The Relationship Between Traditional Chinese Medicine Syndrome Types Of Ischemic Stroke And Blood Glucose Levels

Objective:Cerebral apoplexy, which is so-called stroke, refers to patients with cerebrovascular disease who break out acute cerebral blood circulation obstacle because of brain artery stenosis, occlusion or rupture that caused by various factors. In clinical, stroke can be divided into ischemic cerebral apoplexy and hemorrhagic cerebral apoplexy. According to clinical observation, the proportion of ischemic stroke in cerebral apoplexy is much higher than that of hemorrhagic stroke. And diabetes complicated with ischemic stroke is on the rise year by year, as the main complication and disabling reason of diabetes, ischemic stroke seriously affected the quality of people’s life and even threaten people’s lives. Our research aims to study the distribution characteristics of ischemic cerebral apoplexy and the relationship between every TCM syndrome type and blood glucose levels on the basis of TCM syndrome differentiation and treatment through investigation into relations between different blood glucose levels and ischemic stroke, thus we may provide corresponding basis for the clinical classification of ischemic cerebral apoplexy syndrome differentiation.Method:Retrospective study method is used in this study. According to diagnostic criteria for various kinds of cerebrovascular disease diagnostic essentials that formulated in the fourth national cereborvascular disease conference in 1996 and stroke diagnosis and curative effect evaluation standard(the second generation standard) that was drawn up by the state administration of traditional Chinese medicine encephalopathy emergency scientific research collaboration and the national science and technology commission research project 85-919-02-01 stroke study and clinical diagnosis of apoplexy syndrome in TCM research group. And all patients were hospitalized in rehabilitation department at Second Affiliated Hospital of Dalian Medical University between June 2013 and July 2014. Differentiate the syndrome types of all patients, and measure the fasting blood glucose and postprandial 2 hours blood glucose levels of each patient, then the corresponding relation of each syndrome type and blood glucose levels is analyzed. Log the data and analyze data through SPSS 19.0 statistical analysis software.Result:1.According to the syndrome types, we classify all the patients into seven types: phlegm heat, qi deficiency-blood stasis, wind-phlegm-fire, wind-fire disturbance, phlegm-wet hoodwink god, wind-phlegm-blood stasis and yin deficiency. The general characteristics of patients in the seven groups are compared, there was no statistically significant difference(p>0.05).2.the distribution trend of each TCM syndrome type is compared, the result shows that qi deficiency-blood stasis(30.00%)> yin deficiency(21.33%)> phlegm heat(18.67%)> wind-phlegm-blood stasis(10.67%)> wind-phlegm-fire(8.00%)> wind-fire disturbance(6.67%)> phlegm-wet hoodwink god(4.67%).3. Among the 150 patients with ischemic cerebral apoplexy, there are 90 patients combined with glucose abnormalities, which account for 60 percents of all the ischemic cerebral apoplexy patients. After the classification of TCM syndrome type, we get the distribution rule: qi deficiency-blood stasis(28.89%)> phlegm heat(24.44%)> yin deficiency(13.33%)> wind-fire disturbance(11.11%)> wind-phlegm-fire(8.89%)> wind-phlegm-blood stasis(7.78%)> phlegm-wet hoodwink god(5.56%)。In which qi deficiency-blood stasis accounts for a large proportion, and phlegm-wet hoodwink god accounts for the least proportion.4.Fasting blood glucose level and postprandial 2 hours blood glucose levels of all patients are measured, according to the blood glucose levels, we divide the patients into four conditions: normal(fasting glucose <6.1mmol/L, and postprandial 2 hours blood glucose levels<7.8mmol/L),impaired fasting glucose(IFG)( fasting glucose levels range from 6.1mmol/L to 7.0mmol/L, and postprandial 2 hours blood glucose levels<7.8mmol/L),impaired glucose tolerance(IGT)(fasting glucose <6.1mmol/L, and postprandial 2 hours blood glucose levels range from 7.8mmol/L to 11.1mmol/L),and diabetes mellitus(fasting glucose >7.0mmol/L, and postprandial 2 hours blood glucose levels>11.1mmol/L). The corresponding relations of each blood glucose level and TCM syndrome type is analyzed, the result shows that of all the TCM syndrome types, phlegm heat is mainly dominating in diabetes mellitus, the next is qi deficiency-blood stasis, and yin deficiency accounts for the least proportion; qi deficiency-blood stasis is mainly dominating in impaired fasting glucose, the next is yin deficiency, and phlegm-wet hoodwink god accounts for the least proportion; yin deficiency is mainly dominating in impaired glucose tolerance, the next is qi deficiency-blood stasis, and phlegm-wet hoodwink god accounts for the least proportion.Conclusion:1.the distribution of TCM syndrome type in ischemic stroke is qi deficiency-blood stasis> yin deficiency> phlegm heat> wind-phlegm-blood stasis> wind-phlegm-fire> wind-fire disturbance> phlegm-wet hoodwink god.2.the ischemic stroke patients complicated with diabetes mellitus has a large proportion of phlegm heat in TCM syndrome types, and ischemic stroke patients complicated with impaired fasting glucose(IFG) and impaired glucose tolerance(IGT) has a large proportion of qi deficiency-blood stasis and yin deficiency respectively.3.according to the results above, we can make up some advices in clinic medicine, for the ischemic stroke patients with comorbid diabetes mellitus, we can appropriately add some heat-clearing and phlegm-resolving prescription based on TCM discrimination; as to ischemic stroke patients with comorbid impaired fasting glucose, we can appropriately add some buqi huoxue prescription based on TCM discrimination; for ischemic stroke patients with comorbid impaired glucose tolerance, we can appropriately add some prescription which can tonify the liver and kidney based on TCM discrimination.