Research Of TCM Syndromes And Correlating Factors Of Non-acute Ischemic Stroke

ObjectivesApproach the syndrome categories of non-acute ischemic stroke and their affecting factors,in order to furnish basis for secondary prevention of ischemic stroke to carry out directed treatment.Methods1.Theoretical Exploration:Study about TCM syndrome categories of stroke and their developing discipline in recent years is reviewed,and correlating factors of time,region and biological parameters,etc are explored.2.Clinical Research:Information of 336 subjects,including general condition,phase information and data of TCM four examinations,is collected by cross-sectional study,using the same observing tools.The conducting unit assigns professional researchers,who have received strict training,to diagnose syndrome of subjects and collect blood preparation in the same place.Results1.Generally,syndromes of qi-deficiency and blood-stasis are the most frequent occurrence among 336 subjects.After cluster analysis,combining with the proportion of syndrome elements,subjects of convalescence and sequelae stage mainly present the same syndromes of qi-deficiency and blood-stasis.2.Subjects of single-syndrome and amphi-syndromes have the highest ratio. Qi-deficiency and blood-stasis are important parts of single-syndrome,while blood-stasis plus qi-deficiency and internal-heat plus qi-deficiency are ones of amphi-syndromes.3.Significant deviation is observed in the percentage of blood-stasis between Group 40-49y and Group 60-69y(P＜0.05).The percentage of the latter group is significantly larger than the former.Spearman correlation analysis shows that there is direct correlation between blood-stasis syndrome and age. The possibility of blood-stasis syndrome will increase along with age.4.After cluster analysis,combining with the proportion of syndrome elements,male and female subjects mainly present the same syndromes of blood-stasis and qi-deficiency.However,extremely significant deviation is observed in the percentage of qi-deficiency between men and women(P＜0.01). Spearman correlation analysis shows that there is inverse correlation between qi-deficiency syndrome and gender.The proportion of qi-deficiency in female group is higher than in male group.5.No significant deviation is observed in the percentage of all syndrome elements between convalescence group and sequelae group(P＞0.05).Spearman correlation analysis shows that there is no clear correlation between syndrome elements and course of ischemic stroke.6.After cluster analysis,combining with the proportion of syndrome elements,subjects of North China mainly present syndromes of qi-deficiency, internal-heat and phlegm-damp,subjects of Middle China mainly present syndrome of qi-deficiency,and subjects of East and South China,qi-deficiency and blood-stasis.Significant deviation is observed in the percentage of internal-heat,phlegm-damp and blood-stasis among subjects of different regions.The proportion of internal-heat is obviously higher in North China than in South China,that of phlegm-damp is remarkably higher in North China than in Middle and East China,and that of blood-stasis is significantly lower in Middle China than in East and South China.Spearman correlation analysis shows that there is inverse correlation between internal-heat syndrome and region,and direct correlation between blood-stasis syndrome and region.It is the fact that the happening of internal-heat and blood-stasis is related to region factor.7.No significant deviation is observed in the proportion of all syndrome elements between subjects having and not having diseases including hypertension,heart-disease,diabetes anddyslipidemia(P＞0.05).It manifests that there is no remarkable correlation between syndrome and past history of subjects.8.The selected variables are made multi-element unconditional logistic regression for after single-factor analysis.It displays that factor of East China is risk factor of internal-wind syndrome,factor of North China is risk factor of internal-heat syndrome,North and South China are risk factors of phlegm-damp syndrome,age and South China are risk factors of blood-stasis, Middle China is protecting factor of blood-stasis,and gender is protecting factor of qi-deficiency.Syndrome of yin-deficiency has no obvious correlation with all affecting factors.9.It shows from Spearman correlation analysis and multi-element unconditional logistic regression,that internal-heat syndrome is risk factor of internal-wind,internal-wind and phlegm-damp are risk factors of internal-heat,blood-stasis and qi-deficiency are protecting factors of internal-heat,internal-heat is risk factor of phlegm-damp,internal-heat and qi-deficiency are protecting factors of blood-stasis,internal-heat and blood-stasis are protecting factors of qi-deficiency,but syndrome of yin-deficiency has no significant correlation with other syndrome elements.10.Deviation from T test of IL-1β,IL-6 and TNF-αof subjects is not significant between convalescence group and sequelae group(P＞0.05).Results from multi-way classification ANOVA show that variation of IL-1βcontent is affected by factors of gender,age and syndrome elements,variation of IL-6 content is affected by factor of gender,and that of TNF-αis affected by age.Conclusions1.Patients with first ischemic stroke in the last 1 year mainly present syndromes of qi-deficiency and blood-stasis.The combination of syndrome elements is simple,most manifesting single or combining appearance of qi-deficiency,blood-stasis and internal-heat.2.The possibility of blood-stasis syndrome happening will increase along with age of ischemic stroke patients.The proportion of qi-deficiency in female patients is higher than in male patients.3.The happening of internal-heat and blood-stasis is significantly affected by factor of region.Patients in North and South China differ greatly in TCM syndrome.Internal-heat is the main syndrome in North China,while blood-stasis in South China.4.Syndromes of tip repletion are easy to combine.There is remarkable direct correlation among syndromes of internal-wind,internal-heat and phlegm-damp. 5.Variation of Ih-1βof patients with first ischemic stroke in the last 1 year,is probably affected by TCM syndrome.