| Objective: To explore the correlation between TCM syndromes and serum homocysteine(Homocysteine,Hsy)and uric acid(Uric acid,UA)levels in patients with large artery atherosclerotic(LAA)ischemic stroke in the acute phase,Provide objective diagnosis basis for TCM syndrome differentiation of LAA type ischemic stroke in acute phase,make TCM syndrome differentiation more objective and treatment more specific,and provide new ideas for clinical and scientific research of this disease;for UA,Hcy It is included in routine physical examination screening indicators for middle-aged and elderly people to provide clinical objective evidence;and is gradually widely used in primary prevention and secondary prevention of cerebral infarction,providing a theoretical basis for the prevention and treatment of cerebral infarction with integrated traditional Chinese and western medicine.Methods: This study collected 216 patients from the Department of Brain Diseases of the Hospital of Traditional Chinese Medicine in Inner Mongolia Autonomous Region(strictly following the inclusion and exclusion criteria).Comprehensive medical history,symptoms,signs and related indicators were used to determine the gender,age,and TCM syndrome types of the patients,and to perform statistics and analysis..Data analysis and processing are all carried out by SPSS19.0 statistical software.The measurement data that obeys the normal distribution is expressed as mean ±standard deviation(x±s),if not,it is expressed as the median(interquartile range).For the homogeneity of variance,it is decided to use F test or Kruskal-Wallis H test for comparison between multiple sets of data,and use two independent sample t test or t test for comparison between two sets of data;if it does not conform to the normal distribution and the variance is uneven,more Kruskal-Wallis H test was used to compare the data between the two groups,Mann-Whitney U test was used to compare the data between the two groups,and the qualitative data were expressed as rates or percentages.The chi-square test was used to compare the data between multiple groups.P<0.05 was considered statistically different.Results:(1)The gender ratio of patients with LAA ischemic stroke in the acute phase is 1.27:1,and the average age of onset is(69.92±10.59)years old.It occurs more often after 60 years old,and the high incidence age group is 60-89 years old.,The age group with the largest proportion is 60-69 years old,followed by 70-79 years old.(2)The best season for LAA-type ischemic stroke patients in the acute phase is winter(accounting for 30.1%),followed by autumn(accounting for 28.1%).(3)Apoplexy,phlegm and blood stasis syndrome,is the most common TCM syndrome in LAA-type ischemic stroke patients at the acute stage.The composition ratio of the syndrome types is(from large to small): Wind,phlegm and stasis syndrome(26.9%)> Qi deficiency and blood stasis syndrome(19.0%)>Yin deficiency and wind movement syndrome(15.7%)>Wind-fire upheaval syndrome(13.9%)>Phlegm-heat syndrome(12.5%)>Wind-phlegm-fire hyperactivity syndrome(12.0%).Among them,the relationship between medical syndrome type and age is statistically significant(P<0.05).Patients with Yin deficiency and wind movement syndrome are older than other syndrome types,with an average age of(73.53±8.61)years;while the average age of patients with phlegm-heat-fu organs is The age is(67.56±9.42)years old,which is lower than the age of patients with other syndromes;the distribution relationship between medical syndromes and gender is not statistically significant(P>0.05).(4)The analysis results of the Hcy data of various TCM syndrome types and patients showed that:①The Hcy value of Qi deficiency and blood stasis syndrome was compared with Yin deficiency wind movement syndrome,wind heat disturbance syndrome,wind phlegm stasis syndrome,and the difference was statistically significant(P<0.05);②Hcy value of wind-phlegm-fire hyperactivity syndrome was compared with wind-heat-upper disturbance syndrome,wind-phlegm-stasis syndrome, yin deficiency and wind-movement syndrome,and the difference was statistically significant(P<0.05);Comparing the Hcy values of phlegm-heat and fu-organs syndrome,wind-fire upheaval syndrome,wind-phlegm-stasis syndrome and yin-deficiency wind-movement syndrome,the difference was not statistically significant(P>0.05).The analysis results of the data of various TCM syndrome types and patients’ UA showed: F value=2.542,P value=0.029.①Comparison between the UA value of the syndrome of wind and fire upper disturbance and the syndrome of wind phlegm and blood stasis and phlegm-heat fu organs respectively,the difference was statistically significant(P<0.05);All were statistically significant(P<0.05);③There was no statistically significant difference in the UA values of wind-phlegm and fire hyperactivity syndrome,wind-fire upheaval syndrome,qi deficiency and blood stasis syndrome,and yin deficiency and wind-movement syndrome(P<0.05).(4)The analysis of the Hcy data of various TCM syndrome types and patients showed that:①The Hcy value of Qi deficiency and blood stasis syndrome was significantly different from Yin deficiency and wind movement syndrome,wind and fire disturbance syndrome,and wind phlegm and blood stasis syndrome.(P<0.05);②Hcy values of wind-phlegm and fire hyperactivity syndrome were significantly different from those of wind-heat-upper disturbance syndrome,wind-phlegm-stasis syndrome,yin deficiency and wind-movement syndrome,respectively(P<0.05);③wind There was no statistically significant difference between the syndrome of disturbance of fire,phlegm and blood stasis,and syndrome of phlegm-heat and fu-organs compared with the syndrome of yin deficiency and wind movement(P>0.05).The analysis results of the data of various TCM syndrome types and patients’ UA showed: F value=2.542,P value=0.029.①Comparing the UA value of the syndrome of wind and fire with the syndrome of wind phlegm and blood stasis and the syndrome of phlegm-heat and fu organs respectively,the difference was statistically significant(P<0.05);②There was no significant difference between the UA value of Qi deficiency and blood stasis syndrome and wind phlegm and blood stasis syndrome(P>0.05);③Comparing the syndromes of wind-phlegm and fire hyperactivity,wind-heat disturbance syndrome,qi deficiency and blood stasis syndrome,and yin-deficiency wind-movement syndrome,the differences were not statistically significant(P> 0.05).Conclusion:(1)In this study,LAA ischemic stroke patients in the acute phase are more likely to develop after the age of 60,and the age group with the highest incidence is60-89 years old,of which the most significant age group is 60-69 years old,followed by 70-79 years old.(2)In this study,there is no obvious correlation between the TCM syndrome types of different genders of this disease.Wind,phlegm and blood stasis syndrome accounts for the highest proportion of TCM syndrome types in both male and female patients,considering the environment,diet,and physical fitness.Bias related.(3)In this study,the high incidence of LAA-type ischemic stroke patients in the acute phase was autumn and winter.(4)In this study,the most common TCM syndrome of LAA-type ischemic stroke patients in the acute phase was wind phlegm and blood stasis syndrome,followed by(in order)Qi deficiency and blood stasis syndrome,Yin deficiency and wind movement syndrome,wind and fire Upper disturbance syndrome,phlegm-heat and fu-organ syndrome and wind-phlegm-fire hyperactivity syndrome.(5)In this study,the TCM syndromes of LAA type ischemic stroke in the acute phase are closely related to serum Hcy and UA levels.Serum Hcy levels are elevated,which is considered to be related to blood stasis,phlegm fire,and qi deficiency.The increase of UA level may be related to fire and wind pathogens,so both of them can be an objective quantitative basis for TCM syndrome differentiation. |
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