Study On Traditional Chinese Medicine Diagnosis Of Subarachnoid Hemorrhage

Objective:To investigate the diagnosis of subarachnoid hemorrhage in patients with traditional Chinese medicine.Methods:1.Patients were selected who were diagnosed as subarachnoid hemorrhage according to "Diagnosis Points of All Kinds of Cerebrovascular Diseases" and who were hospitalized at Department of Neurosurgery, Department of Neurology, Department of Traditional Chinese Medicine and Department of Rehabilitation Medicine, the First Affiliated Hospital of Guangxi Medical University, and the retrospective analysis was carried out. According to the "stroke diagnosis and curative effect evaluation standard" established in 1996, the diagnosis of stroke in Chinese medicine was carried out, and the patients who did not meet the criteria of diagnosis were tried to diagnose the disease. At the same time, the collection of subarachnoid hemorrhage patients with head imaging data. According to lesion location, the volume of hemorrhage and cerebral vessels, we combined with clinical manifestations, Hunt-Hess grade, Fisher grade, Glasgow Coma Scale (GCS) and World Federation of neurosurgery grading to investigate the relationship between the grade and the TCM stroke disease diagnosis.2. By using traditional literature research methods of "Distinguishing the Academy of the Chapter; Examining the Mirror Source and Course",we collected the essays on stroke about clinical manifestations, etiology and pathogenesis from Neijing times to the period of the Republic of China, sorted out and analyzed them, analyzed the development of stroke history and summarized the concept of stroke. Compared with the discussion of stroke from contemporary different versions of Chinese internal medicine textbooks to authoritative Chinese medicine monographs in order to clear the connotation of stroke.Results:1. There were 302 eligible patients who must over the age of 18 or older with subarachnoid hemorrhage in total, of which 160 were male (53%), of which 142 were female (47%), and the gender ratio was: 1.127:1. Ages ranged from 19 years to 84 years, mean age was 53.94±13.886 years. The mean age of the male was 52.82±14.666 years, and the female was 55.2±12.888 years.2. Among all these patients with subarachnoid hemorrhage,33 of them met the diagnostic criteria of stroke while 269 didn’t. The coincidence rate was 10.9% and the rate of inconsistency was 89.1%.3. The occurrence rate of primary disease in patients with subarachnoid hemorrhage:main symptoms from large to small is as follows:headache (83.4%)> vomiting (59.6%)> disturbance of consciousness (50.3%)> dizziness (47.4%)> meningeal irritation sign (43.0%)> oculomotor paralyses (34.1%)> epileptic seizures (17.9%)> hemiplegia (10.3%)> facial paralysis (3.0%).4. In the logistic model of Fisher classification and the stroke, the Fisher classification has a significant correlation with stroke. There was no significant correlation between Hunt-Hess classification、GCS classification and stroke in the logistic model.5. Multivariate analysis for subarachnoid hemorrhage stroke cases consciousness disorders, dizziness, vomiting, hemiplegia, paralysis of main symptoms showed that there is significant correlation of hemiplegia and subarachnoid hemorrhage with stroke.6. In ancient Chinese literature, there are many disease names related to stroke:Da Jue, Bo Jue, Shi Jue, Jian Jue, Wei Jue, stroke coma, Pian Ku, Pu Pian Ku, Pu Ji, Ji Pu, Dao Pu, Cu Dao, Fei, stroke, Feng Fei, FengYi, Feng Bi, Cu Zhong Feng, Zhong Xue Mai, Zhong Fu, Zhong Zang, Zhen Zhong Fei, Lei Zhong Feng, Zhen Zhong, Lei Zhong, Wai Zhong, hemiplegia, Wai Pi, Qian Ying, Zhong Xue Mai Jing Luo Zang Fu.7. There is no specific TCM disease name of subarachnoid hemorrhage in ancient TCM literature. Based on the clinical manifestation, the relevant description could be found in the ancient TCM literature, such as Da Jue, Bo Jue, Shi Jue, Jian Jue, etc. Modern TCM doctors have various views on the name of the disease attributed, which can be found in some clinical cases reports of diagnosis and treatment by experienced TCM doctors.8. The concept and diagnosis of stroke was a development process of continuous evolution. Different physicians in different dynasty have different comprehension, so they had their own different concepts of stroke.Conclusions:1. The concept of stroke is a process of historical evolution. Different physicians based on various studying relationship and clinical experience, have different definition of stroke.2. Subarachnoid hemorrhage should be included in the scope of stroke disease of traditional Chinese medicine, and the existing TCM stroke disease diagnosis standard should be changed. The diagnostic standard of new TCM stroke should be adopted to modern results of CT/ MRI and/or other physical findings.