Study On The Correlation Between Nutritional Status Of Hospitalized Stroke Patients And TCM Syndrome Types

Objective:The study is to explore the correlation between nutritional status of ischemic stroke and TCM syndrome types,and summarize the characteristics of syndrome types,syndrome factors and related risk factors of nutritional status of stroke patients.In order to give a reference to TCM in prevention and treatment of clinical nutrition management of stroke disease.Methods:A cross-sectional study of 195 patients with ischemic stroke admitted to the department of encephalopathy,dongzhimen hospital,Beijing university of traditional Chinese medicine during the period of 2019.05-2020.01 was conducted.The nutritional risk assessment results,information of the four traditional Chinese medicine diagnosis,physical measurement data and clinical examination data of each patient were filled in the questionnaire,and then the questionnaire contents were entered into Epidata3.1 version by two researchers back to back to ensure the accuracy of the data.We used SPSS23.0 to analyze the correlation between factors and nutritional risk of ischemic stroke,the factors including TCM syndromes,characteristics of syndrome types,age,gender,disease stage,combined diseases,laboratory indicators,responsible lesionsResults:1.Statistics of TCM syndrome factors and syndrome types:Among the 195 patients,2 cases which were grouped by single syndrome factor were phlegm-dampness syndrome and blood stasis syndrome.There were 84 cases of syndrome types grouped by two syndrome factors,the majority syndrome types including 24 cases of phlegm-dampness and blood-stasis syndrome,13 cases of phlegm-dampness and internal-fire syndrome,13 cases of phlegm-dampness and qi-deficiency syndrome,and 8 cases of phlegm-dampness and internal-wind syndrome.There were 90 cases of syndrome types grouped by three syndrome factors,the majority syndrome types including 20 cases of internal-wind and phlegm-dampness and blood-stasis syndrome,16 cases of phlegm-dampness and internal-fire and blood-stasis syndrome,15 cases of internal-wind and phlegm-dampness and internal-fire syndrome.There were 18 cases grouped by four syndrome factors,including 8 cases of internal-wind and phlegm-dampness and internal-fire and blood-stasis syndrome,3 cases of internal-fire and qi-deficiency and blood-stasis and phlegm-dampness syndrome.There was one case grouped by five syndrome factors which was internal-wind and phlegm-dampness and internal-fire and blood-stasis and qi-deficiency syndrome.The occurrence frequency of a single syndrome factor was statistically analyzed,including 116 cases of blood-stasis syndrome factor,156 cases of phlegm-dampness syndrome factor,81 cases of internal-fire syndrome factor,70 cases of internal-wind syndrome factor,56 cases of qi-deficiency syndrome factor,and 38 cases of Yin-deficiency syndrome factor.Yin-deficiency has statistical significance with nutritional risk.2.Nutrition statistics:The screening results of NRS2002 showed 120 patients with nutritional risk,the majority syndrome types of which were grouped by two or three syndrome factors.The nutritional risk group includes 16 cases of phlegm-dampness and blood stasis syndrome,9 cases of phlegm-dampness and internal-fire and blood stasis syndrome,8 cases of phlegm-dampness and internal-fire syndrome,8 cases of internal-wind and phlegm-dampness and internal-fire syndrome,and so on.According to the stratification of albumin level,64 patients suffered from malnutrition,including 9 cases of phlegm-dampness and internal-fire and blood-stasis syndrome,6 cases of Yin-deficiency and blood-stasis syndrome,6 cases of phlegm-dampness and qi-deficiency syndrome,4 cases of phlegm-dampness and internal-fire syndrome.According to the results of body mass index stratification,1 case of emaciated patients was phlegm-dampness and internal-fire and blood stasis syndrome,and 58 cases of overweight patients included 9 cases of internal-wind and phlegm-dampness and blood stasis syndrome,7 cases of phlegm-dampness and blood stasis syndrome,6 cases of phlegm-dampness and internal-fire syndrome,and 5 cases of phlegm-dampness and qi-deficiency syndrome.There were 5 obese patients.According to the stratification of waist circumference,108 patients were abdominal obesity,including 83 males and 25 females.Among of the femals,4 patients were with internal-wind and phlegm-dampness and blood stasis syndrome,3 patients were with phlegm-dampness and qi-deficiency and blood stasis syndrome.Among of the males,13 cases were with phlegm-dampness and blood stasis syndrome,9 cases with intenal-wind and phlegm-dampness and blood stasis syndrome,7 cases with internal-wind and phlegm-dampness and internal-fire syndrome,8 cases with phlegm-dampness and internal-fire syndrome.Among the six syndrome factors,only Yin-deficiency syndrome factors and malnutrition were statistically significant3.Results of single factor analysis of nutritional risk:To analyze age,sex,stroke frequency,stroke phase,body mass index,waist circumference,stroke symptoms,the frequency of the syndrome factors,hypertension history,diabetes history,coronary heart disease history,atrial fibrillation history,hyperlipidemia history,and high homocysteine history,medical history,smoking history,drinking history and responsibility of stroke,the content of hemoglobin,the red blood cell count,lymphocyte count,albumin with nutritional risk,P<0.05 was statistically significant.The results showed that gender,age,history of coronary heart disease,history of atrial fibrillation,history of smoking,history of alcohol consumption,Yin-deficiency syndrome factor,dysphagia,numbness of limbs,peeling off of moss,hemoglobin content,red blood cell count,albumin,these indicators P<0.05 were statistically significant.4.Nutritional risk multivariable Logistic regression analysis results:Age,dysphagia,hemoglobin content are the independent factors of stroke nutritional risk(P<0.05).Low hemoglobin content is a bad factor.Every increasing 1 year old,the possibility of ischemic stroke with nutritional risk increased 1.103 times.At the same time,nutritional risk of ischemic stroke with dysphagia is 4.833 times of nutritional risk ischemic patients without dysphagia.Conclusion:1.The ratio of nutritional risk in 195 hospitalized patients with ischemic stroke was 61.53%,the ratio of malnutrition was 32.82%stratified according to the albumin content.The proportion of patients with abdominal obesity was 55.38%,and the majority of patients with abdominal obesity were males.2.In 195 patients,the majority syndrome types of them were grouped by two or three syndrome factors.The syndrome types of malnutrition patients mainly included phlegm-dampness and internal-fire and blood stasis syndrome,phlegm-dampness and qi-deficiency syndrome,Yin-deficiency and blood stasis syndrome,phlegm-dampness and internal-fire syndrome;The majority of overweight patients mainly included internal-wind and phlegm-dampness and blood stasis syndrome,phlegm-dampness and blood stasis syndrome,phlegm-dampness and internal-fire syndrome.The majority of abdominal obesity in women were internal-wind and phlegm-dampness and blood stasis syndrome,phlegm-dampness and qi-deficiency and blood stasis syndrome,while the majority of abdominal obesity in men were phlegm-dampness and blood stasis syndrome,inner-wind and phlegm-dampness and internal-fire syndrome,inner-wind and phlegm-dampness and blood stasis syndrome,phlegm-dampness and internal-fire syndrome.Among the six syndrome factors,only Yin-deficiency syndrome factor had statistical significance in the nutritional risk statistics.3.Age,dysphagia,hemoglobin content are independent factors of stroke nutritional risk.Low hemoglobin content is a bad factor.Every increasing 1 year old,the possibility of ischemic stroke patients with nutritional risk increased 1.103 times.Ischemic stroke patients with dysphagia have nutritional risk probability is 4.833 times of ischemic stroke patients without dysphagia.