【目的】 探讨脑卒中后失语症（PSA）患者的中医证候要素与语言功能及日常生活能力的相关性。【方法】 选取2023年4月 至2024年4月期间在福建中医药大学附属康复医院住院治疗的98例PSA患者，分析患者的语言功能特征、中医证素特征以 及两者的相关性。【结果】（1）PSA患者中，男性患者多于女性；PSA患者在失语症相关的各个量表中表现不同，语言功能损 伤主要集中在命名、自发言语等领域。（2）不同年龄段 PSA 患者各证素的分布不同，其中，＜50 岁年龄段以气闭（占 100.00%）、痰证（占100.00%）、湿证（占100.00%）为主，50 ~ 59岁年龄段以痰证（占100.00%）和阳亢证（占96.30%）为主，60 ~ 69岁年龄段也以痰证（占 100.00%）和阳亢证（占 96.15%）为主，70 ~ 79岁年龄段以气虚证（占 100.00%）为主，80 ~ 89岁年龄 段的患者在气不固证、气闭证、气虚证、痰证、阳亢证、血瘀证、动风证、血寒证较为集中（均占100.00%）。但不同年龄段 PSA患者中医证素分布情况比较，差异无统计学意义（P＞0.05）。（3）不同性别PSA患者虚证、实证证素分布不同，虚证证素 中，男性以阳亢、气虚、阴虚为主，女性以阳亢、气虚、血虚为主；实证证素中，男性以痰证、气闭证、湿证为主，女性 以痰证、气闭证、气滞证为主。但不同性别PSA患者虚证、实证证素分布情况比较，差异均无统计学意义（P＞0.05）。（4）部 分相关性分析结果：在控制PSA患者的年龄和性别因素后的偏相关分析显示，病位证素中，PSA患者波士顿命名测验（BNT） 自发命名（r = -0.588，P = 0.027）、BNT提示命名（r = -0.558，P = 0.038）与大肠负相关；病性证素中，PSA患者 BNT提示命 名（r = 0.821，P＜0.001）与气陷正相关，BNT 自发命名与血热（r = -0.544，P = 0.044）负相关，与津液亏（r = 0.860，P = 0.028）正相关；BNT选择命名与外风（r = 0.966，P = 0.034）正相关；BNT提示命名错误与气陷（r = -0.540，P = 0.005）负相关； 改良Barthel指数（MBI）与精亏（r = 0.572，P = 0.021）正相关。【结论】 PSA患者的证素主要集中在痰证、气闭、阳亢、气虚等， PSA患者语言功能及日常生活能力与中医证素有一定的相关关系。

Objective To explore the correlation of traditional Chinese medicine（TCM） syndrome elements with language function and activities of daily living （ADL） in patients suffering post-stroke aphasia （PSA）. Methods Ninety-eight PSA patients hospitalized at the College of Rehabilitation Medicine，Fujian University of Traditional Chinese Medicine from April 2023 to April 2024 were selected. The language function，TCM syndrome elements， and their correlations were analyzed. Results （1）Among PSA patients，males outnumbered females. PSA patients exhibited different performances on various aphasia-related scales， with language impairments mainly concentrated in naming and spontaneous speech.（2） The distribution of TCM syndrome elements varied in PSA patients with different age groups. In the age group ＜50 years old，qi obstruction （100.00%），phlegm syndrome （100.00%），and dampness syndrome （100.00%） were predominant. In the age group of 50-59 years old，phlegm syndrome （100.00%） and yang hyperactivity syndrome （96.30%） were predominant. In the age group of 60-69 years old，phlegm syndrome（100.00%） and yang hyperactivity syndrome （96.15%） were also predominant. In the age group of 70-79 years old，qi deficiency syndrome （100.00%） was predominant. In the age group of 80-89 years old，syndromes such as qi insecurity，qi obstruction，qi deficiency，phlegm，yang hyperactivity，blood stasis， wind stirring，and blood cold were concentrated （all 100.00%）. However，there were no statistically significant differences in the distribution of TCM syndrome elements among various age groups（P＞0.05）.（3）The distribution of deficiency and excess syndrome elements varied in PSA patients with different genders. Among deficiency syndrome elements， yang hyperactivity， qi deficiency， and yin deficiency were predominant in males， while yang hyperactivity， qi deficiency， and blood deficiency were predominant in females. Among excess syndrome elements，phlegm syndrome，qi obstruction，and dampness syndrome were predominant in males，while phlegm syndrome， qi obstruction， and qi stagnation syndrome were predominant in females. However， there were no statistically significant differences in the distribution of deficiency and excess syndrome elements between genders （P＞0.05）. （4） After controlling the factors of age group and gender， partial correlation analysis of syndrome elements and language function showed that among the disease-location syndrome elements，spontaneous naming （r = -0.588，P = 0.027） and sematic cued naming （r = -0.558，P = 0.038） in the Boston Naming Test （BNT） were negatively correlated with the large intestine；among the disease-nature syndrome elements，BNT sematic cued naming （r = 0.821，P＜0.001） was positively correlated with qi sinking，while BNT spontaneous naming was negatively correlated with blood heat （r = -0.544， P = 0.044） and was positively correlated with fluid depletion （r = 0.860， P = 0.028）； BNT recognitive naming was positively correlated with external wind （r = 0.966，P = 0.034）；errors in BNT sematic cued naming were negatively correlated with qi sinking（r = -0.540， P = 0.005）；the Modified Barthel Index （MBI） was positively correlated with essence deficiency（r = 0.572，P = 0.021）. Conclusion The TCM syndrome elements of phlegm，qi block，yang hyperactivity，and qi deficiency are commonly seen in PSA patients. There is a certain correlation of language function and ADL with TCM syndrome elements in PSA patients.

R277.7

国家自然科学基金项目（编号： 82074512）；福建省科技计划项目社会发展引导性（重点）项目（编号：2023Y0035）；福建中医药 大学康复技术协同创新中心项目（编号：X2022011）