Investigate The Principal Syndrome Differentiation Of Tcm With Staging And Typing Of Acute Anterior Circulation Infarction

Objective: Cerebral Infarction(CI) is the generic name of cerebral ischemic stroke, including cerebral thrombosis, lacutypingar infarction and cerebral embolism, et al. It accounts for about 70% of all stroke. Cerebral circulatory system is divided into anterior circulation and posterior circulation [1]. On the basis of clinical manifestations, acute anterior circulation infarction belongs to stroke category of Traditional Chinese Medicine(TCM). TCM has extensive clinical experience on syndrome differentiation and Treatment of stroke. Based on the experience of syndrome differentiation, cerebral infarction in different periods and different clinical conditions should be different in symptom factors of TCM distribution. There must be some symptom factors which play a major role.'Only by accurately identifying the principal syndrome, we can understand and master the law of the occurrence, development and change of the disease. And then we can enact appropriate treatment plan for the disease[2].'In order to bring into full play to the advantages of TCM, we investigate the principal syndrome differentiation of TCM with staging and typing of acute anterior circulation infarction. This topic creat new ideas and new methods of principal syndrome differentiation. It can be a complement of traditional Chinese medicine syndromes. We hope that it can guide clinical treatment of TCM and improve the cure rate and alleviate the suffering of patients.Methods: The total 693 cases are chosen from inpatient in the Second Hospital of Hebei Medicine University Department of neurology. We divided the acute anterior circulation infarction into two stages: earlier stage, crest-time. We divided it into three types according to serious degree: mild, moderate and severe. The basis of the symptom factors differentiation is Zhu Wenfeng syndrome differentiation scale. In each stage and each type, we select the significant symptom factors and use factor analysis to processing the data of these symptom factors. Then the principal syndrome is summarized according to the results of factor analysis.Result:1 The symptom factors with higher frequency: Symptom factors of disease location in mild of earlier stage: meridian, liver, bladder, spleen, kidney, large intestine; symptom factors of disease nature in mild of earlier stage: phlegm syndrome, endogenous wind, syndrome of blood stasis, asthenic yin, pyretic syndrome,hemopenia, damp pathogen, excess symdrome of stroke, syndrome of stagnation of QI, YANG hyperactivity syndrome, deficiency of vital energy. Symptom factor of disease location in the moderate and severe type of earlier stage: meridian, liver, heart-spirit, large intestine, spleen, bladder, kidney; symptom factor of disease nature: phlegm syndrome, endogenous wind, syndrome of blood stasis, damp pathogen, excess symdrome of stroke, pyretic syndrome, asthenic yin, YANG hyperactivity syndrome, hemopenia. Symptom factor of disease location in the mild type of crest-time: meridian, liver, large intestine, bladder, kidney, spleen; symptom factor of disease nature: phlegm syndrome, endogenous wind, pyretic syndrome, syndrome of blood stasis, damp pathogen, asthenic yin, hemopenia, YANG hyperactivity syndrome, syndrome of stagnation of QI, excess symdrome of stroke; Symptom factor of disease location in the moderate and severe type of crest-time: meridian, liver, large intestine, heart-spirit, spleen, bladder, kidney; symptom factor of disease nature: phlegm syndrome, endogenous wind, pyretic syndrome, excess symdrome of stroke, syndrome of blood stasis, damp pathogen, asthenic yin, YANG hyperactivity syndrome, hemopenia.2 Major symptom factor: The mild type of earlier stage: factor 1 reflects the information of meridian, phlegm syndrome, syndrome of blood stasis, endogenous wind; factor 2 reflects the information of kidney, asthenic yin; factor 3 reflects the information of spleen, damp pathogen; factor 4 reflects the information of hemopenia; factor 5 reflects the information of liver, YANG hyperactivity syndrome. The moderate and severe type of earlier stage: factor 1 reflects the information of meridian, phlegm syndrome, syndrome of blood stasis, endogenous wind; factor 2 reflects the information of heart-spirit, excess symdrome of stroke; factor 3 reflects the information of YANG hyperactivity syndrome, pyretic syndrome; factor 4 reflects the information of spleen, damp pathogen; factor 5 reflects the information of liver, asthenic yin. The mild type of crest-time: factor 1 reflects the information of meridian, phlegm syndrome, syndrome of blood stasis, endogenous wind; factor 2 reflects the information of large intestine, pyretic syndrome; factor 3 reflects the information of liver, YANG hyperactivity syndrome; factor 4 reflects the information of asthenic yin; factor 5 reflects the information of kidney. The moderate and severe type of crest-time: factor 1 reflects the information of meridian, phlegm syndrome, syndrome of blood stasis, endogenous wind; factor 2 reflects the information of heart-spirit, excess symdrome of stroke; factor 3 reflects the information of liver, asthenic yin; factor 4 reflects the information of spleen, damp pathogen; factor 5 reflects the information of pyretic syndrome, YANG hyperactivity syndrome.3 The principal syndrome of each stage and type: According to the result of the factor analysis and professional knowledge of TCM and clinical findings, we obtained the following results. The principal syndrome in the mild type of earlier stage is obstruction of collateral caused by windphlegm and syndrome of blood stasis. The principal syndrome in the moderate and severe type of earlier stage is obstruction of collateral caused by windphlegm and syndrome of blood stasis; excess symdrome of stroke and pyretic syndrome are the accompanied syndromes. The principal syndrome in the mild type of crest-time is obstruction of collateral caused by windphlegm and syndrome of blood stasis; sthenia heat of large intestine is an accompanied syndrome. The principal syndrome in the moderate and severe type of crest-time is the same to that in the moderate and severe type of earlier stage.Conclusion:1 In the mild type of both stages of acute anterior circulation infarction the principal syndrome is endogenous wind, phlegm syndrome and syndrome of blood stasis block meridian. In the mild type of crest-time sthenia heat of large intestine is an accompanied syndrome. This illustrate that with the development of the course the functional activities of vital energy in entrails is disordered, and then the function of stomach intestine is effected. As a result clinical situation of sthenia heat of large intestine is becoming obvious gradually.2 In the moderate and severe type of both stages of acute anterior circulation infarction the principal syndrome is obstruction of collateral caused by windphlegm and syndrome of blood stasis; excess symdrome of stroke and pyretic syndrome are the accompanied syndromes. This demonstrate that mind disorder and pyretic syndrome are common.The common principal syndrome of acute anterior circulation infarction is obstruction of collateral caused by windphlegm and syndrome of blood stasis. This reflects the common pathological change of TCM in acute stage of this disease. And the accompanied syndrome reflect that different course and condition have different effects on the pathological change of TCM. In a word, staging and typing of acute anterior circulation infarction has some relationship with principal syndrome of TCM. It can provid reference for treatment of TCM of CI.