Syndrome Distribution And Tcm Risk Assessment Model Of Apoplexy In High Risk Population

Objective: To explore the distribution of TCM syndromes in high risk population of stroke through analysis.To summarize the risk factors of high risk population of stroke and establish the risk assessment model of apoplexy related to TCM syndrome.Methods:1.Syndrome distribution rule of high risk population of stroke: 1183 cases of stroke high-risk population were included,the four-diagnosis information of patients was collected,and the correlation between symptoms and symptoms was studied by frequency analysis system cluster factor analysis and other methods,and the syndrome factors of patients were statistically analyzed.2.Establishment of syndrome factors diagnostic scale for high risk population of stroke: Syndrome factors of each patient were determined according to the results of syndrome factors and symptoms obtained from cluster analysis and factor analysis in Chapter 1 Spearman correlation pair and binary Logistic regression were used to analyze the correlation between syndrome factors and symptoms,and the relevant symptoms were assigned according to the regression coefficient.The receiver operating characteristic curve(ROC)was drawn and the diagnostic threshold was determined to re-include 298 patients.The diagnostic scale of syndrome factors was verified and the diagnostic value was evaluated.3.Establishment and verification of TCM risk assessment model for high risk population of stroke: According to the diagnosis scale of syndrome factors of high risk population of stroke obtained in Chapter 2,1183 patients were followed up by telephone,wechat or return visit to determine whether the patients had apoplexy The independent variables in the prediction model were screened by univariate Logistic regression,the prediction equation was established by multivariate Logistic regression,the receiver operating characteristic curve(ROC)was drawn,the variables in the equation were assigned,and the risk assessment scale of stroke risk population was established A total of 298 patients were re-enrolled,and the syndromes of the patients were determined by the diagnostic factors of syndromes in the high risk population of stroke.The patients were followed up for 1 year to determine whether the patients were suffering from stroke,and the prediction equation and risk assessment scale were verified by substituting patient information.Results:1.Syndrome distribution rule of high risk population of stroke: In this study,118 TCM related symptoms were selected through literature research and medical records retrieval,and 55 symptoms were finally determined,from which 5 TCM syndrome elements were extracted,including 645 patients with fire syndrome,phlegm syndrome,blood stasis syndrome,qi deficiency syndrome,Yin deficiency syndrome and fire syndrome,accounting for 54.5%,Sputum syndrome in 662 cases(56.0%),513 cases,accounting for43.4%,367 cases of Yin deficiency syndrome(31.0%),504 cases of qi deficiency syndrome,accounting for 42.6%.2.Establishment of syndrome factors diagnostic scale for high risk population of stroke: The area under the fire syndrome curve was 0.998,and the diagnostic threshold was16 points.The area under the curve of sputum syndrome was 0.998,and the diagnostic threshold was 12 points.The area under the blood stasis curve was 0.997,and the diagnostic threshold was 12 points.The area under the curve of Qi deficiency syndrome was 0.989,and the diagnostic threshold was 15 points.The area under the curve of Yin deficiency syndrome was 0.97,the diagnostic threshold was 13 points and 298 patients were selected for verification.The accuracy,sensitivity and specificity of fire syndrome were 91.3%,93.5% and 89.0%,respectively.Sputum syndrome accuracy was 94.0%,sensitivity was 95.0%,specificity was 92.8%.The accuracy,sensitivity and specificity were 98.7%,100% and 97.6%,respectively.The accuracy,sensitivity and specificity were91.9%,95.2% and 89.7% respectively.The accuracy,sensitivity and specificity were 92.3%,90.5% and 93.4% respectively.3.Establishment and verification of TCM risk assessment model for high risk population of stroke:In this part of the study,according to univariate logistic re gression analysis,the risk factors related to stroke were age,fire syndrome,phlegm syndrome,hypertension and diabetes The risk factors were put into the multivariate logistic regression analysis to establish the risk assessment and diagnosis equation P=Exp(3.502+1.773* fire syndrome +1.586* phlegm syndrome +1.489* hypertension+1.578* diabetes +1.649* hyperlipidemia-0.083* age)/1+Exp(3.502+1.773* fire synd rome +1.586* Phlegm syndrome +1.489* hypertension +1.578* diabetes +1.649* hyp erlipidemia-0.083* age),the area under ROC curve of the diagnostic equation was0.736,which was verified by the verification group with 72.8% accuracy and 71.0%sensitivity The variables were assigned according to the multivariate regression anal ysis,so that the evaluation model was transformed into a scale that was easy to ap ply.The area under the ROC curve of the scale was 0.787,and the diagnostic thre shold was 80 points.The verification group was carried out with accuracy of 71.4%,sensitivity of 77.4%,and specificity of 70.4%.Conclusion: Based on the analysis of the four-diagnosis information of the high-risk population of stroke,five syndrome factors were summarized in the high-risk popul ation of stroke,among which sputum syndrome was the most,accounting for 56.0%,followed by fire syndrome(54.5%),stasis syndrome(43.4%),qi deficiency syndro me(42.6%),Yin deficiency syndrome(31.0%).The syndrome factor diagnostic scale was established,and the total score was set at 100 points.The diagnostic thresholds of fire syndrome,phlegm syndrome,stasis syndrome,qi deficiency syndrome,Yin deficiency syndrome were 16 points 12 points 12 points 15 points 13 points respect ively.A risk assessment model based on TCM syndromes was established to establis h the risk assessment and diagnosis equation P=Exp(3.502+1.773* fire syndrome +1.586* phlegm syndrome +1.489* hypertension +1.578* diabetes +1.649* hyperlipidem ia-0.083* age)/1+Exp(3.502+1).773* fire syndrome +1.586* Phlegm syndrome +1.489* hypertension +1.578* diabetes +1.649* hyperlipidemia-0.083* age).It has been proved that the equation and risk assessment scale have a good value in assessing the risk of stroke in high-risk population.