Study On The Treatment Of Acute Ischemic Stroke And The Correlation Between TOAST Criteria And Prognosis

Objective: 1. To analyze the current situation of acute ischemic stroke in the real world. 2. To analyze the effects of TOAST criteria on the prognosis in acute period of cerebral apoplexy.Methods:The topic continuous record from March 2015 to January 2016 about the patients with acute ischemic stroke that was hospitalized in the First Affiliated Hospital of Henan Traditional Chinese Medicine and the zhengzhou central hospital,then investigated the therapy,the result of treatment,the TOAST criteria of acute ichemic stroke patients in the real clinical practice for 90 days,and the results were statistically analyzed.Results: 1. In the real world,the patients received thrombolytic therapy was 2.2%.83% of patients was given the brain protective agent treatment,94% of patients received antiplatelet therapy.The higher proportion of combination therapies were quadruple medication, and Combination of five treatment options. The patients that treated with Chinese medicine injection and antiplatelet drugs and improving cerebral circulation drugs and neuroprotective agent was 36%,the patients that treated with Chinese medicine decoction and traditional Chinese medicine injection and antiplatelet drugs and improve cerebral circulation drugs and neuroprotective agent of patients was 26%,the patients that treated with Chinese medicine decoction and traditional Chinese medicine injection and antiplatelet drugs and neuroprotective agents was 24%. 2. There was no statistically significant difference before treatment between the hospital of traditional Chinese medicine and Western medicine in sex, age, and NIHSS score (P> 0.05).After the drug intervention when the patients leaveing hospital,there was no statistically significant between the two groups in the nerve function defect improvement rate, markedly effective, the effect is poor.There was no statistically significant in hospital seven days after drug intervention in PRO score,which was based on stroke patients(P> 0.05).and the PRO score of two groups has a significant difference when the patients leaveing hospital (P= 0.015< 0.05). 3. In each sub group of TOAST criteria,the sex, age had no significant difference (P> 0.05); among the subtypes entry school NIHSS score and improvement rate of comparison is made to show:The TOAST criteria of patients compared with the admitted to the hospital (P=0.007<0.05), discharge (P=0.017<0.05) and improvement rate (P=0.023<0.05) had statistical significance. The CE group compared with other groups, NIHSS score was the highest, and the improvement rate was the lowest SAO group and the group of CE results Instead. Clinical results show SAO is obviously better than other groups, the clinical therapeutic effect of best (P 0.01); LAA effect than CE, SOE good (P< 0.01); Sue efficacy and LAA, SOE had no significant difference (P> 0.05), CE and SOE, Sue effect is the worst has statistical significance (P< 0.01). The recurrence rate shown CE and each sub group to compare the recurrence rate (P< 0.05) was statistically significant.Conclusion: 1.The proportion of the patients with thrombolysis in the real world is still low, the proportion of four drug combination is highest; 2.The Traditional Chinese Medicine treatment has more advantage than simple Western Medicine treatment to improve the patients’PRO score. 3. The small artery occlusion of the TOAST criteria is the best efficacy of stroke, cardiac cerebral embolism efficacy is poor and has high recurrence rate, the TOAST criteria can be used as predictive indicators in acute ischemic stroke treatment process.