Diabetes Stroke And Non-diabetic Stroke Tcm Syndromes Control Study

Stroke features with acute onset, severe condition and rapid change, therefore, the accurate and dynamic evaluation of condition are particularly important. Western medicine often clinically uses the recognized and mature scale as the guideline to objectively evaluate the default of neurological function, for the diagnosis of syndrome characterized by high specificity and sensitivity in traditional Chinese medicine," diagnostic criteria of stroke syndrome," in which the six syndromes such as the wind, fire, phlegm, blood stasis, qi deficiency,and yin deficiency with yang hyperactivity are evaluated by collected the information about the four diagnostic methods (inspection, listening and smelling examination, inquiry, palpation), from the overall concept, determines the pathogenesis and reason of disease, which is widely used in the traditional Chinese medicine in China. Stroke is a complication of Diabetes, with stroke the incidence of Diabetes is increased, the incidence of combined Diabetes and strokeis also increased, in recent years some literatures have presented the concept of "Diabetes Stroke". Rightnow, the type and regularity of Diabetestroke in Chinese Medicine are still lack of systematic researches, and it is still uncertain whether the syndrome elements has any relationship with those aspects such as the degree of neurological deficit, blood glucose and blood lipids,etc.Object:Discuss the frequency distribution and dynamic changes of scores of acute syndrome elements of Diabetes stroke and non-diabetes stroke, as well as the relationship between those syndrome elements and the degree of neurological deficit, blood glucose, and lipids,etc.Methods:Prospective study on 88 patients of acute stroke in Eastern hospital from October 2009 to February 2010. According to "Guide of Prevention and Treatment of type 2 diabetes in China", the diabetic group and non-diabetic group were divided, collected the related information such as the TCM syndrome evaluated scores on the day of admission,7 days after onset,14 days after onset,28 days after onset to evaluate, as well as the information about fasting blood glucose, blood lipids, and imaging, etc, and then which would be evaluated by the U.S. National Institutes of Health Stroke Scale (NIHSS), routine life activity scale (ADL), Rankin Scale revised (MRS),using the SPSS 13.0 software for statistical analysis.Results:①syndrome diagnosis:the syndrome type distribution of diabetic group and non-diabetic group was mainly consist of the wind phlegm with excessive fire and the mental confusion causing by wind fire, the frequency distribution of the stirring of wind due to deficiency of YIN in diabetes group was higher than non-diabetic group's. However, the distribution of those seven syndrome types had no significant difference.②Analysises of syndrome elements:the frequency distribution of stirring of wind due to deficiency of YIN on 7 days after onset,14 days after onset,28 days after onset were significantly different, but only on 28 days after onset the scores of syndrome elements would be significantly different. The frequency distribution of phlegm would have significant difference on 28 days after onset. The frequency distribution and scores of wind syndrome in both groups would have significant difference on those four periods, the frequency distribution of phlegm syndrome in the diabetes group would have significant difference on those four periods,the scores of syndrome elements of blood stasis syndrome in both groups would have significant difference on those four periods.③Western scale:comparing the evaluated score of NIHSS on the day of admission and 28 days after onset in non-diabetic group, the significant different would be found, while the NIHSS scores of those four periods in diabetic had no significant difference. The element score of hot syndrome in diabetic group have linearly correlated with the NIHSS score on 7 days after onset and 14 days after onset, while the element score of phlegm and qi deficiency syndrome have linearly correlated with the NIHSS score on 14 days after onset.The element scores of wind syndrome and hot syndrome in non-diabetic group have linearly correlated with the NIHSS score on three periods, while the score of qi deficiency syndrome have linearly correlated with the NIHSS score on the day of admission.④Physical and chemical examination:the elemet scores of hot syndrome on the admission day and 7 days after onset, as well as the yin deficiency with yang hyperactivity on 28 days after onset, have linearly corralated with fasting blood glucose, the brainstem was the the responsibe lesion in diabetes group, whose incidence rate was higher than non-diabetic group's, and there was significant difference.Conclusion:The element frequency distribution and scores of the stirring of wind due to deficiency of YIN in both groups were significant different on 28 days after onset, the score of the NIHSS on the day of admission was sinigicant different to the score of 28 days after onset in non-diabetic group, the brainstem was the the responsibe lesion in diabetes group, whose incidence rate was higher than non-diabetic group's, and there was significant difference.