A Study On Incidence?the Influence Factors And TCM Syndromes Of Post-stroke Anxiety Disorder

Objective:To study the incidence,and the influence factors and syndromes differentiation of the post-stroke anxiety disorder(PSAD),in order to prevent post-stroke anxiety disorder and offer reference to TCM treatment.Methods:86 patients with stroke were assessed by Prevalence of PSAD in the Department of Neurology of the Affiliated People's Hospital of Fujian University of traditional Chinese medicine(2016-2017).Analysis of the hospitalization data,including gender,age,education level,nursing staff,medical history,medical history(hypertension,diabetes,coronary heart disease),imaging examination(brain CT or MRI brain),relative scale(hanmyce anxiety scale,the degree of neural function defect scale and daily life ability score).At the same time,the collection of symptoms of traditional Chinese medicine,TCM syndrome analysis,in order to understand the characteristics of TCM Syndromes of stroke prone PSAD.SPSS 18.0 statistical software was used to analyze the incidence,the influence factors and TCM Syndromes of PSAD.Results:1.The study met the inclusion criteria of 86 stroke patients including 15 people who were diagnosed with PSAD.The incidence rate was about 17.42%.of which there were male and female,with the incidence rates of 18.33%and 15.38%.Compared with the incidence of all ages,people over 70-year were more likely to suffer from PSAD,but there was no significant difference in the incidence of different age groups(Z =-1.053,P = 0.292).The higher the education level,the lower the incidence.2.Among the influence factors,PSAD was not associated with hypertension,diabetes,coronary atherosclerotic heart disease,stroke type,stroke duration.The patients in the group were accompanied by caregivers,so it was impossible to compare the differences.3.Patients with basal ganglia and brain injury were more likely to suffer from PSAD than who injury on the location of the center of the oval,frontal lobe,occipital lobe,parietal lobe,lateral ventricle,brain stem,temporal lobe,cerebellum,thalamus,external capsule,and insula.4.The right brain damage is more likely to cause PSAD than other sites.The difference was statistically significant(X2=4.143,P = 0.042).5.The ability of daily living and neurological deficits were closely related to PSAD.HAMA was negatively correlated with ADL score and clinical neurological deficit score.The severity of neurological deficits after stroke and the decline of daily living ability were more likely to cause PSAD.6.Most people have various types of syndromes and the individual can appear more than one type of syndrome in the investigation of TCM syndrome of stroke.Only a single syndrome group of 49 cases(56.97%),biased constitution for the people.Phlegm turbidity obstruction of the highest frequency,accounting for 59.30%,followed by kidney essence deficiency accounting for 27.90%,liver yang hyperactivity in the third,accounting for 13.95%.7.Phlegm turbidity obstructing the orifices,hyperactivity of liver Yang and burning heat are leading to PSAD.There were significant differences in the incidence of PSAD between the patients with liver yang hyperactivity syndrome and the intrinsic heat syndrome(P<0.01).8.Multivariate Logistics regression analysis showed that the ability of daily life(P = 0.002,Exp(B)= 0.897),neurologic impairment(P = 0.003,Exp(B)= 0.474)was a protective factor of PSAD,education level(P = 0.092,Exp(B)= 0.313)has the tendency of the protection of PSAD factor.Hyperactivity of liver Yang Syndrome(P = 0.069,Exp(B)= 1.291),fiery intrinsic syndrome(P = PSAD,Exp(B = 1.548))had the tendency of the risk factor.Conclusion:1.This study showed that the incidence of PSAD in our hospital was 17.42%2.Age,gender,hypertension,diabetes,coronary atherosclerotic heart disease,stroke type,stroke duration,number of strokes had no significant effect on the incidence of PSAD.3.The influence factors of PSAD were educational level,location of stroke(midbrain,basal ganglia,right brain),ability of daily living and degree of neurological deficit.Among them,the ability of daily living and the degree of neurological deficit were the protective factors of PSAD,and the educational level tended to be protective factors.4.Phlegm turbidity obstruction,kidney essence deficiency,hyperactivity of liver yang are the main syndromes of stroke.The hyperactivity of liver Yang and the tendency of internal heat syndrome are risk factors of PSAD.