The Correlation Research Between TCM Syndrome Element Of Ischemic Stroke And Risk Factors And CISS Classification

Objective : To explore the risk factors of ischemic stroke,the classification of Chinese ischemic stroke subclassification(CISS),the correlation between neutrophil and lymphocyte ratio(NLR),serum uric acid level and TCM syndromes,and to observe whether there is any characteristic correlation between them,so as to guide the integrated traditional Chinese and western medicine diagnosis and treatment of ischemic stroke.Methods:This study selected 305 ischemic stroke patients from December 2021 to September 2022 in neurology department and traditional Chinese medicine ward of Shandong First Medical University.To investigate the characteristics of TCM syndromes,risk factors,CISS classification,improve the physicochemical examination of patients after admission to further clarify the risk factors and pathogenesis,calculate their NLR.The correlation between TCM syndromes and risk factors,CISS etiology,NLR,blood uric acid level were statistically analyzed.SPSS26.0 statistical software was used for statistical analysis,P<0.05 was statistically significant.Results:1.Risk factors and TCM syndrome element relevance: Statistical significance of hypertension history in the distribution of syndrome element spleen,syndrome element phlegm and blood stasis of ischemic stroke patients(P<0.05): The proportion of hypertension patients in the spleen,phlegm and blood stasis syndrome group was higher.There is statistical significance in the distribution of syndrome element kidney,syndrome element yin deficiency,fire(heat)and yang hyperactivity of ischemic stroke patients(P<0.05): The proportion of diabetic patients in kidney,yin deficiency,fire(heat)and yangkang syndrome group was higher.There is statistical significance in the distribution of syndrome factors,such as syndrome factors of heart,syndrome factors of Qi deficiency and Yang deficiency(P<0.05): Patients with ischemic apoplexy with history of heart disease in the groups of heart,Qi deficiency and Yang deficiency syndrome element had higher proportion.Smoking history of ischemic stroke patients has statistical significance in the distribution of pathogenic syndrome factors dampness and fire(heat)(P<0.05): Patients with smoking history in the group of syndrome element of dampness and fire(heat)were higher.Drinking history of ischemic stroke patients has statistical significance in the wet distribution of disease syndrome factors(P<0.05): Patients with ischemic stroke who had a history of drinking in the damp syndrome element group was higher.High HCY has statistical significance in the distribution of syndrome factors and blood stasis(P<0.05): The proportion of HCY patients in blood stasis group was higher.The abnormal increase of BMI in ischemic stroke patients has statistical significance in the distribution difference of syndrome element phlegm and qi deficiency(P<0.05): Patients with abnormal increase of BMI in the groups of phlegm and Qi-deficiency syndrome element was higher.2.The classification of CISS is correlated with syndrome element of TCM: Large arteryatherosclerosis(LAA)is related to syndrome element liver,meridian,activating wind,phlegm and blood stasis;penetrating artery disease(PAD)is related to syndrome element activating wind,heat(heat)and large intestine;cardiogenic stroke(CS)is related to syndrome element heart,blood stasis and qi deficiency;undetermined etiology(UE)is related to syndrome element liver,mind,activating wind and Yin deficiency.3.Correlation between NLR value,serum uric acid level and sex,age,syndrome factor: Uric acid level in male patients was significantly higher than that in female patients,and the difference was statistically significant(P<0.05);Serum uric acid level was negatively correlated with age.The older the age,the lower the serum uric acid level.The NLR values of phlegm,fire(heat)and yang were significantly higher than those of other syndromes,and the difference was statistically significant(P<0.05).4.Correlation between NLR value,serum uric acid level and etiological typing of CISS: Serum uric acid levels in PAD,LAA and UE subtypes were higher than those in CS and OE subtypes,but there was no significant difference between them(P>0.05).The NLR of CS subtype was significantly higher than that of PAD subtype,and the difference was statistically significant(P<0.05).Conclusion:1.Hypertension history of ischemic stroke patients is correlated with syndrome element spleen,phlegm and blood stasis;diabetes history is correlated with syndrome element kidney,yin deficiency,fire(heat)and yang hyperactivity;heart disease history is correlated with syndrome element heart,qi deficiency and yang deficiency;smoking history is correlated with syndrome element dampness and fire(heat);drinking history is correlated with syndrome element dampness;high HCY is correlated with blood stasis;abnormal elevation of BMI is correlated with syndrome element phlegm and qi deficiency2.LAA subtype is related to syndrome element liver,meridian and collaterals,activating wind,phlegm and blood stasis,PAD subtype is related to syndrome element wind,fire(heat)and large intestine,CS subtype is related to syndrome element heart,blood stasis and qi deficiency,OE subtype is not related to disease position and pathogenic syndrome element,but may be related to small sample size,UE subtype is related to syndrome element liver,mind,activating wind and Yin deficiency.3.The uric acid level in male patients with ischemic stroke was significantly higher than that in female patients.As an inflammatory marker,NLR in patients with CS subtype is significantly higher than that in patients with PAD subtype,which may provide more possibilities for further treatment of ischemic stroke.