TCM Differential Diagnosis And Its Association With Infarction Site In Patients With Acute Cerebral Infarction

Background The differences both in neurological deficit sign and the infarction site are very important to the clinic stroke diagnosis and treatment in modern neuroscience. While in Traditional Chinese Medical (TCM) differential diagnosis, there lays little emphasis on the symptoms defining stroke. Absorbing the modern research fruit can help us to extend the denotation of "method of four diagnoses", enlarge our optic scope, which can make the TCM differential diagnosis go with special particularities.Objective The aim of this study is to explore the relationship between infarction site and TCM differential diagnosis in patients with acute cerebral infarction.Materials and Methods We carried both respective and prospective studies in this paper. The former is the basic work of the latter. In it, we reviewed 299 selected patients with ischemic stroke, who had acute infarction confirmed with brain magnetic resonance imaging (MRI) in 38 patients and CT in 261 patients combining with neurological deficit sign. Owing to the missing of information both in imaging results and physical exam, we find some limitations in this study.To get more accurate spatio-temporal orientation, we prospectively studied 89 selected patients with ischemic stroke, who had acute infarction confirmed with brainmagnetic resonance imaging (MRI) in 41 patients and diffusion weighted imaging (DWI) in 48 patients combined with neurological deficit sign. The location of infarction was classified as two systems, anterior and posterior. The anterior infarctions were further classified as cortex, white matter and basal ganglia. The posterior infarction included brain stem, thalamus and cerebella. The TCM differential diagnosis was assessed within 30 days after symptoms onset. The TCM differential diagnosis was categorized three types, excess syndrome, deficiency syndrome, and excess & deficiency syndrome.Results In patients with cortical infarction, excess syndrome were found in 58.8% and deficiency syndrome in only 17.6%. 85% had deficiency syndrome in patients with basal ganglia infarction. None of patient was found excess syndrome in this group. 42.9% of patients had excess syndrome and 35.7% had deficiency syndrome in patients with white matter infarction. Posterior circulation infarction had more excess syndrome (46.7%) than deficiency syndrome (20.0%).Conclusion There is relationship between site of infarction and TCM differential diagnosis in patients with acute cerebral infarction. Cortical and posterior circulation infarction had more excess syndrome than deficiency syndrome. While in patients with basal ganglia infarction we found more deficiency syndrome without any excess syndrome.