| Objective:Large sample epidemiological survey in patients with acute hemprrhagic stroke,and divide into two groups the meridians and the organs, observe the two groups difference in pathogenesis syndrome factor distribution,combination and dynamic evolvement rules.Compared the two groups differences in general stiuation,laboratory parameters,disease severity and prognosis.In order to deepen the understanding of the meridians,organs pathogenesis syndrome,and provides a new way of thinking the treatment of the acute phase of stroke.Method:The theoretical part of the systematic summary of the ancient physicians understanding of the classification of stroke. the meridians and the organs syndromes distribution,combination,evolution and the relationship between the two syndrome distribution with some related factors.Clinical study of800cases of hemorrhagic stroke in patients with acute symptoms of the performance of epidemiological investigations,in accordance with the relevant classification criteria,divided into meridians and organs.using of the"hemorrhagic stroke the acute phase pathogenesis syndrome factor diagnosis scale", each group of patients the pathogensis card prime diagnosis.Compared of two groups of disease distribution, combination and the dynamic evolution rules of the difference;Two groups were compared pathogenesis card distribution factors in age, previous history of stroke onset differences of therelevant factors; Two groups were compared in patients with differences in blood lipids,blood rheology,coagulation,cerebral hemorrhageparts,brain bleeding,brain edema and other laboratory parameters; The two groups were compare the prognosis of patients with diagnosis of stroke diagnosis score, Glasgow score (GOS), correction of RANKIN score difference.Result:Pathogenesis permit distribution of elements to the evolution of regulatiory rate: begin with two groups of pathogenesis syndrome factor distribution are Stagnant heat, hot in the first place,which in the meridian group Stagnant heat(74.6%),hot(64.5%),group of organs Stagnant heat(82.8%),hot(73.7%), this situation has continued to21days;in the meridian Blood stasis pathogenesis syndrome factor from the first days to the11days is always in the third world,and in the21days dropped to fourth place;Wind pathogenesis card factors in newly diagnosed in fourth place,in the3days dropped to sixth place, in the5days up to fifth place and maintained it until21days;group of orangs Wind pathogenesis card elements always remain in third place in the first11days,an dropped to fourth place in the21days; Blood stasis pathogenesis of the syndrome factor in the first three days in the fifth,the5days,7days dropped to sixth place,11days,21days up to fifth place again.With the illness progresses,the Qi deficiency proportion is gradually increased,Hot phlegm proportion gradually decreased and with Wet phlegm,yin staggered in the last three.Syndrom factor combination in the form of pathogenesis:the first visit,meridian group a combination of two cards,followed by three cards,four-cards combination;of viscera group is the combinantion of four cards,followed by five card,three card combination;11days of admission,the meridian group pathogenesis syndrome factor is becoming a single,mainly to the document,followed by the two cards,a combination of three certificates of viscer group pathogenesis card elements still and folders infestation,a combination of cards,followed by the documents,the combination of the three certificates;21days,meridians,organs group to document,followed by two card combination of the three certificates.Syndrome factor of two pathogenesis-related factors of stroke incidence:the elderly group patients with Stasis heat,Wind,Fire, Hot phlegm,Wet phlegm disease syndrome factor was significantly higher than that in meridian patients;The non-elderly group patients with Stagnant heat,Wind, Hot phlegm,Wet phlegm disease syndrome factor was significantly higher than that in meridian patients. Suggesting that Wind,Fire,Phlegm,Blood stasis is the maior pathological factors of the acute phase of hemorrhagic stroke,and regardless of age.Pathogenesis syndrome factor and compared with the past medical history, history of hypertension patients, the Wind,Fire, Hot phlegmy,Blood stasis syndrome factor appears rate is higher than in meridian group,suggesting that Wind, Fire, Wet phlegm,Blood stasis as a risk factor for hypertension; In patients with a history of diabetes, Qi deficiency appeared rate is higher than in meridian group,prompyed Qi deficiency and diabetes closely related;Coronary heart disease in history, the Wet phlegmy pathogenesis syndrome factor appear rate is higher than in meridian group, prompt phlegm is the important pathogenesis of coronary.Laboratory parameters:the two groups in blood lipids,coagulation,blood rheology laboratory parameters showed bo significant difference.The amount of bleeding, the bleeding site,the degree of cerebral edema:the basal ganglia,parts of the bleeding in meridian group than in the viscera group,and in organs in brain bleeding,brain edema was significantly heavier than in the meridian group.The degree of severity,and prognosis:the viscera group of stroke diagnosis,Glasgow score,the correction RANKIN score weie significantly higher than that in meridian group.Conclusion:In this study, clinical large sample epidemiologic survey shows that the pathogenesis of patients with acute hemorrhagic stroke midterm meridian,organs permit distribution are Stagnant heat, hot pathogenesis syndrome factor in the top bits. In the meridian acute period of Blood stasis,in viscer acute phase Windy;Qi deficiency is in the nature of the zang-fu organs and meridians of factors;Hot phlegmy, Wet phlegmy, Yin deficiency with the end,hard to be cured.Syndrome factor of two pathogenesis and folders mix of viscera group pathogenesis syndrome factor combination is more complexand changeable;the Stagnant heat and other diseases machine syndrome factor and folders combination throughout the diseasease has benn.The correlation between old age group organs in patients with Stagnant heat, Wind, Fire,Hot phlegmy, Wet phlegmy pathogenesis was significantly higher than that in meridian patients;organs in the non-elderly group of patients with Blood stasis, Wind, Hot phlegmy,Wet phlegmy disease syndrome factor was significantly higher than in meridian patients, prompted Wind, Fire,Phlegm,Blood stasis is the major pathological factors in the acute phase of hemorrhagic stroke,and have related to age,severity. Two groups of past medical history are in the majority in history of hypertension.The meridian group Stagnant heat, Hot phlegmy and Blood stasis,and a history of hypertension are closely related. And the Wind, Blood stasis in the group organs is closely related to the history of hypertension,Qi deficiency is closely related with the history of diabetes.No difference between the two groups in the lipids,coagulation,blood rheology laboratory indicators. The amount of the organs in patients with cerebral hemorrhage, cerebral edema is more important than in meridian patients, prompt brain bleeding, brain edema and the severity of disease superficial, deep, altered consciousness is closely related to. Basal ganglia, parts of the meridian group bleeding than in organs group, suggesting that the basal ganglia, parts of the bleeding were relatively light, less soul obstacle condition. Of viscera group of stroke diagnosis, Glasgow score, fix RANKIN score significantly higher than that in meridian group, suggesting that the organs in patients with severe illness and poor prognosis. |
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