Study Of The Relationship Between The Evolution Of The Syndrome Factors In The Acute Phase Of Ischemic Stroke And The Degree Of Nerve Function Defect And Prognosis

Objective To explore the characteristics of the evolution of syndrome factors in acute ischemic stroke,and to analyze the correlation between the factors and the neural function defect and the long-term prognosis,through the differences among them at different time points.It may provide evidence-based evidence for Chinese medicine in the early stage of clinical intervention and treatment of apoplexy,and a research method for further improving combination of disease and TCM syndromes with traditional Chinese medicine intervention program to provide.Methods This study is a part of the research project of "the relationship between Qi deficiency syndrome and the degree of neurological deficit and prognosis in acute phase of ischemic stroke",which is a special research topic of the national administration of traditional Chinese medicine,the national clinical research base of Chinese medicine.In the 72 hours of ischemic stroke,50 patients were eligible for hospitalization.According to the group of the day "ischemic stroke syndromes diagnosis scale" were originating the main elements ofsyndrome group,all patients in the "guide to the diagnosis and treatment of acute ischemic stroke Chinese 2014 edition" the standardization of medical treatment on the basis of dynamic acquisition was 90 days and seventh,fourteenth,twenty-eighth patients with ischemic stroke syndromes "diagnostic scale",the National Institutes of Health Stroke Scale(NIHSS)score and the incidence of ninetieth days of daily life ability score.After the end of the follow-up,all the data were registered in the special EXCEL form designed by the research group.After data cleaning and sorting,combined with the score of patients’ symptom scale,the SPSS24.0 statistical toolkit was used for statistical analysis.The collected data were classified statistically,and the basic data were analyzed by frequency distribution analysis.According to the nature of clinical research data(measurement data,classification data and grade data),appropriate statistical analysis methods were selected.The study of all measurement data are used(`X±S)display measurement data,test of normality and homogeneity of variance test,multiple samples were compared with the rate or composition ratio were compared using chi square test;multiple sample mean variance analysis;when the same observation of the like(such as human or animal etc.)at different time points of the same observation index(more than 3)repeated measurement,the test method of analysis of variance of repeated measure.All statistical tests were both bilateral test,and there were statistical differences when P < 0.05.On the basis of the analysis of the data,the results are obtained and discussed in combination with the analysis of professional knowledge.Results 1.Syndrome evolution law: The present study found thatthere are multiple syndromes coexisting at different time points for ischemic stroke.Within 72 hours after onset,the highest proportion of internal wind syndrome occurs,followed by dampness and internal fire,and yin deficiency is least;On the 7th,14 th,and 28 th days,dampness,blood stasis,and internal fire were all ranked in the top three syndromes.On the 90 th day of onset,the bloodthirsty ratio was the highest,and the internal fire group was the least.In the changes in scores of TCM syndrome scores,the wind group averaged the highest in the day of the group.As the observation time went by,the average scores of all groups decreased.The inner wind group fell to 10 points on the 7th day of onset.In the following,the internal fire group,the Qishen group,the Qi deficiency group,and the Yin deficiency group all fell below 10 points on the 28 th day after onset.There was no significant change in the mean score of blood stasis group.2.Comparison of neurological deficit scores(NIHSS): In this study,statistical methods for repeated measures analysis of variance were used to compare the differences in neurological deficits at different time points for each syndrome group.The results revealed differences in the NIHSS scores at different time points(P=0.000);NIHSS sharing between groups was different(P=0.001);the NIHSS scores in patients with Qi deficiency group were higher than those in other groups,and the scores gradually decreased with time delay,and the differences were statistically significant(P=0.000).There was no interaction between group factor and time factor(P=0.336).3.Barthel-Index(BI)comparison: From the onset of 90 days,qi deficiency group had the highest incidence of poor prognosis.Theprognosis of each group was compared by Kruskal-Wallis test,P<0.01,significant statistical difference.Conclusion 1.The evolution of the syndrome in the acute phase of ischemic stroke has a certain rule,the change of the internal wind is the fastest,the blood stasis is relatively stable,and the Yin deficiency syndrome is rare in the acute phase.On the 7th day after the onset of illness,the turning point of the change of the internal wind syndrome was found.On the 28 th day,it was an inflection point of the change of the syndrome elements such as dampness,internal fire,and qi deficiency.The evolution process is related to the characteristics of pathogenic diseases,patient symptoms,physical fitness and other factors.2.In patients with clear ischemic stroke during the acute phase of acute ischemic stroke,the deficiency of nerve function in the acute and recovery period is more serious and the long-term prognosis is even worse.3.During the acute phase of ischemic stroke,we should pay close attention to the dynamic changes of syndrome factors.Combined with the relationship between the evolution of syndrome elements and the degree of neurological impairment,we can identify positive elements,positive,dialectical and effective interventions so as to change the long-term prognosis of patients.