Post-stroke Depression Syndrome And Pathology Of Acquisition And Analysis

Objective:This study was designed to investigate syndrome distribution and pathogenesis of PSD,thus providing theoretical basis for syndrome differentiation and clinical treatments.Methods:From February in2012to February in2014,200suitable cases were selected at the neurology outpatient and ward department in Dongzhimen Hospital.The general information and syndromes of the four diagnostic material of patient were investigated,as well as HAMD scores,ADL scores and NIHSS scores.All of the four diagnostic information was analyzed by frequency analysis with SPSS19.0.The symptoms with frequency of less than3%were excluded. Based on hierarchical cluster analysis performed on the other symptoms,The TCM syndromes of PSD were summarized according to clinical practice.The principal component analysis was used to identify the main symptoms of each syndrome.Finally,investigate the distribution of each TCM syndrome among the PSD patients.Results:1.The general information:Of all the200PSD patients included in this study,96were men and104were women,which made the the male-to-female ratio1:1.08.The average age was69.09±9.22years.14.0%patients was under the age of60;78.0%was between60and80;8.0%was over80.According to the frequency analysis,the top10symptoms,in declining order,were spiritlessness and weakness (53.0%),hypomnesia (37.0%),indifference (35.0%),dizziness (31.0%),soreness and heaviness of limbs (28.0%),fixed pain (26.5%),dim complexion (26.0%),retardation of thinking (24.5%),sallow complexion (24.0%) and reticence (23.0%).Dim tongue (36.5%) and pale tongue (36.0%);yellow greasy fur (33.0%) and white greasy fur (22.5%);stringy pulse (47.0%) and slippery pulse (42.5%)were the top2tongue or pulse manifestation respectively.2.The results of cluster analysis and principal component analysis:According to hierarchical cluster analysis and principal component analysis,there were five cluster of syndrome as follows,①qi deficiency and phlegm-stasis syndrome (29.0%),main symptoms:spiritlessness and weakness,dizziness,dim complexion,dim lips,fixed pain,expectoration,tongue and pulse manifestation:dim tongue, ecchymosis on tongue,yellow greasy fur,deep pulse,slippery pulse secondary symptoms:disabled wilted limbs,lethargy;②deficiency of heart and spleen syndrome (25.5%),main symptoms:indifference,soreness and heaviness of limbs,sallow complexion;tongue and pulse manifestation:pale tongue,pink tongue,white greasy fur,thin white fur,stringy pulse,thready pulse;secondary symptoms:reticence,depression,emaciation, loose stool,abdominal distension;③deficiency of heart and spleen syndrome (17.5%),main symptoms:hypomnesia,retardation of thinking,pale complexion,anorexia,pale lips;tongue and pulse manifestation:plump tongue,teeth-printed tongue,weak pulse;secondary symptoms: spontaneous sweating,dreaminess,festless sleep,palpitation and skittishness,worrisome mood;④syndrome of stagnation of liver qi transforming into fire (15.0%),main symptoms: irritability,oppression in chest and suffocation;tongue and pulse manifestation:red tongue, wry tongue,thin yellow fur,excess pulse;secondary symptoms:dry mouth,constipation,bitter taste in mouth,hypochondriac pain and fullness,Preference for sighing;⑤syndrome of yin deficiency of liver and kidney (13.0%),main symptoms:difficulty in falling asleep,soreness and weakness of waist and knees,dysphoria with feverish sensation in chest, palms and soles, numbness of the limbs;tongue and pulse manifestation:thin tongue, less moss,rapid pulse; secondary symptoms:frequent urination at night,tidal fever,flush face,vexation,night sweating, dry throat,tinnitus and dry eyes.Conclusions:The main TCM syndromes include qi deficiency and phlegm-stasis syndrome, deficiency of heart and spleen syndrome,deficiency of heart and spleen syndrome,liver qi stagnation transforming into fire syndrome, liver and kidney yin deficiency syndrome.The nature of PSD is intermingled deficiency and excess,mainly based on deficiency. The location of PSD is related with liver, heart,spleen and kidney.The pathogenesis is especially related to liver dysfunction.Deficiency of zang-fu viscera is important pathologic basis; Phlegm,blood stasis and fire are primary pathological factors of PSD.