| Obj ectivesThis paper retrospectively studied two cases of ischemic stroke,which were related to atherosclerosis of large arteries and occlusion of small arteries,to explore the distribution rules of traditional Chinese medicine(TCM)syndromes and clinical application characteristics of them.Significance1.Through the analysis of the similarities and differences between the two syndromes,the differences between the pathogenesis of the two traditional Chinese medicine were explored,so as to provide more targeted prevention and treatment of ischemic stroke lesions in large and small arteries.2.By analyzing the similarities and differences between the two drugs,it is conducive to summarize the law of drug use,so as to explore the similarities and differences in terms of treatment.Methods1.Based on CNKI database(2001-2018)and ischemic stroke in the related literature research,professor in wen-feng zhu "syndrome factor differentiation to learn" for reference,combining with related syndrome factor in this study include symptoms as the first prototype,combining with the traditional Chinese medicine new medicine clinical research guiding principles(try out)"in the common symptom of ischemic stroke,refine the symptoms point to two kinds of disease and eventually made into"syndrome factor symptom clinical questionnaire".2.A retrospective study was conducted on 150 patients with ischemic stroke who were clearly diagnosed with aortic atherosclerosis and arterial occlusion during the period from May 2015 to May 2018 in the department of encephalopathy,dongzhimen hospital of Beijing university of traditional Chinese medicine with complete medical records.3.The original data were quantified and processed before input into the computer,and SPSS22.0 statistical software was used for medical statistical analysis.Results1.TCM syndrome element results:(1)In 75 patients with ischemic stroke with large atherosclerotic artery,25 syndromes were extracted and sorted out after clinical symptoms,and the syndromes with a frequency of no less than 20 ranged from high to low:a total of 13 syndromes including liver,wind,meridian,phlegm,heat,heart,qi deficiency,blood stasis,dampness,blood deficiency,qi stagnation,Yang deficiency and kidney.(2)In 75 patients with ischemic stroke with small artery occlusion,27 syndromes were extracted and sorted out after clinical symptoms,and the syndromes with a frequency of no less than 20 ranged from high to low:there were 11 syndromes in the following categories:wind,liver,phlegm,dampness,heat,heart,qi stagnation,blood deficiency,meridian and collateral,kidney and Yang deficiency.(3)The same syndromes of the two subtypes of atherosclerosis and small artery occlusion in ischemic stroke are liver,dynamic wind,meridian and collateral,phlegm,heat,heart,dampness,blood deficiency,qi stagnation,Yang deficiency and kidney.Through statistical comparison,it is found that there are statistical differences between the two subtypes of ischemic stroke in meridian,phlegm,qi deficiency,blood stasis,Yin deficiency and Yang hyperactivity.In the four syndromes of meridian,phlegm,qi deficiency and blood stasis,the atherosclerosis type of aorta is obviously larger than that of arteriole occlusion type.In the two syndromes of Yin deficiency and Yang hyperactivity,the small artery occlusion type is larger than the large artery atherosclerosis type.There was no significant difference in liver,moving wind,heat,heart,dampness,blood deficiency and qi stagnation.2.Clinical TCM results:(1)Seventy-five patients with ischemic stroke with atherosclerosis of the great arteries were found to have 164 kinds of traditional Chinese medicines.The high frequency Ch-inese medicines were angelica sinensis,poria cocos,radix paeoniae alba,atractylodes mac-rocephala,rhizoma ligustici,rhizoma ligustici,rhizoma chuanxiong,calamus gramineus,astra galus,salvia miltiorrhiza,pinellia ternata,radix glycyrrhizae,orange peel,radix scutellariae s-cutellariae,caulis spatholobi,peach seed,gastrodia elata,dilong,rhizoma coptidis,fructus aur-antii,dan-nan-star and cassia twig.The drug was cold(36.40%),warm(35.15%)and normal(21.21%).The drug flavor was gan(29.55%),bitter(29.17%)and xin(25.38%).Mainly to the liver(19.46%),lung(15.33%),spleen(14.84%),stomach(13.63%),heart(10.95%),renal(10.94%).(2)In 75 patients with ischemic stroke with arterial occlusion,160 kinds of traditional Chinese medicines were found.The high frequency Chinese medicines were:chuanxiong,poria cocos,atractylodes macrocephala,angelica root,red peony root,astragalus root,radix cynanchi,radix glycyrrhizae,raw licorice,raw oyster,white peony root,gastrodia elata,cala-mus flagellus,raw dragonbone,pueraria,orange peel,fructus aurantii,bupleurum,rhizoma co-ptidis,and cassia twig.The drug was temperature(33.74%),cold(33.74%),flat(23.31%).The drug flavor was bitter(30.86%),gan(28.13%),and xin(26.17%);Mainly to the liver(19.85%),spleen(15.44%),lung(14.95%),stomach(12.01%),renal(11.52%),heart(10.78%).(3)Two groups of the same high frequency Chinese medicine as:angelica,poria cocos,ra-dix paeoniae rubra,atractylodes,rhizoma ligustici wallichii,stone calamus,astragalus mem branaceus and salvia miltiorrhiza,pinellia tuber,licorice,dried tangerine or orange peel,r-hizoma gastrodiae,rhizoma coptidis,bitter orange,cassia twig,radix bupleuri,radix scutellar-iae,caulis spatholobi,peach kemel,earthworm,bravery south star,amomum villosum,safflo-wer,radix rehmanniae,ginger,selfheal,uncaria,radix scrophulariae,fructus gardenia,radix pae-oniae alba,radix cyathulae,radix puerariae,polygala,rhizoma atractylodis,radix achyranthis bidentatae,cortex eucommiae,rhubarb,keel,raw oysters,American ginseng,fructus schisandr-ae,white thistle,god eight,rhizoma polygonati,cortex phellodendri,notoginseng,donkey-hide gelatin of 48 kinds of traditional Chinese medicine.Among them,there were significant differences in the drug use of peach kernel,spatholobus spatholobus,trichosanthes tricho-santhis,rhubarb,white peony,schisandra fruit,ejiao,huangjing,keel,oyster and kudzu root.Pe-ach kernel,caulis spatholobi,bravery south star,fructus,radix et rhizoma rhei,radix paeoni-ae alba in artery atherosclerosis model used in more than a small artery occlusion ty-pe;Schisandra chinensis,donkey-hide gelatin,huangjing,keel,oyster and kudzu root were more commonly used in arteriole occlusion than in aorta atherosclerosis.There was no statistically significant difference between the two groups.Conclusion(1)By extracting ischemic stroke aortic atherosclerosis and small arterial occlusion syndrome,both in liver,wind,heat,heart,dampness,blood deficiency,qi stagnation,yang deficiency,kidney syndrome No significant difference.It can be known that both are virtual and real,and the main pathogens are responsible for the yin and yang disorders of the liver and kidney,the wind and fire are opposite,the phlegm is stagnation,and the qi stagnation is bloody.(2)There are significant differences in the syndromes of meridians,phlegm,qi deficiency,phlegm,yin deficiency and impotence.The aortic atherosclerosis type is more manifested as sputum,phlegm,qi deficiency,and meridian syndrome;while the small arteriolar occlusion type is mostly yin deficiency and impotence syndrome.(3)In the traditional Chinese medicine treatment of ischemic stroke with large atherosclerosis and small artery occlusion,the two mainly cover the ischemic stroke,sputum,phlegm,deficiency,wind,fire and other etiological diseases.Machine,treatment is more to benefit Qi and activating blood circulation,phlegm and blood stasis,clearing heat and detoxification.There is no difference in the distribution of traditional Chinese medicines in the four gas and five flavors.The drug is mainly cold and warm;the drug taste is mainly bitterness and bitterness;the main gut is liver,lung,spleen,stomach and kidney,and the large intestine is second. |
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