| Objective : Through the statistical analysis of the manifestations of magnetic resonance plain scan + DWI in patients with acute ischemic stroke,the correlation between the manifestations of magnetic resonance plain scan + DWI and the prognosis of patients with acute ischemic stroke and the classification of TCM syndromes was discussed,which provided objective quantitative evidence for the Classification of acute ischemic stroke.It provides a theoretical basis for TCM intervention in acute ischemic stroke and may have a positive effect on improving the prognosis of ischemic stroke.Methods :1.A total of 352 patients with acute ischemic stroke admitted to Anhui Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were selected.The clinical data of the patients were reviewed,and the patient ’s name,gender,age,contact method,TCM syndrome type,infarct location,infarct volume,infarct number were recorded.2.Pass to the different types of TCM syndrome differentiation,the patients were divided into liver yang type,wind phlegm type,phlegm heat type,blood stasis type and yin deficiency type.the location of the infarct,the volume of the infarct,and the number of infarcts were obtained by reading the patient ’s magnetic resonance images and reports,and then the results were reviewed by the imaging doctors with two deputy directors and above.Prognostic indicators : 90 days after the onset of the patient,the modified Rankin scale score was completed through outpatient follow-up or hospitalization review and telephone return visit.The prognosis was divided into good and poor according to the modified Rankin scale score.3.Statistical software SPSS26.0 was used to analyze the correlation between TCM syndromes and infarct volume.the number of infarction and the prognosis,and then analyzed according to the statistical results combined with relevant literature.Result:1.General information A total of 352 patients,Among them,185 people were man,about52.6 % of the all number,and 167 were woman,about 47.4 % of the all number.In age,the highest incidence age is 51-80 years old.About 79.0 % of the all number.For age,the quantity of man gradually low.Before 71 years old,the incidence of man was higher than that of woman.The rate of man to woman patients in 71-80 years old is close to 1 :1.Over 80 years old,the incidence of woman patients is higher than that of men.2.Distribution of TCM syndrome types Among the 352 patients,the rate of patients with wind-phlegm blocking collaterals was the highest,accounting for 34.9 %,followed by qi deficiency and blood stasis,accounting for 29.0 %.The proportion of liver-yang hyperactivity type,phlegm-heat fu-organ excess type and yin deficiency and wind stirring type was similar,accounting for 10.2 %,14.5 % and 11.4 % respectively.3.TCM syndrome type and infarct site In 352 patients,the infarct site was mainly concentrated in the lobe and the basal ganglia of the internal capsule,accounting for42.5 % and 28.4 % of the total number,respectively.The number of infarct sites was similar to the total number,which was thalamus(11.9 %),brain stem(8.5 %),cerebellum(8.5 %).Through the chi-square test of the R × C table,2 = 27.105 p =0.040 < 0.05,the difference between the groups was statistically significant.Dialectically,most of the infarcts of qi deficiency and blood stasis type occur in the cerebral lobe.4.TCM syndrome type and infarct volume Among 352 patients,140 patients showed small infarction,accounting for 39.8 % of the total number;156 patients showed moderate infarction,accounting for 44.3 % of the total;56 patients showed large infarction,accounting for 15.9 % of the total number;through the non-parametric test Kruskal-Wallis test p = 0.010 < 0.05,indicating that the difference between the groups was statistically significant,dialectical for the wind phlegm obstruction type,often infarct volume is small,often small infarction and infarction;dialectically,it is liver yang hyperactivity type,and the infarct volume is large,often manifested as large infarction;dialectically,it is phlegm-heat fu-organ excess type,and the infarct volume is often medium infarction;dialectical for qi deficiency and blood stasis type,infarct volume is often small infarction and infarction;dialectically,it is Yin deficiency wind type,and the infarct volume is often small infarction.5.TCM syndromes and the number of infarcts Among the 352 patients,the number of patients with single lesions was 131,accounting for 37.2 % of the total number,and the number of patients with multiple lesions was 221,accounting for 62.8 % of the total number.Through the chi-square test of the R × C table,2 = 24.918 p = 0.000 < 0.05,the difference between the groups was statistically significant.In the different TCM syndrome types of acute ischemic stroke,the infarcts of liver-yang hyperactivity type,wind-phlegm obstruction type and qi deficiency and blood stasis type are often manifested as multiple lesions.The syndrome differentiation of Yin deficiency wind type infarction often showed single lesion;syndrome differentiation is often more uniform in the number of infarcts of phlegm-heat fu-organ excess type.6.TCM syndrome type and prognosis Among the 352 patients,the number of poor prognosis in the prognosis classification was 83,accounting for 23.6 % of the total number;the number of patients with good prognosis was 269,accounting for 76.4 % of the total number.Through the chi-square test of the R × C table,2 = 47.073 p = 0.000 <0.05,indicating that the difference between the groups is statistically significant.The dialectical classification is qi deficiency and blood stasis type,yin deficiency and wind type,phlegm heat and fu-organ excess type.The prognosis is often good.The dialectical classification is wind phlegm obstruction type and liver yang hyperactivity type.The prognosis is general,and some may have poor prognosis.Conclusion : The magnetic resonance plain scan + DWI of acute ischemic stroke is closely related to the classification of TCM syndromes in the location,volume and number of infarcts.Early dialectical accuracy,early intervention may improve the prognosis of patients with acute ischemic stroke. |
PDF Full Text Request