%) is the most in asthenia syndrome. Secondly, the combination rule is as follows, two elements combination is at most(33.64%). Followed by three elements combination(19.44%) and single element(16.98%).Then come no element(10.80%),four elements combination(10.19%), six elements combination(4.32%), five elements combination(3.70%),seven elements combination(0.93%).Neither eight elements combination nor nine elements combination is found. When it comes to single element, turbid phlegm,blood stasis, blood deficiency and liver yang see multiple (> 10%). Two elements combination in 16types, common combination (> 10%) is wind fire disturbing upper, deficiency of qi and blood. Three elements combination in 18 types, common combination (>10%) is wind fire phlegm blocking,wind fire stasis blocking,et al. Thirdly, age-related:internal injury headache often occurs in middle-aged patients between the ages of 45-60.Liver fire can be found in each age group (P<0.05).Older group also sees blood stasis (P<0.01). Fourthly, gender-realted: regardless of gender,liver fire is the most common.In terms of gender differences, men see more of blood deficiency (P<0.01), female common congealing cold (P<0.05). Fifthly, the relationship with the influence factors:①Emotion, fatigue and insomnia are three common factors of internal injury headache.②Emotional factors relate to live fire, qi depression and blood deficiency.③Insomnia factors relate to liver yang and liver fire.④Blowing cold factors relate to congealing cold and turbid phlegm.⑤Fatigue fators relate to blood deficiency and qi deficiency.⑥Menstrual factors relate to liver fire and blood deficiency.⑦Diet and drink factors have nothing to do with elements in this research.Conclusion:The epidemiologic survey display that the main elements of internal injury headache are liver yang,liver fire.Liver yang and liver fire in multiple combinations of elements are most common. Blood deficiency is common in the combination of deficiency syndrome. Wind fire phlegm blocking is the most common syndrome type in three combinations.Regardless of age and gender,internal injury headache is related to liver fire.Old people see more of blood stasis. Men see more of blood deficiency, female common congealing cold.In terms of influencing factors, emotion, fatigue and insomnia are three common factors of internal injury headache.