A Research On The Relationship Between Yin And Yang Syndrome Of Acute Ischemic Stroke And Carotid Artery Atherosclerosis

BackgroundCerebrovascular disease has the characteristic of high morbidity and high mortality. Carotid atherosclerosis is one of the most important risk factors of ischemic stroke.It is really meaningful in the clinical affairs if we can make the early diagnosis of the carotid artery intima-media thinking (IMT), carotid plaque and carotid artery stenosis through carotid ultrasonography.Object ivesTo find out the risk factors of the yin-yang syndrome differentiation of acute ishenmic stroke which can provide some preferable information of the yin-yang syndrome differentiation. Meanwhile,through the discuss about whether the carotid artery stenosis can influence the yin-yang syndrome differentiation, we hope some objective index can be used during the differentiation. Furthermore, the study discussed the relationship between the Carotid atherosclerosis and the occurrence, development and prognosis of the cerebral infarction.Methods1069 patients from the neurology department of Guangdong Provincial Hospital of Chinese Medicine diagnosed as the acute ischemic stroke were enrolled from Oct.2005 to Sep.2008.All the patients were diagnosed as yin or yang syndrome.And among the patients who had their ultrasound done during hospitalization,we collected the information of the carotid atherosclerosis,such as IMT, the shape and nature of the carotid artery atherosclerotic plaque, the degree of carotid artery stenosis and the hemodynamics.As for the evaluation, we used the NIHSS scale to evaluate the neurological deficit of the patients and we used chi square test and rank-sum test to explore the correlationship between Yin-Yang syndrome and the carotid atherosclerosis.At last, we applied multivariate analysis to analyze the risk fators of prognosis of acute ischemic strok.Results1 The study has showed that male, drinking and smoking patients tended to have yang syndrome while older ones tended to have yin syndrome. Through the binary logistic regression, we knew that male and smoking were the independently risk factors for Yang syndrome. Compared to yin syndrome, it seemed that the neurologic impairment of Yang syndrome patients were higher (P<0.05). The peak systolic velocity(PSV) of the internal carotid artery of Yang syndrome patients was slower. It showed that there was no correlation between Yin-Yang syndrome differentiation, the degree of the carotid atherosclerosis, and the nature of the carotid artery atherosclerotic plaque, neither the degree of carotid artery stenosis.2 The binary logistic regression showed that ageing, hypertension, smoking and drinking were all risk factors of carotid atherosclerosis. The incidence rate of carotid atherosclerosis, the occurrence of ischemic stroke, the intima-media thickness (IMT) thicking as well as the resistent index(RI) of the carotid artery are increasing while ageing. However, PSV is quite the contrary.3 The carotid atherosclerosis was often formed in the carotid bifurcation and it is often found that the PSV, RI and IMT are increasing in the local stenosis of the carotid artery.The patients whose carotid artery stenosis was severe always had the more serious neurological deficit and were more like to develop into progressive stroke compared to the mild ones.4 Yang syndrome, sroke history, infection during hospitalization and progressive stroke were important risk factors of poor prognosis in acute ischemic stroke.ConclusionThere is no correlationship between Yin and Yang syndrome differentiation and carotid artery atherosclerosis. However, the occurrence and development of carotid artery atherosclerosis are closed related with the occurrence,severity and prognosis of the ischemic stroke.