Study On Syndrome Differentiation Of Regular Syndrome Of Stroke

Objective:to investigate classical prescription and its clinical use for acute phase of stroke by collecting and analyzing literature; Using Traditional Chinese Medicine Inheritance System(TCMIS) to analyze the composing principles of classical prescription for stroke; to understand the distributions of six-meridian syndromes and that of prescriptions and syndromes in patients with acute stage of stroke through clinical observation and prescription and syndrome differentiation, and to provide a referential path for treating stroke with classical prescription.Methods:Part1:Documental studyA computer-based online search of periodical database and a manual retrieval about relevant books were undertaken for literature about classical prescription treating acute phase of stroke. We classified literature accorded with the inclusive criteria according to different prescription, and acquired information such as pattern of literature (clinical trial, experience or case report),syndrome differentiation and changes of prescription by Microsoft Excel software.The collected classical prescription for stroke reported in the literature was entered into the TCMIS, by using revised mutual information, complex system entropy cluster and unsupervised hierarchical clustering to analyze composing principles.Part2:Clinical studyClinical data was collected such as general condition, four diagnostic information, clinical index of300patients with acute phase of stroke. Differentiated the patients by six-meridian, then by prescription and syndrome. Using SPSS software, investigated distributions of six-meridian syndromes and that of prescriptions and syndromes, as well as the relationship between syndromes of six-meridian and gender, age,risk factors, stroke history.Results:Documental studyPart11. there were145literatures about treatment for acute phase of stroke including33classical prescriptions. Classifying prescriptions by six-meridian could get19prescriptions treating single meridian disease and14that treating6kinds of combined meridians diseases.2. The most literature was about treatment for yangming disease. The involved prescriptions were Dachengqi decoction, Taohechengqi decoction, Didang decoction, Baihu decoction, Xiexin decoction, Dahuangzhechong pills, Gujinluyanxuming decoction, Fengyin decoction. There were50literatures of Chengqi decoction, accounted for34.5%3. There were91literatures of experience or case report, accounted for62.8%, and54of clinical trial, accounted for37.2%. Most literature used changed classical prescription with only22unchanged, accounted for18%.And formula combination was used in14literatures.Part2Based on the analysis of92cases of classical prescription, the frequency of130kinds of herbs included in the database was computed.26new potential combinations were got by cluster analysis, which further evolved8core combinations.4new prescriptions were finally mined from the database.Clinical study1.21types occurred in300patients by six-meridian differentiation, including6single meridian diseases and15combined meridian diseases. The most common one was Shaoyang and Yangming combined disease, which could be found in107patients, accounted for35%,then Shaoyang disease17.3%,Shaoyang and Yangming and Taiyin combined disease9.7%, Shaoyang and Taiyin combined disease8.3%.There were significant differences in distribution of21types through non-parameter test.2.89prescriptions and syndromes occurred in300patients. The most common one was Dachaihu decoction syndrome, which could be found in35patients, then Sini powder syndrome (23),Dachaihu and Guizhifuling pills syndrome (21),Sini powder and Guizhifuling pills syndrome (17),Sini powder combining with plaster stone syndrome (13),Dachaihu decoction combining with tuckahoe and atractylodes macrocephala syndrome (12),Xiaochengqi decoction and Xiaoxianxiong decoction syndrome (11),Xiaochaihu decoction syndrome (10).3. There were no significant differences between six-meridian syndromes and gender, age,risk factors, stroke history through non-parameter test.Conclusions:1. Classical prescriptions treating Yangming disease in acute stage of stroke are the most of all prescriptions reported in literature, and Chengqi decoction is more common than the other.2. The literatures are mainly about experience and case report. Clinical trials with high quality are fewer, which influence the referential suggestions.3. The four new prescriptions based on TCMIS have concise composition and definite target, which can provide reference for clinical application of classical prescription in the treatment of stroke and development of new drug.4. All of the six meridians can occur in acute stage of stroke. Shaoyang disease and Yangming disease are more common found than Taiyang disease and three-yin disease. Combined meridian disease is more common found than single meridian disease. Shaoyang and Yangming combined disease is the most common one in all combined meridian diseases.5. Dachaihu decoction syndrome, Dachaihu decoction and Guizhifuling pills syndrome are the most common prescription and syndrome in acute stage of stroke.