| Objectives:By observing and studying the patients with ischemic stroke,the relationship between TCM syndromes and intracranial vascular stenosis and related indexes was discussed.Methods:A total of 150 patients with ischemic stroke who met the inclusion criteria in the Encephalopathy department of Wuhu hospital of traditional Chinese medicine were selected to collect and analyze the data of patients' general conditions,serological indicators,NIHSS score,cervical vascular color doppler ultrasound and intracranial vascular MRA,so as to understand the correlation between the TCM syndrome of ischemic stroke and intracranial vascular stenosis.Results:1.In this study,150 patients with ischemic stroke were collected,including 94 males(62.67%)and 56 females(37.33%).The syndrome of wind phlegm obstruction collaterals,the syndrome of phlegm heat relieving excess and the syndrome of wind fire pathogen were mainly males,while the syndrome of qi deficiency and blood stasis were mainly females.The youngest was 40 years old and the oldest was 88 years old,of which the oldest was 60-79 years old,accounting for 71.3%,the oldest was 60-69 years old accounting for 26%and the oldest was 70-79 years old accounting for 45.3%respectively.In the distribution of syndromes,71 cases(47.33%)of wind phlegm obstruction collaterals,13 cases(8.67%)of qi deficiency and blood stasis,19 cases(12.67%)of wind fire pathogen,14 cases(9.33%)of yin pneumatic syndrome,and 33 cases(22%)of phlegm heat relieving excess syndrome.There were differences in age and sex distribution of each syndrome(P<0.05)2.Among the 150 patients,96(64%)had hypertension,52(34.7%)had cerebral infarction,33(22%)had diabetes,29(19.3%)had coronary heart disease,and 16(10.7%)had atrial fibrillation.The main syndromes of hypertension were wind phlegm obstruction collaterals syndrome and phlegm heat relieving excess syndrome,while those of diabetes were qi deficiency and blood stasis syndrome,Wind phlegm blocking collaterals syndrome and phlegm heat relieving excess syndrome There was a significant difference between the two syndromes(P<0.05).3.Compared with each syndrome,the mean value of TC was basically within the range of normal value,of which the positive phlegm heat relieving excess was the highest,and that of wind phlegm blocking collaterals was the lowest(P<0.05).In comparison with the TG values of all syndromes,the positive evidence of qi deficiency and blood stasis and phlegm heat relieving excess were higher than the normal range,and the yin pneumatic was the lowest(P<0.05).Compared with LDL-C of each syndrome,the mean value of LDL-C of each syndrome was higher than the normal range,among which the phlegm heat relieving excess was the highest,and that of wind phlegm blocking collaterals was the lowest(P<0.05).Among all of HDL-C,the wind fire pathogen syndrome was the highest,and phlegm heat relieving excess was the lowest(P<0.05).In comparison with all of HCY,all of them were higher than the normal range except the wind fire pathogen syndrome,of which the wind phlegm obstruction collaterals syndrome was the highest(P<0.05).There was no statistical difference in the UA of each syndrome4.NIHSS of patients with various syndromes showed that the score of patients with qi deficiency and blood-stasis syndrome was significantly higher than that of wind-fire pathogen syndrome(P<0.05).Hemiplegia was the most common symptom of wind phlegm obstruction collaterals syndrome,accounting for 39.2%of the total 56 cases(39.2%).wind fire pathogen syndrome was dominated by tongue skew,with 12 cases(37.5%),accounting for 37.5%.Phlegm heat relieving excess syndrome was also dominated by tongue skew,with 22 cases(37.9%),accounting for 37.9%.The clinical manifestations of each syndrome were different(P<0.05)5.A total of 199 cervical vascular plaques were found,among which the wind-phlegm obstruction collaterals syndrome was dominated by soft spots,with 40 cases accounting for 45%.Comparing the thickness of each syndrome plaque and carotid internal media,the wind phlegm obstruction collaterals syndrome was higher than the qi deficiency and blood stasis syndrome,and there was no statistical difference in the distribution of cervical vascular plaque and the thickness of internal media in patients with each syndrome6.There were 273 stenosis vessels in total,145 of which were anterior circulation stenosis(53.11%)and 128 of which were posterior circulation stenosis(46.89%).Among them,Wind phlegm obstruction collaterals syndrome,phlegm heat relieving excess syndrome and qi deficiency and blood stasis syndrome all had former circulation stenosis,while wind fire pathogen syndrome and yin pneumatic syndrome had later circulation stenosis.There are 87 branches(63.5%)in wind phlegm obstruction collaterals syndrome,23 branches(67.6%)in wind fire pathogen syndrome,18 branches(72%)in yin pneumatic syndrome,11 branches(61.1%)in qi deficiency and blood stasis syndrome,24 branches(40.7%)in phlegm heat relieving excess syndrome,with different degrees of stenosis(P<0.05);to explore the differences of the number of narrow blood vessels in various types of syndromes,it was found that the w ind phlegm obstruction collaterals syndrome was mainly multi vessel stenosis,36 cases,accounting for 50.7%;the phlegm heat relieving excess syndrome was also mainly multi vessel stenosis,16 cases,accounting for 48.5%,there was no statistical difference in the number of narrow blood vessels in various of syndromesConclusion:1.The distribution of ischemic stroke syndrome is related to age,gender,hypertension and diabetes.The syndrome of wind phlegm obstruction collaterals,phlegm heat relieving excess and wind fire pathogen are mainly male,the syndrome of qi deficiency and blood stasis is mainly female,the minimum is the syndrome of wind fire pathogen,the maximum is the syndrome of qi deficiency and blood stasis,the hypertension is mainly the syndrome of wind phlegm obstruction collaterals and phlegm heat relieving excess,the diabetes is mainly the syndrome of wind phlegm obstruction collaterals.The syndrome of wind phlegm blocking collaterals,qi deficiency and blood stasis,and the syndrome of phlegm heat relieving excess are mainly positive2.The distribution of ischemic stroke syndrome is related to the level of blood lipid and homocysteine,but not to the level of uric acid.The increase of TC,TG,LDL-C and the decrease of HDL-C can be used as the reference index for the syndrome differentiation of phlegm heat relieving excess.Hcy can guide the syndrome differentiation of wind phlegm obstruction collaterals3.There is a correlation between the distribution of ischemic stroke syndromes and NIHSS scores and clinical manifestations,among which the patients with qi deficiency and blood stasis have the highest score and the patients with wind fire pathogen have the lowest score;in the clinical manifestations,the syndrome of wind phlegm obstruction collaterals is mostly hemiplegia,the syndrome of wind fire pathogen and the syndrome of phlegm heat relieving excess are mainly tongue skewness,which indirectly proves the correlation between syndromes and vascular stenosis4.There was no correlation between the distribution of ischemic stroke syndromes and the vascular plaque and the intima-media thickness5.There is a correlation between the distribution of ischemic stroke syndromes and the location and degree of vascular stenosis.In the distribution of vascular stenosis,wind phlegm obstruction collaterals syndrome,qi deficiency and blood stasis syndrome,and phlegm heat relieving excess are all former circulation stenosis,while wind fire pathogen syndrome and yin pneumatic syndrome are later circulation stenosis;in the degree of vascular stenosis,wind phlegm obstruction collaterals syndrome,wind fire pathogen syndrome,yin pneumatic syndrome are all mild stenosis.This study did not find the relationship between the number of vascular stenosis and the type of ischemic stroke. |
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