| Objective:To explore the distribution characteristics of TCM syndrome elements in patients with Ischemic Stroke(IS)complicated with Erectile Dysfunction(ED)and the effects of age,onset season and body mass index(BMI)on the distribution of the syndrome elements,and summarize the core treatment methods for the sequelae of IS in the Department of Encephalopathy.According to the concept of "testing the syndrome with drugs" and "treating different diseases together",the correlation between the core pathogenesis of IS and ED was explored.Method:1 Epidemiological survey:A four-diagnosis information collection table was made based on the Syndrome Differentiation Common Witness Scale of Syndrome Differentiation in Syndrome Differentiation by Professor Zhu Wenfeng.A total of 425 subjects with IS combined with ED meeting the inclusion criteria were collected,including 115 patients in IS group.The distribution pattern of syndrome elements and their differences between the two groups were statistically analyzed.Patients with IS complicated with ED were grouped according to age,season,body mass index(BMI),etc.,and the differences of TCM syndromes in patients with IS complicated with ED in different groups were analyzed.2 Prospective cohort study:A total of 90 cases of hospitalized patients with IS sequelae meeting the inclusion criteria of IS combined with ED group were selected by prospective cohort study.They were divided into Chinese medicine group and control group according to whether they received TCM syndrome differentiation treatment on the basis of basic Western medicine treatment during the observation period.In the end,a total of 50 cases were included in the Chinese medicine group and 40 cases in the control group.The TCM group received TCM syndrome differentiation treatment combined with basic Western medicine treatment,while the control group only received basic Western medicine treatment.The observation lasted for 4 weeks.The rule of TCM medication in the TCM group was summarized,and the changes of neurological function,erectile function and syndrome element scores in the two groups before and after treatment were observed.Results:1 Epidemiological survey:1.1 In this survey,there were 17 disease site elements and 25 disease site elements in IS combined with ED group,16 disease site elements and 23 disease site elements in IS combined with ED group.Among them,the common disease site elements in IS combined with ED group were liver,kidney and meridian,and the common disease site elements were dampness,phlegm,blood stasis,qi deficiency,Yang deficiency and Yin deficiency.The common locus syndromes of IS group were liver and meridians,and the common locus syndromes were phlegm,dampness and Yin deficiency.1.2 Compared with the IS group,the distribution of syndrome elements in liver,meridians,dampness,blood stasis and Yin deficiency were the same,but there were differences in the distribution of kidney,phlegm,Yang deficiency and qi deficiency(P<0.05).1.3 The frequency of lung,kidney,muscles and bones,cold,blood stasis,Yang hyperactivity,essence deficiency in elderly IS patients with ED was higher than that in young and middle-aged patients,and the difference was statistically significant(P<0.05).1.4 The distribution of syndrome element lung,liver,meridian,heat,qi stagnation and Yang deficiency in patients with IS complicated with ED was different in four seasons.Specifically,the distribution of syndrome element lung in autumn group was>in summer(P<0.05),syndrome element liver in spring group was>in summer(P<0.05),and syndrome element meridian in autumn group was>in summer(P<0.05).Syndrome element hot summer group>winter group(P<0.05),syndrome element qi stagnation spring group,summer group>winter group(P<0.05),syndrome element Yang deficiency autumn group,winter group>summer group(P<0.05);1.5 Compared with patients with normal weight IS complicated with ED,overweight and obese patients had higher incidence of spleen,dampness,phlegm and hyperthyroidism,with statistical significance(P<0.05);1.6 Compared with the IS group,the incidence of depression,anxiety and depression and anxiety combined in IS patients with ED was significantly higher,with statistical significance(P<0.05);2 Prospective cohort study:1.1 In the sequelae stage of IS,the four qi of traditional Chinese medicine are mainly warm,cold and calming drugs;the five flavors are mainly bitter,acrid and sweet drugs;the channeling channels are mainly liver,spleen,heart,lung,stomach and kidney meridians;the efficacy classification of traditional Chinese medicine IS mainly composed of drugs to replenish deficiency,drugs to promote blood circulation and remove blood stasis,drugs to reduce phlegm,calm the liver and chill the wind,and drugs to clear heat.1.2 After 4 weeks of treatment,NIHSS scores of patients in the TCM group improved more than those in the control group,but the difference was not statistically significant(P>0.05).IIEF-5 scores and sexual satisfaction scores in the TCM group improved more significantly than those in the control group,and the difference was statistically significant(P<0.05).Compared with the control group,the improvement of the scores of liver,kidney,meridians,qi deficiency,Yang deficiency,blood stasis,Yin deficiency,phlegm and dampness in TCM group was more significant,with statistical significance(P<0.05)Conclusion:1.1 The high-frequency syndromes of IS patients with ED are liver,kidney,and meridian,and the high-frequency syndromes are dampness,phlegm,blood stasis,qi deficiency,Yang deficiency,and Yin deficiency.It can be seen that the basic pathological basis of IS patients with ED IS phlegm turbidity and blood stasis,and the basic pathogenesis IS liver and kidney deficiency,phlegm turbidity and blood stasis.1.2 IS combined ED with IS group of patients in the kidney,phlegm,Yang deficiency,qi deficiency exist differences,IS combined ED patient more belong to collaterals stasis,long illness,and kidney and more performance for qi deficiency,Yang deficiency,such as virtual syndromes characteristic,and IS group of patients in the early stages of disease development,disease in liver and channels and collaterals,and the kidney,the firm IS given priority to,It is mainly characterized by solid syndromes of evil obstruction meridians1.3 Compared with young and middle-aged patients,the occurrence frequency of lung,kidney,muscles and bones,cold,blood stasis,Yang hyperactivity,essence deficiency and other syndrome elements in elderly IS patients complicated with ED IS higher,suggesting that we should strengthen the treatment of strengthening the strength and strengthening the capital on the basis of promoting blood circulation and removing blood stasis in the treatment of elderly IS patients complicated with ED;1.4 Different season,the evidence IS combined ED patients element distribution differences,embodied in the lung,liver,channels and collaterals,the distribution of heat,and qi and Yang deficiency in the four seasons are differences(P<0.05),suggesting we when treatment IS combined ED patient should according to different onset seasons,the investment,since according to different pathogenesis of emphasis;1.5 Compared with normal weight IS combined ED patients,patients with overweight and obesity in the spleen,dampness,phlegm and the higher the incidence of hand,prompt our intervention for overweight and obese patients on the basis of conventional dialectical treatment need to pay more attention to the spleen phlegm treatment train of thought,on the other hand,overweight and obese patients need to alert the happening of the hand.1.6 Depression,anxiety may be risk factors for causing the merge IS ED,at the same time IS combined ED patients had more adverse mood disorders such as depression or anxiety,so that should be noticed in clinical treatment in patients with emotional relief,psychotherapy or liver resolve depression with routine therapy of Chinese medicine,for disease prevention and control will have a better curative effect;1.7 In the sequelae stage of IS,the four qi of traditional Chinese medicine are mainly warm,cold and calming drugs,the five flavors are mainly bitter,pungent and sweet drugs,and the drugs belong to the meridian of liver,spleen,heart,lung,stomach and kidney.The efficacy of traditional Chinese medicine IS mainly classified as drugs to replenish deficiency,drugs to promote blood circulation and remove blood stasis,drugs to reduce phlegm and calm the liver and chill the wind,and drugs to clear heat,in IS combined with ED group,the core treatment of traditional Chinese medicine was "nourishing qi and blood,resolving phlegm and removing blood stasis".According to the traditional Chinese medicine concept of "measuring the syndrome with drugs",the core pathogenesis of IS was "basic deficiency and standard solid,phlegm turbidity and blood stasis".1.8 IS sequela period "tomifying qi and blood,phlegm and remove blood stasis" core treatment for IS combined ED patients with nerve function defect symptoms and also had an improved erectile function,it IS consolidated core pathogenesis of ED patients for "mark this virtual to real,phlegm turbidity and blood stasis",on the basis of the TCM concept of "different word",the core of the visible IS the same as the ED may have pathogenesis,Is also "the virtual standard,phlegm turbid blood stasis";the improvement of syndrome element scores before and after treatment has a strong correlation with the improvement of neurological function and erectile function of patients,and it is feasible to use witness as an evaluation index of TCM efficacy. |
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