Epidemiologic Study Of 156 Stroke Cases In Taiwan In The Fields Like High Risk Elements, Common Clinical Symptoms And Body Signs And Chinese Medicine Constitution Types

ObjectiveThis research adopts epidemiologic study methods and investigated 156 stroke cases in Taiwan in the fields like high risk elements, common clinical symptoms and body signs and Chinese Medicine constitution types. It further discusses the rules of Chinese Medicine syndromes. The classification avoids the defects of theoretical inference and provides important theoretical and clinical material for clinical work as well as basis for making Chinese Medicine and Integrated Chinese and Western Medicine treatment plans.MethodsThis research adopts epidemiologic study methods and investigated 156 stroke cases in Taiwan in the fields like high risk elements, common clinical symptoms and body signs and Chinese Medicine constitution types. According to the interviewees'answers and physical examination results, the author refers to the Investigation Form of Chinese Medicine Clinical Symptoms and Body Signs of Stroke Presymptoms in the "Diagnosis of Stroke Presymptoms and Evaluation Standards". The author refers to Professor Wang Qi's 9 classifications of constitution, including mild constitution, yi-deficiency constitution, yang-deficiency constitution, phlegmatic hygrosis constitution, humid heat constitution, qi-deficiency constitution, stagnant blood constitution, depressed qi constitution, and special constitution. Based on the above, the author makes Investigation Form on Chinese Medicine Constitutions.Record the qualified questionnaires in Epidata 3.02 and analyze with SPSS15.0. Data analysis methods:use SPSS 15.0. Descriptive statistics:adopt descriptive statistical methods to process the interviewees'basic information, the clinical symptoms and body signs, the Chinese Medicine syndrome types and Chinese Medicine constitution types of stroke presymptoms. The measurement data is expressed by x±S and the numeration data is expressed by percentage. Univariance analysis:apply tor Ftest for interclass measurement data comparison. (For heterogeneity of variance, adopt Wilcoxon rank sum test or Kruskal-Wallis test). Interclass multiple comparison adopts q test (Newman-Keuls methods). The interclass comparison of classification data adopts x test. The ranked data analysis adopts Wilcoxon rank sum test. The making of part of the statistic graphs adopts software Graph Pad Prism 4.03.Results1. Basic information of patients of Stroke PresymptomsThere are 250 qualified subjects, including 156 of stroke presymptoms and 94 healthy ones. Stroke Presymptom Group:male 91, female 65, average age 59.84±8.26. The Healthy Group:male 55, female 39, average age 57.89±8.63. Both groups have comparability in gender and age, etc.2. Analysis of the influencing factors of Stroke PresymptomsThere's no statistical significance in the difference of the clinical symptom score between different genders and there is statistical significance (P<0.01) in the difference of clinical symptoms score between different age periods of 156 stroke presymptoms patients in this study. The score rises with age and reaches peak at the age of 60-69, which has significance in the difference compared with other age periods and then the score decreases.Sentiment factors:Among the 156 cases of stroke presymptoms,77 are irritable, at the ratio of 49.4%. Among the 94 cases in the Healthy Group, 30 are irritable, at the ratio of 31.9%. The Stroke Presymptoms Group and the Healthy Group's OR in the factor of irritability is 2.08, and 95% CI is (1.22, 3.55) with irritability as the risk factor; while the OR in the factor of happiness is 0.39, and 95% CI is (0.21,0.72) with happiness as the protective factor.Diet factors:Greasy food affects the stroke presymptoms and the difference has statistical significance (P<0.05). The Stroke Presymptoms Group and the Healthy Group's OR in the factor of greasy food is 2.65, and 95%CI is (1.20,5.83). Greasy food and stroke presymptoms have positive association and the former is the risk factor. Therefore, the light flavor of food and no addiction to cold or hot food are very important.Smoking and drinking factors:63 cases of Stroke Presymptoms Group (40.4%) and 18 cases of the Healthy Group (19.1%) smoke a lot and smoke for decades with the smoking index above 450. The difference has statistical significance (P<0.01).40 cases of Stroke Presymptoms Group (25.6%) and 5 cases of the Healthy group (5.3%) drink a lot (daily drinking volume>150ml). The interclass difference has statistical significance (P<0.01).It shows smoking and drinking can induce Stroke Presymptoms and are the high risk factors.History of physical and mental strain:The Stroke Presymptoms Group has 39 cases (25.0%) and the Healthy Group 12 cases (12.8%). Their OR in the this factor is 2.28 and the 95% CI is (1.12,4.61). The difference has statistical significance (P<0.01) and it can be said that physical and mental strain is the important risk factor of stroke.3. Distribution of the Chinese Medicine syndromes of stroke presymptomsThe first ten in the occurrence frequency of the 19 clinical common symptoms of the 156 stroke presymptoms patients are:episode unilateral anesthesia, irritability, finger numbness, constipation, dry and bitter mouth, paroxysmal vertigo, red tongue with yellowish fur with string-like, slippery and rapid pulse, ache and distension of head, dark color of tongue, petech and the string-like and uneven pulse, red face and eyes, etc. These symptoms are related to pathological factors like fir, phlegm and stasis, etc.In the distribution of Stroke Presymptoms'syndrome types:liver and gall fire and phlegm and stasis impatency occupy the largest percentage with 49.4% and 33.3% respectively. They are the major syndrome and the major etiological factors and pathogenesis, therefore are the key to the differentiation treatment.4. Distribution of the constitution of stroke presymptomsThe investigation of the 156 cases of stroke presymptoms patients' constitution shows 107 (68.6%) are deficiency constitution (including qi, yin and yang deficiencies); 48 (30.8%) are excess constitution (including phlegmatic hygrosis constitution, humid heat constitution, stagnant blood constitution, depressed qi constitution) and 11 (7.1%) cases are mild constitution. It shows that the stroke presymptoms patients are mainly of deficiency constitutions, especially qi and yin deficiency. Qi deficiency (34.6%), yin deficiency (21.2%) and phlegmatic hygrosis constitution (20.5%) are the most commonly seen constitution types of stroke presymptoms.Among male patients,30.8% are qi deficiency,23.1% are yin deficiency and 23.1% are phlegmatic hygrosis constitutions. Among female patients,40.0% are qi deficiency,18.5% are yin deficiency and 16.9% are phlegmatic hygrosis constitutions. The percentage of qi deficiency constitution is far above that of the other two constitutions.Considering the distribution of different age, the author finds patients below 70 are mainly qi deficiency and phlegmatic hygrosis constitutions, while those above 70 are mainly qi and yang deficiency constitutions.ConclusionBy this investigation, we find that stroke is closely related to factors like age, constitution, sentiment, weather, diet and living habits, etc. Old age, poor health, yin deficiency and yang excess, irritability, mental and physical strain, greasy food, smoking and drinking are very important factors. The clinic manifestation is mainly fire, heat, phlegm and stasis. Liver and gall fire and phlegm and stasis impotency are two major syndrome types. They are the major syndrome of stoke presymptoms. It indicates that fire heat and phlegm and stasis are the major etiological factors and pathogenesis of stroke presymptoms. The constitution types are mainly qi deficiency, yin deficiency and phlegmatic hygrosis constitutions. Patients of stroke presymptoms above middle age are mainly deficiency constitutions.