Research On The Correlation Between Posterior Circulation Ischemic Stroke With Vertebral Artery Hypoplasia And TCM Syndromes

Objective: Clinical investigation of posterior circulation ischemic stroke with vertebral artery hypoplasia ratio,posterior circulation ischemic stroke and posterior circulation ischemic stroke with vertebral artery hypoplasia distribution of TCM syndrome,analysis of the correlation between posterior circulation ischemic stroke with vertebral artery hypoplasia and TCM syndrome.Methods:(1)218 patients who met the inclusion and exclusion criteria of posterior circulation ischemic stroke were collected,and another 461 patients who met the inclusion criteria of non-posterior circulation ischemic stroke in the same period were collected as the control group.Patients' four diagnostic summaries(including tongue pulse),gender,age,biochemical indicators(blood glucose,blood lipid,homocysteine,etc.),previous medical history,smoking and drinking history were recorded.According to the diagnostic criteria of vertebral artery hypoplasia and the diagnostic criteria of ischemic stroke risk factors,the proportion of vertebral artery hypoplasia,the proportion of risk factors and the relationship between vertebral artery hypoplasia and posterior circulation ischemic stroke were analyzed.According to integral principle of wind syndrome,fire syndrome,phlegm syndrome,blood stasis syndrome,qi deficiency syndrome,yin deficiency syndrome,to statistical patient TCM syndrome of patients with posterior circulation ischemic stroke,and the relationship between posterior circulation ischemic stroke,posterior circulation ischemic stroke with vertebral artery hypoplasia and TCM syndromes was analyzed.(2)SPSS 23.0 statistical software was used.Chi-square test was used to analyze the proportions of vertebral artery hypoplasia and risk factors,relationship during TCM syndrome,posterior circulation ischemic stroke with vertebral artery hypoplasia and posterior circulation ischemic stroke in the two groups.To various risk factors(including vertebral artery hypoplasia)with posterior circulation ischemic stroke using binary classification Logistic regression analysis;Chi-square test was conducted on the proportion of vertebral artery hypoplasia of single TCM syndromes and combined TCM syndromes in the posterior circulation ischemic stroke group(Fisher's exact probability method is used when more than 20% of the theoretical frequency < 5).Test level = 0.05.Results:(1)The incidence rate of vertebral artery hypoplasia A total of 102 patients with vertebral artery hypoplasia(15.02%)were enrolled in posterior circulation ischemic stroke group and non-posterior circulation ischemic stroke group.There were 43 cases of vertebral artery hypoplasia in the posterior circulation ischemic stroke group(19.7%),witch of 26 cases(60.5%)of men,women 17 cases(39.5%),on the left side of the vertebral artery hypoplasia 12 cases(27.9%),the right side of the vertebral artery hypoplasia 30 cases(69.8%).Among the 59 cases(12.8%)of vertebral artery hypoplasia in the non-posterior circulation ischemic stroke group,39 cases(66.1%)were male,20 cases(33.9%)were female,20 cases(33.9%)were left vertebral artery hypoplasia,and 38 cases(64.4%)were right vertebral artery hypoplasia.The incidence of vertebral artery hypoplasia between the two groups was statistically significant(P < 0.05),while the incidence of left and right vertebral artery hypoplasia between the two groups was not statistically significant(P > 0.05),and there was no statistically significant difference in the neutral gender of vertebral artery hypoplasia between the two groups(P > 0.05).(2)Correlation between vertebral artery hypoplasia and other risk factors and posterior circulation ischemic stroke In the posterior circulation ischemic stroke group,the risk factors were hyperlipidemia(74.3%),hypertension(61.9%),male(56.9%),smoking history(41.7%),hyperhomocysteinemia(34.4%),alcohol consumption history(24.3%),diabetes mellitus(22.0%),and vertebral artery hypoplasia(19.7%).In the non-posterior circulation ischemic stroke group,hypertension(64.2%),hyperlipidemia(62.9%),male(59.0%),smoking history(40.9%),hyperhomocysteinemia(35.1%),diabetes mellitus(24.5%),drinking history(20.3%),and vertebral artery hypoplasia(12.8%)were in sequence.After statistical analysis,it was found that the proportion of vertebral artery hypoplasia and hyperlipidemia in the two groups was statistically significant(P < 0.05),while the proportion of other risk factors in the two groups was not statistically significant(P > 0.05).Binary Logistic regression analysis of risk factors showed that vertebral artery hypoplasia,hyperlipidemia and gender were significantly correlated with posterior circulation ischemic stroke(OR value :2.230?1.385?1.581).(3)Distribution of single raditional Chinese medicine syndrome of posterior circulation ischemic stroke and posterior circulation ischemic stroke with vertebral artery hypoplasia Among the 218 cases of posterior circulation ischemic stroke,the single TCM syndrome distribution was phlegm syndrome(63.3%),blood stasis syndrome(39.9%),Yin deficiency syndrome(37.2%),fire syndrome(36.7%),wind syndrome(33.9%),and qi deficiency syndrome(20.2%).Among 43 patients of posterior circulation ischemic stroke with vertebral artery hypoplasia,the single TCM syndrome type was successively phlegm syndrome(79.1%),blood stasis syndrome(74.4%),wind syndrome(60.5%),fire syndrome(53.3%),Yin deficiency syndrome(46.5%),and qi deficiency syndrome(20.9%).According to the proportion,statistical analysis of the proportion of single TCM syndromes in the two groups of posterior circulation ischemic stroke and posterior circulation ischemic stroke with vertebral artery hypoplasia,it was found that there were statistically significant differences in the proportion of wind syndrome,fire syndrome and blood stasis syndrome between the two groups(P < 0.05),while there were no statistically significant differences in phlegm syndrome,qi deficiency syndrome and Yin deficiency syndrome between the two groups(P > 0.05).(4)Distribution of combined TCM syndromes of posterior circulation ischemic stroke and posterior circulation ischemic stroke with vertebral artery hypoplasia There were 16 combined TCM syndromes syndromes in 218 cases of posterior circulation ischemic stroke.Sorted of high and low respectively the phlegm syndrome,blood stasis syndrome(15.1%),Yin deficiency syndrome and fire syndrome(11.9%),phlegm syndrome + fire syndrome(11.1%),Yin deficiency syndrome + wind syndrome(9.6%),the wind syndrome + phlegm syndrome(9.2%),qi deficiency syndrome,blood stasis syndrome(6.4%),phlegm syndrome + fire syndrome + blood stasis syndrome(5.9%),phlegm syndrome+qi deficiency syndrome and phlegm + Yin deficiency syndrome + blood stasis syndrome(5.5%),wind syndrome + fire syndrome(5.0%),wind syndrome+phlegm syndrome+blood stasis syndrome(4.1%),wind syndrome + fire syndrome + phlegm and qi deficiency syndrome+Yin deficiency +phlegm syndrome(2.6%),wind syndrome+ blood stasis syndrome(2.3%).There were 14 combined TCM syndromes of posterior circulation ischemic stroke with vertebral artery hypoplasia,among which the syndromes with the highest proportion were phlegm syndromes +blood stasis syndromes(34.9%),Yin deficiency blood+ fireblood(18.6%)and Yin deficiency blood + wind blood(18.6%).(5)The proportion of vertebral artery hypoplasia of single TCM syndrome and combined TCM syndrome in the posterior circulation ischemic stroke group The proportion of each single TCM syndrome is blood stasis syndrome(36.8%),wind syndrome(35.1%),fire syndrome(28.8%),Yin deficiency syndrome(24.7%),phlegm syndrome(24.6%),and qi deficiency syndrome(20.5%)from high to low in the order.Wind syndrome and blood stasis syndrome account for the most in vertebral artery hypoplasia,indicating that the relationship between vertebral artery hypoplasia and TCM syndromes of blood stasis and wind was the largest.Chi-square test was conducted on the proportion of vertebral artery hypoplasia in each single syndrome,and the results showed that there was no significant difference in the incidence of vertebral artery hypoplasia in each single syndrome(P > 0.05).The highest percentage of the combination of TCM syndrome was blood stasis syndrome+blood stasis syndrome(60%),followed by the wind syndrome+fire+phlegm syndrome(50%),phlegm+blood stasis syndrome(45.5%),and qi deficiency syndrome+blood stasis(42.8%),the wind + Yin deficiency syndrome(38.1%),wind+phlegm+blood stasis syndrome(33.3%),vertebral artery hypoplasia with "wind syndrome,phlegm,blood stasis syndrome,Yin deficiency" combination relations between the most closely.Fisher's exact probability method was used to test the proportion of hypoplasia of vertebral artery in each combination TCM syndrome,and the result showed that the difference was not statistically significant(P > 0.05).Conclusion:(1)ischemic stroke with vertebral artery hypoplasia is not uncommon,which is more common in posterior circulation ischemic stroke.The right side is more common than the left side,and males are more common than females.Vertebral artery hypoplasia is an independent risk factor for posterior circulation ischemic stroke.(2)TCM syndrome of posterior circulation ischemic stroke and posterior circulation ischemic stroke with vertebral artery hypoplasia has a certain difference.The most common single TCM syndrome of posterior circulation ischemic stroke with vertebral artery hypoplasia are phlegm syndrome,blood stasis syndrome and wind syndrome.phlegm syndrome and blood stasis syndrome,fire excess from yin deficiency and phlegm heat syndrome and yin asthenia causing wind syndrome was the most common combination of TCM syndrome.Vertebral artery dysplasia can occur in each single or combination syndrome of posterior circulation ischemic stroke.The key pathogenesis of posterior circulation ischemic stroke caused by vertebral artery hypoplasia is phlegm and blood stasis syndrome.