Investigate The Correlation Between Syndrome Differentiation Of TCM With Staging And Typing Of Cerebral Infarction

Objective: Cerebral infarction(CI), is the generic name of cerebral ischemic stroke, include cerebral thrombosis, lacutypingar infarction and cerebral embolism, et al. It becoming more important that diagnose and treat it by staging and typing according to course, clinical manifestation, etiopathogenisis and pathology. We made staging and typing to CI patients that had identified by western medical diagnosis, with the method of combination of traditional Chinese medicine(TCM) with Western medicine. At the same time, we set up six symptom factors of disease nature and nine symptom factors of disease location. Approach the Correlation between Syndrome Differentiation of TCM with Staging and Typing of Cerebral Infarction, we expect to provid reference for differentiation of symptoms and signs.Method: The 144 cases of CI are selected from hospitalized patients in the Second Hospital of Hebei Medicine University. We divided CI into five stages: super-earlier stage, earlier stage, crest-time, earlier convalescence stage, intermediate convalescence stage. We divided CI into three types according to serious degree: light, middle and heavy. Each staging, we diagnosed each patient with six symptom factors of disease nature (endogenous wind, syndrome of fire-heat , phlegm syndrome, syndrome of blood stasis, deficiency of vital energy and asthenic yin causing predominant yang) and nine symptom factors of disease location (heart, liver, spleen, lung, kidney, meridian, brain, large intestine, stomach).Result: 1. The relation between staging of CI and symptom factors of disease nature: The frequency of endogenous wind had significant difference among stages (P<0.01). The frequency had fall-off tendency. Super-earlier stage(100%) and earlier stage(87.8%) had the highest frequency. It began to descend from crest-time(32.63%). Earlier convalescence stage(7.5%) and intermediate convalescence stage(5%) had the lowest frequency. The frequency of syndrome of fire-heat had significant difference among stages(P<0.01). The frequency had first rise and then fall-off tendency. It achieved peak at crest-time (72.63%). Other stages were also in high level(46.34%-62.5%). The frequency of phlegm syndrome, syndrome of blood stasis, deficiency of vital energy and asthenic yin causing predominant yang had nonsignificant difference among stages(P>0.05). The frequency of phlegm syndrome was always in high level, between 50% and 65.26%. The frequency of syndrome of blood stasis was between 23.08% and 41.05%. The frequency of deficiency of vital energy and asthenic yin causing predominant yang were always in low level. The frequency of deficiency of vital energy was between 15.85% and 30%. The frequency of asthenic yin causing predominant yang was between 11.54% and 25%. 2. The relation between staging of CI and symptom factors of disease location: The frequency of liver had significant difference among stages (P<0.01). The frequency had fall-off tendency, decreased from 92.31% of super-earlier stage to 40% of intermediate convalescence stage. It decreased obviously at convalescence stage. The frequency of meridian had significant difference among stages (P<0.01). The frequency had fall-off tendency, decreased from 96.15% of super-earlier stage to 60% of intermediate convalescence stage. The frequency of brain had significant difference among stages (P<0.01). The frequency first rise and then fall off, increased from 34.62% of super-earlier stage to 54.74% of crest-time, then decreased to 25% of intermediate convalescence stage. The frequency of heart, spleen, lung, kidney, large intestine, stomach had nonsignificant difference among stages(P>0.05). The frequency of heart was between 19.23% and 32.5%. The frequency of spleen was between 8.75% and 15%. The frequency of lung was between 20% and 30%. The frequency of kidney was between 7.32% and 20%. The frequency of large intestine was between 20% and 34.74%. The frequency of stomach was lower than 8.42%. 3. The relation between typing of CI and symptom factors of disease nature: The frequency of syndrome of fire-heat and phlegm syndrome in middle type and heavy type was higher than light type at each stage. Comparison of three types (light, middle and heavy) had statistical significance: syndrome of fire-heat and phlegm syndrome at earlier stage (P<0.01), syndrome of fire-heat (P<0.05) and phlegm syndrome (P<0.01) at crest-time. Compared each two: the frequency of syndrome of fire-heat in heavy type was significant higher than light type at earlier stage, the frequency of phlegm syndrome in middle and heavy type was significant higher than light type at earlier stage, the frequency of phlegm syndrome in heavy type was significant higher than light type at crest-time, above all P<0.0125. The frequency of endogenous wind, syndrome of blood stasis, deficiency of vital energy and asthenic yin causing predominant yang had nonsignificant difference among types(P>0.05). 4. The relation between typing of CI and symptom factors of disease location: The frequency of lung, brain, meridian and large intestine in middle type and heavy type was higher than light type at each stage. Comparison of three types (light, middle and heavy) had statistical significance: lung, brain, large intestine (P<0.01) and heart (P<0.05) at earlier stage (P<0.01); lung, meridian, brain(P<0.01) at crest-time. Compared each two: the frequency of lung, large intestine in heavy type was significant higher than light type at earlier stage, the frequency of brain in middle and heavy type was significant higher than light type at earlier stage, the frequency of lung in heavy type was significant higher than light type at crest-time, the frequency of brain in middle and heavy type was significant higher than light type at crest-time, above all P<0.0125. The frequency of liver, spleen, kidney, stomach had nonsignificant difference among types(P>0.05).Conclusion: The relation between staging of CI and symptom factors of disease nature: the frequency of endogenous wind fell-off gradually; the frequency of syndrome of fire-heat first rise and then fell-off; the frequency of phlegm syndrome, syndrome of blood stasis, deficiency of vital energy and asthenic yin causing predominant yang had nonsignificant difference among stages. The relation between staging of CI and symptom factors of disease location: the frequency of liver and meridian fell-off gradually; the frequency of brain first rise and then fell-off; the frequency of heart, spleen, lung, kidney, large intestine, stomach had nonsignificant difference among stages. The relation between typing of CI and symptom factors of disease nature: The frequency of syndrome of fire-heat and phlegm syndrome in middle type and heavy type was higher than light type at each stage; the frequency of endogenous wind, syndrome of blood stasis, deficiency of vital energy and asthenic yin causing predominant yang had nonsignificant difference among types. The relation between typing of CI and symptom factors of disease location: The frequency of lung, brain, meridian and large intestine in middle type and heavy type was higher than light type at each stage; the frequency of liver, spleen, kidney, stomach had nonsignificant difference among types. In a word, Staging and Typing of CI has some dependablity with symptom factors of disease nature and disease location of TCM. It can provid reference for differentiation of symptoms and signs of TCM.