Acute Ischemic Stroke Disease Of Phlegm-heat Syndromes Of The Corresponding Law Of Evolution And Party Cards

Objective:Supported by the structured and standardized platform of clinical data gathering,we collected a large number of the clinical data of Traditional Chinese Medicine(TCM) diagnosis and treatment.We investigate the dynamic evolutive rule of the phlegm-fire syndrome and we explore the correlation between six prescriptions including wendan decoction,xinglou chengqi decoction, zhengan xifeng decoction and tianma gouteng drink,buyang huanwu decoction, banxia baizhu tianma decoction which are often used to therapy stroke and six syndrome elements as wind syndrome,fire syndrome,phlegm syndrome,syndrome of blood stasis,syndrome of qi deficiency,syndrome of hyperactivity of yang due to yin deficiency.This research will lay a foundation for further study of the dynamic evolutive rule of the phlegm-fire syndrome and the correspondence of the prescription and the syndrome.Method:All the data of this research have been chosen from the major project of Beijing—"The research on Evaluation System of major disease by Traditional Chinese Medicine Clinical Individualized Diagnosis and Treatment".Criterion for Diagnose and Differentiation of Syndromes of Stroke(CDDSS) is used to Judge the syndrome.Part 1:We refered the result of cluster analysis made by Preliminary workers which was used to differentiate the degree of the syndrome,then we defined phlegm-fire syndrome as phlegm＞5 score and fire＞4 score.Based on that,we explored the dynamic evolutive rule of the phlegm-fire syndrome by using the Bivariate Correlations and Descriptive Statistics.Part 2:We extracted the Clinical information of 359 patients(451cases) who were in accordance with the inclusive criteria and drank wendan decoction, xinglou chengqi decoction,zhengan xifeng decoction and tianma gouteng drink, buyang huanwu decoction and banxia baizhu tianma decoction.We investigated the correlation between six prescriptions and six syndrome elements through comparing the mean value of score of each syndrome element which is corresponding to each prescription.Then we analyzed their combinative styles and the appearance probability of syndromes.At last,we obtained their odds ratio by using the Multinominal Logistic Regression.Results:Part 1: 1 The sum of phlegm syndrome score and fire syndrome score is strong interrelated with the sum of the all yndromes score.The correlation coefficient in five points in time respectively is 0.704,0.726,0.753,0.726 and 0.618. They have the consistent trend during the Changes.2 During the evolution of the phlegm-fire syndrome,conversion probability was about 70%probability of still further into the original syndrome.3 The NIHSS score was different because of different forms of evolution of the syndrome.And the differences in NIHSS scores had Statistical significance in 7th and 14th days.The NIHSS score change was hidden in unchanged group,and it was obvious in the changed group.Part 2:1 The cases who drank wendan decoction were 152.The mean value of phlegm syndrome,wind syndrome and fire syndrome were in the top three.There are 33 kinds of the patterns of the combinant of syndrome elements.The mean value of phlegm syndrome is much larger than wind syndrome and fire syndrome.In the patterns of the combinant of syndrome elements,wind syndrom+fire syndrome +phlegm syndrome pattern is most.And in the all combinant of syndrome elements.The occurring frequency rate of the combinant which includes fire syndrome+phlegm syndrome pattern is 52%.By analyzing logistic regression,we know that Wendan decoction has close correlation with phlegm syndrome,and their correlation is positive.2 The cases who drank xinglou chengqi decoction were 32.The mean value of phlegm syndrome,wind syndrome and fire syndrome were in the top three.There are 18 kinds of the patterns of the combinant of syndrome elements.In the patterns of the combinant of syndrome elements,wind syndrom+fire syndrome+phlegm syndrome and syndrome of blood stasis+fire syndrome+phlegm syndrome pattern were the most.The occurring frequency rate of the combinant which includes fire syndrome+phlegm syndrome pattern is 53%.By analyzing logistic regression,we know that xinglou chengqi decoction has close correlation with phlegm syndrome or fire syndrome,and their correlation is positive.3 The cases who drank zhengan xifeng decoction were 21.The mean value of phlegm syndrome,wind syndrome and fire syndrome were in the top three.There are 15 kinds of the patterns of the combinant of syndrome elements.In the patterns of the combinant of syndrome elements,wind syndrom+fire syndrome+phlegm syndrome,wind syndrom+phlegm syndrome+syndrome of blood stasis,wind syndrom+fire syndrome+syndrome of qi deficiency were the most.The occurring frequency rate of the combinant which includes wind syndrom and syndrome of hyperactivity of yang due to yin deficiency pattern pattern is 19%.By analyzing logistic regression,we know that zhengan xifeng decoction has close correlation with phlegm syndrome or syndrome of qi deficiency,and their correlation is negative.4 The cases who drank tianma gouteng drink were 18.The mean value of fire syndrome,phlegm syndrome and wind syndrome were in the top three.There are 10 kinds of the patterns of the combinant of syndrome elements.In the patterns of the combinant of syndrome elements,wind syndrom+fire syndrome+phlegm syndrome pattern were the most.The occurring frequency rate of the combinant which includes wind syndrome+fire syndrome is 61%.In the logistic regression, we know that tianma gouteng drink has close correlation with syndrome of hyperactivity of yang due to yin deficiency,and their correlation is positive.5 The cases who drank buyang huanwu decoction are 134.The mean value of wind syndrome,phlegm syndrome,syndrome of blood stasis were in the top three. There are 38 kinds of the patterns of the combinant of syndrome elements.In the patterns of the combinant of syndrome elements,wind syndrom+phlegm syndrome+syndrome of blood stasis pattern were the most.The occurring frequency rate of the combinant which includes syndrome of blood stasis+syndrome of qi deficiency pattern is 31%.By analyzing logistic regression,we know that Wendan decoction has close correlation with syndrome of qi deficiency or syndrome of blood stasis,and their correlation is positive.6 The cases who drank banxia baizhu tianma decoction are 94.The mean value of phlegm syndrome,wind syndrome and fire syndrome were in the top three.There are 25 kinds of the patterns of the combinant of syndrome elements.In the patterns of the combinant of syndrome elements,wind syndrom+phlegm syndrome +fire syndrome pattern were the most.The occurring frequency rate of the combinant which includes wind syndrome and phlegm syndrome is 68%.By analyzing logistic regression,we know that banxia baizhu tianma decoction has close correlation with wind syndrom or phlegm syndrome,and their correlation is positive.Conclusion:Part 1:The method we used to define phlegm-fire syndrome is reasonable.The evolution of the phlegm-fire syndrome was Consistent with the overall syndrome, and is representative.Part 2:The prescription corresponds with the syndrome element,and doctors prescribe according to syndrome elements.Simultaneously,clinical doctors should combine the characteristics of the disease.For example,wind syndrome and phlegm syndrome is existed during the acute phase of iscbemic stroke,so we should also extinguish wind syndrome and phlegm syndrome.