Discussion On The Distribution Of Syndrome Types Of Traditional Chinese Medicine And The Law Of Traditional Chinese Medicine In 326 Cases Of Ischemic Stroke Sequelae

Objective: To investigate the distribution of TCM syndrome types in 326 patients with sequelae of ischemic stroke(apoplexy-middle meridian).Through data mining and analysis of traditional Chinese medicine prescriptions,the frequency of use of various drugs in the prescription,the nature and taste of the meridian and the drug cluster analysis were established to explore the law of traditional Chinese medicine in the treatment of ischemic stroke sequelae,in order to provide reference for the prevention and treatment of ischemic stroke sequelae.Methods: The clinical data of 326 patients with ischemic stroke sequelae from January 2020 to December 2022 were collected,such as gender,age,smoking history,drinking history,hypertension,diabetes,symptoms and signs,TCM syndrome types,TCM prescriptions,etc.At the same time,data mining was carried out on the prescription of traditional Chinese medicine for the treatment of sequelae of ischemic stroke,and the frequency analysis,cluster analysis and other methods were used to obtain the drug frequency,four gases and five flavors,meridian statistics,drug cluster combination,and high-frequency drugs of various syndrome types.Results: 1 In the study of cases with sequelae of ischemic stroke:male patients were more than female patients;Among them,227 were male patients,accounting for 69.6%,and 99 were female patients,accounting for 30.4%.The age is mainly between 61 and 70 years old.2 In the sequelae of ischemic stroke,Qi deficiency and blood stasis syndrome is the most common syndrome,of which 152 cases(46.6%)are Qi deficiency and blood stasis syndrome;70 cases(21.5%)of wind-phlegm obstruction syndrome;62 cases of wind-yang disturbance syndrome,accounting for 19%;22 cases(6.7%)of yin deficiency and wind movement syndrome;There were 20 cases of phlegm-heat syndrome,accounting for 6.1%.3 Among 326 patients with stroke sequelae included in this study,199 patients with hypertension,accounting for 61.0%;66 patients(20.3%)had diabetes;78 patients(23.9%)had a history of smoking;77 patients(23.6%)had a history of drinking.4 In this study,326 patients with sequelae of ischemic stroke were included for statistical analysis: there was no significant difference in the distribution of different TCM syndrome types in age(using one-way ANOVA results P>0.05);The results of multi-classification logistic regression analysis showed that gender had no effect on syndrome types of traditional Chinese medicine in patients with sequelae of ischemic stroke(P>0.05);The common combined risk factors(hypertension,diabetes,smoking history and drinking history)are not the influencing factors of TCM syndrome types of patients with ischemic stroke sequelae(P>0.05).5 Characteristics of traditional Chinese medicine:(1)The top 10 drugs with the highest frequency of use are ranked as follows: salvia miltiorrhiza,ligusticum chuanxiong,astragalus,angelica,panax notoginseng,peach kernel,licorice,codonopsis pilosula,caulis spatholobi,and mulberry branch.(2)Among the 326 prescriptions included in this study,warm drugs>mild drugs>cold drugs>cool drugs>hot drugs were used.(3)Use sweet medicine>bitter medicine>bitter medicine>sour medicine>salty medicine>mild medicine>astringent medicine.(4)Drugs for liver meridian>drugs for spleen meridian>drugs for heart meridian>drugs for lung meridian>drugs for stomach meridian>drugs for kidney meridian>drugs for gallbladder meridian>drugs for large intestine meridian>drugs for pericardium meridian>drugs for bladder meridian>drugs for triple energizer meridian>drugs for small intestine meridian.6 The drugs with the frequency of drug use in the top 10 for each TCM syndrome type:(1)Syndrome of wind and phlegm blocking collaterals: Pinellia ternate,orange peel,calamus,poria cocos,licorice,ginger,cinnamon twig,salvia miltiorrhiza,atractylodes lanceolata,hawthorn.(2)Syndrome of wind-yang disturbance: Gastrodia elata,Uncaria tenuifolia,Cassia chinensis,Morus parasiticus,Chrysanthemum,Lily,Dipsacus,Eupatorium adenophorum,Mulberry leaf,ochre.(3)Qi deficiency and blood stasis syndrome: astragalus,angelica,ligusticum chuanxiong,peach kernel,salvia miltiorrhiza,panax notoginseng,codonopsis pilosula,caulis spatholobi,mulberry branch,peony bark.(4)Phlegm-heat viscera syndrome: mirabilite,rhubarb,trichosanthes kirilowii,galanga,atractylodes macrocephala,pinellia,magnolia officinalis,fructus aurantii,amomum villosum,tangerine peel.(5)Yin deficiency and wind movement syndrome: oyster,white peony,achyranthes bidentata,keel,malt,ass hide glue,ophiopogon japonicus,turtle shell,rehmannia glutinosa,schisandra chinensis.Conclusion: 1 In the study of cases with sequelae of ischemic stroke:male patients are more than female patients;The age is mainly distributed among the elderly aged 61-70.The common risk factors were hypertension,diabetes,smoking and drinking history.2 The statistical analysis results of this study show that gender,age,hypertension,diabetes,smoking history and drinking history are not the influencing factors of TCM syndrome types of patients with ischemic stroke sequelae(P>0.05).3 In the sequelae stage of ischemic stroke,the disease location is mainly in the liver,and is closely related to the spleen and heart.4 The results showed that the pathological factors in the sequelae of ischemic stroke were mostly qi deficiency and blood stasis,with the characteristics of deficiency and excess.At the same time,wind and phlegm are also important pathological factors.5 The syndrome types of traditional Chinese medicine in the sequelae of ischemic stroke are qi deficiency and blood stasis syndrome and wind-phlegm obstruction syndrome,followed by wind-yang disturbance syndrome and yin-deficiency and wind-dynamic syndrome,and phlegm-heat syndrome is the least common.The traditional Chinese medicine treatment of Qi deficiency and blood stasis syndrome is characterized by the combination of invigorating qi and activating blood circulation drugs,and the consideration of both specimens;The treatment of wind-phlegm obstructing collaterals syndrome is mainly based on drugs for resolving phlegm and turbidity,supplemented by drugs for clearing blood vessels to strengthen the effect of eliminating wind and resolving phlegm;The characteristics of drugs used in the syndrome of wind-yang disturbance are the combination of drugs for cooling the liver and calming the liver and tonifying the kidney;Traditional Chinese medicine for the syndrome of yin deficiency and wind movement pays attention to benefiting yin and suppressing yang to strengthen water and contain wood;The drugs of phlegm-heat and fu-organ syndrome are mainly used to clear the fu-organ and reduce excess,and the drugs of clearing heat and resolving phlegm are supplemented.