Study On Correlations Between TCM Syndromes In Stroke And Cerebrovascular Stenosis

ObjectiveOccurrence of ischemic stroke is closely related to vascular stenosis. Digital subtraction angiography (DSA) is the golden standard for judging of cerebrovascular stenosis, which performs accurate measurement of the stenosis and provides basis for therapeutic schedules followed. Pathogenesis of stroke is complex with rapid progression, and the four traditional diagnostic methods of observation, auscultation and olfaction, inquiry and pulse diagnosis are of strong subjectivity. By concluding and analyzing the correlations between TCM syndrome classification and the displaying of cerebrovascular stenosis by Digital subtraction angiography (DSA), relations between cerebrovascular stenosis and TCM syndromes are preliminarily summarized in this project, and on the basis of objective imaging evaluation, rules between cerebrovascular stenosis and various TCM syndromes are explored. All these provides basis for treatment and prevention regarding patients of ischemic stroke with cerebrovascular stenosis.MethodOn the basis of inclusion criteria and exclusion criteria,120patients were selected from the inpatients in the Rehabilitation Department of Hospital of Traditional Chinese Medicine of Zhongshan.The included patients are scored base on the diagnostic criteria of TCM syndrome, upon results of which TCM syndrome classification is performed among the patients; then digital subtraction angiography is performed and analysis for degree and location of vascular stenosis is made after operation. The data is recorded for statistical treatment and the conclusion is reached. Statistical data are analyzed using SPSS19.0. Cases like distribution of syndromes and stenosis are analyzed using descriptive analysis; while enumeration data is tested using χ2tests.Results①By analyzing the included patients in this study, the average age of the120patients is58.7±9.6, with mainly middle-aged patients, among which there are76males and44females. Amount of patients with a smoking history is73, accounting for60.8percent of the entire patients; Amount of patients with a history of hypertensive disease is98, accounting for81.7percent of the entire patients; Amount of patients associated with hyperlipoidemia is49, accounting for40.8percent of the entire patients; and amount of patients with a history of stroke is18, accounting for15percent of the entire patients.②Percentages occupied by frequencies of occurrence of TCM syndromes among the120patients, in order from high to low, are that syndrome of deficiency>fire-heat syndrome> yin-deficiency and yang-predominance syndrome> phlegm syndrome> wind syndrome> syndrome of blood stasis. Analyzing the distribution of the syndromes, males are mainly with fire-heat syndrome, in total22males with fire-heat syndrome and18males each with yin-deficiency and yang-predominance syndrome and syndrome of deficiency; amount of females with syndrome of deficiency is13while females with phlegm syndrome is12.③Syndrome of deficiency usually occurs in anterior circulation cerebral infarction, with the amount of in total25patients, and then comes the phlegm syndrome, with15patients; While wind syndrome and fire-heat syndrome usually occurs in posterior circulation cerebral infarction, with the amount of in total34patients. There are statistical significances using chi-square test.④Syndrome of deficiency is mainly seen in vascular stenosis within anterior circulation, with the total amount of70branches; Yin-deficiency and yang-predominance syndrome and wind syndrome are mainly seen in vascular stenosis within posterior circulation, with the total amount of80branches; There are statistical significances using chi-square test (P<0.05).⑤Wind syndrome and phlegm syndrome are mainly with medium-degree stenosis, with the total amount of58branches; Yin-deficiency and yang-predominance syndrome and syndrome of deficiency are mainly with reflection of severe stenosis.⑥Statistical analysis is carried out for degrees of vascular stenosis among patients with anterior and posterior circulation infarction, and there is no statistically significant difference between degrees of vascular stenosis of patents with anterior and posterior circulation cerebral infarction(P>0.05).⑦There is homogeneous distribution of intracranial vascular stenosis(P>0.05); However, mild extracranial vascular stenosis has a large proportion, with the amount of84branches (P<0.05). It shows that extracranial vascular stenosis mainly occurs with mild degrees. There is no significant difference between degrees of intracranial vascular stenosis.⑧The amounts of intracranial and extracranial vascular stenosis of patients with cerebral infarction in different regions are counted and no statistical difference is found between the amounts of intracranial and extracranial vascular stenosis of patients with anterior circulation cerebral infarction. However, posterior circulation cerebral infarction is mainly with intracranial vascular stenosis, with no statistical significance (P<0.05).Conclusion(DPatients of ischemic stroke with cerebrovascular stenosis are mainly middle-aged and old people; Among all the patients, males are mainly with a history of smoking and hypertensive disease and with mainly the fire-heat syndrome; females are mainly with a medical history of disease associated with diabetes and with mainly syndrome of deficiency and phlegm syndrome.②Syndrome of deficiency mainly occurs in anterior circulation cerebral infarction and then comes the phlegm syndrome; Wind syndrome and fire-heat syndrome usually occurs in posterior circulation cerebral infarction. Wind syndrome and phlegm syndrome are mainly with medium-degree stenosis, while yin-deficiency and yang-predominance syndrome and syndrome of deficiency are with reflection of severe stenosis.③Patients with anterior circulation cerebral infarction are mainly of mild and medium-degree vascular stenosis; There is no statistical difference between the amounts of intracranial and extracranial vascular stenosis within anterior circulation cerebral infarction; posterior circulation cerebral infarction is mainly with intracranial vascular stenosis.④There is no significant difference between degrees of intracranial vascular stenosis, and extracranial vascular stenosis are mainly with mild degrees.