| ObjectiveTo investigate TCM (traditional Chinese medicine) physical type in atherosclerotic cerebral infarction patients, to study the relationship of TCM physique and stroke risk factors, and simultaneously analyse the correlation between TCM constitution and common carotid artery IMT and carotid plaques. To explore new way for prevention and treatment of stroke from the perspective of TCM physique.MethodsPhysical questionnaires were used to survey276patients with ischemic stroke hospitalized in neurological department one, two and three of Guang Dong Province Hospital of TCM and constitutions were diagnosed based on "classification and decision of the constitution of TCM(ZYYXH/T157-2009)". Using Logistic regression analysis to analyse the relationship between constitution and risk factors of stroke, Intima-media thickness of common. carotid artery, and carotid plaques.Results1. The study included276cases, basic gentle quality186cases (67.4%), phlegmy-wet-tendency constitution129cases (46.7%),blood stasis qualitative tendency111cases (40.2%), the qi-deficiency qualitative tendency50cases (18.1%), yin qualitative tendency25cases (9.1%), yang deficiency qualitative tendency17cases (6.2%), normal constitution16cases (15.8%),qi deficiency14cases (5.1%), qi depression tendency14cases (5.1%), phlegmy wet constitution12cases (4.3%), blood stasis constitution11cases (4.0%), yang deficiency6cases (2.2%), qi depression6cases (2.2%), yin deficiency4cases (1.4%), special intrinsic constitution tendency2cases (0.7%), damp and hot qualitative tendency1case (0.4%); During them, there were45cases with single quality, main in gentle quality;175cases with two combined constitutions, main in basic gentle quality combined phlegmy-wet-tendency and clamp and basic gentle quality combined blood stasis qualitative tendency;39cases with three combined constitutions;10cases with four combined constitutions;6cases with five combined constitutions;1case with six combined constitution.2. Correlation of physical types and risk factors of stroke:②The single factor analysis of basic gentle quality with stroke risk factors showed that P values of age, hypertension were less than0.05, having a statistical significance, suggesting its association with basic gentle constitution. Put all the factors influencing stroke into the binary Logistic regression analysis of basic gentle constitution. The results showed that age OR (95%CI)=0.923(0.895,0.952) hypertension OR (95%CI)=0.413(0.183,0.930), smoking OR (95%CI)=0.396(0.185,0.847), male OR (95%CI)=2.122(1.035,4.352), suggesting age, hypertension, smoking were basic gentle constitution’s negative factors, male was positive to basic gentle constitution.②The single factor analysis of qi deficiency combined its qualitative tendency with risk factors of stroke showed that age and atrial fibrillation or valvular heart disease had a statistical significance(P<0.05), suggesting they were associated with qi deficiency combined its qualitative tendency Put all the factors influencing stroke into the binary Logistic regression analysis of qi deficiency combined its tendency. The results showed that age OR (95%CI)=1.059(1.027,1.093), suggesting age was positive to qi deficiency combined its qualitative tendency.③The single factor analysis of phlegmy wet mass combined its tendency constitution with risk factors of stroke showed that age, acute stroke phase had a statistical significance (P<0.05), suggesting they were relateded to phlegmy wet mass combined its tendency constitution. Put all the factors influencing stroke into the binary Logistic regression analysis of phlegmy wet mass combined its tendency, the results showed that age OR (95%CI)=0.974(0.950,0.998), acute stroke phase OR (95%CI)=1.725(1.244,2.390), suggesting age was a negative factor and acute stroke phase was a positive factor to phlegmy wet mass combined its tendency constitution. ④The single factor analysis of blood stasis and its qualitative tendency with stroke risk factors showed that age had a statistical significance (P <0.05), suggesting it was relevant, to blood stasis and its qualitative tendency. Put all the factors influencing stroke into the binary Logistic regression analysis of blood stasis and its tendency constitution, the results showed that age OR (95%CI)=1.141(1.102,1.181), suggesting age was positive to blood stasis and its qualitative tendency.⑤The single factor analysis of basic gentle quality combined phlegm wet mass tendency with stroke risk factors showed that age had a statistical significance (P<0.05), suggesting it was relevant to basic gentle quality combined phlegm wet mass tendency. Put all the factors influencing stroke into the binary Logistic regression analysis of basic gentle quality combined phlegm wet mass tendency, the results showed that age OR (95%CI)=0.897(0.865,0.931), acute stroke phase OR (95%CI)=1.539(1.031,2.295), suggesting age was negative to basic gentle quality combined phlegm wet mass tendency, acute stroke phase was positive to basic gentle quality combined phlegm wet mass tendency.⑥The single factor analysis of basic gentle quality combined blood stasis quality tendency with stroke risk factors showed that no stroke risk factors had a statistical significance Put all the factors influencing stroke into the binary Logistic regression analysis of basic gentle quality combined blood stasis quality tendency, the results showed that smoking OR (95%CI)=0.399(0.161,0.990), suggesting smoking was negative to basic gentle quality combined blood stasis quality tendency.3. Correlation of physical types and common carotid artery IMT and carotid artery plaque:①The single factor analysis of common carotid artery IMT-thickening showed that age, acute stroke phase, triglyceride, secondary stroke, coronary heart disease and hypertension had a statistical significance (P<0.05), suggesting they were associated with common carotid artery IMT-thickening; Put the researched physiques respectively into the binary Logistic regression analysis of common carotid artery IMT-thickening as a variable, and the variables were adjusted twice, first the statistical significant variables of common carotid artery IMT-thickening, second the variables that had an effect on plaques from the medical angle. The results showed that the studied constitutions weren’t related to common carotid artery IMT-thickening.②The single factor analysis of carotid plaques showed that age, triglyceride, secondary stroke, and hypertetion had a statistical significance (P<0.05), suggesting they were relevant to carotid plaques. Put the researched physiques respectively into the binary Logistic regression analysis of carotid plaques as a variable, and the variables were adjusted twice, first the statistical significant variables of carotid plaques, second the variables that had an effect on plaques from the medical angle. The results showed that the studied constitutions weren’t related to carotid plaques.②The single factor analysis of strong echo plaques showed that triglyceride, low density lipoprotein cholesterol, gender, age and coronary heart disease had a statistical significance(P<0.05), suggesting they were related to the strong echo plaques. Put the researched physiques respectively into the binary Logistic regression analysis of the strong echo plaques as a variable, and the variables were adjusted twice, first the statistical significant variables of the strong echo plaques, second the variables that had an effect on plaque from medical angle. The results showed that the studied constitutions weren’t related to strong echo plaques.③The single factor analysis of equal echo plaques showed that the factors that may affect the plaques from the medical angle had no statistical significance. Put the researched physiques respectively into the binary Logistic regression analysis of the equal echo plaques as a variable, and adjusted the variables that may affect the plaques. The results showed that the studied constitutions weren’t related to equal echo plaques.④The single factor analysis of low echo plaques showed that total cholesterol and low density lipoprotein cholesterol, had a statistical significance (P<0.05), suggesting they were relevant to the low echo plaques. Put the researched physiques respectively into the binary Logistic regression analysis of the low echo plaques as a variable, and the variables were adjusted twice, first the statistical significant variables of the low echo plaques, second the variables that had an effect on plaque from the medical angle. The results showed that blood stasis quality combined its tendency was negative to low echo plaques, the rest weren’t related to low echo plaques.⑤The single factor analysis of mixed echo plaques showed that age, acute stroke phase, triglyceride,, secondary stroke and coronary heart disease had a statistical significance (P<0.05), suggesting they were associated with the mixed echo plaques. Put the researched physiques respectively into the binary Logistic regression analysis of the mixed echo plaques as a variable, and the variables were adjusted twice, first the statistical significant variables of the mixed echo plaques, second the variables that had an effect on plaque from medical angle. The results showed that the studied constitutions weren’t related to mixed echo plaques.Conclusions1. Distribution of physical types with cerebral infarction was main in basic gentle quality, phlegmy wet quality tendency, blood stasis quality tendency and qi deficiency communication tendency; Main in combined constitutions, the most was basic gentle quality combined phlegmy wet tendency.2. The stroke risk factors associated with the researched TCM constitution was age, gender, hypertension and smoking. Older patients with cerebral infarction had smaller possibility of basic calm constitution, phlegmy wet mass combined its tendency, and basic gentle quality combined phlegm wet mass tendency, greater possibility of qi deficiency combined its tendency and blood stasis quality combined its tendency; The probability of being basic calm quality and basic gentle quality combined blood stasis quality tendency with smoking in cerebral infarction patients was about60%lower than those without smoking; The probability of being basic calm quality with hypertension in cerebral infarction patients was still about60%lower than those without hypertension history; Male in cerebral infarction patients was2.122times of female to be basic calm quality.3. The analysis results was not found the researched constitutions were associated with carotid artery IMT; The probability of having low echo plaques with blood stasis combined its quality tendency in cerebral infarction patients was60%lower than those without blood stasis combined its quality tendency in cerebral infarction patients. |
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