| 1. ObjectiveIschemic stroke in the central nervous system occupies an important position, which has incidence and morbidity high. At present, western medicine therapy method with traditional Chinese medicine could achieve good effect. Always related material have for a single research center of ischemic stroke (stroke disease were retrospectively syndrome), but the research scope and research contents were more extensive,thorough, there is no the multicenter clinical research about syndrome rule and Eliminating phlegm to invigorate the dredging method of acute ischemic stroke patients at present. Therefore, the purpose of this study:(1) Through a retrospective observation of acute ischemic stroke in patients in double centers, we further study channels of acute ischemic stroke of TCM syndrome, deepen understanding about the pathology and pathogenesis of acute ischemic stroke. (2) Retrospective observation on the Clinical effectiveness and differences of acute ischemic stroke patients in two hospitals by using Eliminating phlegm to invigorate the dredging method.2. Methods2.1. Syndrome research:In this study,232 cases of acute ischemic stroke meridians cases who were in accordance with the inclusion criteria were reviewed and observed, TCM syndrome differentiation based on national planning of higher institutions of teaching materials of Chinese medicine, "Chinese internal medicine ", "Chinese diagnostics "and "Syndrome-differentiated diagnosis standard", summarizes the clinical manifestations and syndromes distribution rule of acute ischemic stroke in meridian. 2.2 Clinical observation on the therapeutic effect:select the patients that TCM syndrome belong to differentiation of phlegm and blood stasis, and at the same time been taked in eliminating phlegm to invigorate the dredging method, 109 cases from the main symptoms, signs, NIHSS scores before and after the treatment of change, syndromes integral change, evaluation the clinical efficacy of eliminating phlegm to invigorate the dredging method and compare the differences of two hospital by the law.3. Results3.1 syndrome research:by the clinical retrospective study of syndromes learning characteristic of 232 patients with acute ischemic stroke in two hospital, the results show that the Syndrome types of acute ischemic stroke(Stroke in meridian) most belong to phlegm stasis mutual type, and the basic syndrome with a high incidence is blood stasis syndrome, phlegmy wet card and wind card, followed by deficiency syndrome, internal fire card, a low incidence is Yin deficiency syndrome hand syndrome, Yang syndrome. We can see that phlegmy wet and blood stasis are the pathogenesis key of acute ischemic stroke (stroke in meridian). In a composite type, mainly for two or more, the most common form is the combination of phlegm stasis for deficiency, phlegm and blood stasis syndrome, wind phlegm and blood stasis syndrome, secondly common form of debility blood stasis syndrome, liver and kidney deficiency and phlegm and blood stasis syndrome, phlegmy heat stasis resistance syndrome, the sum of above six syndrome types takes 90.52%, the rest ones taking 9.48% are Yin deficiency syndrome hand, phlegmy heat astringing empirical, liver Yang hyperactivity, context stasis resistance syndrome, phlegm fire shut qiao card, Qi and Yin deficiency of two empty clip stasis, deficiency of phlegm and blood stasis clip heat syndromes, the wind on the fire faze card, phlegmy heat perturbation card on, Yang phlegm stasis, Yang, moisture resistance syndrome. Although in clinical syndrome differentiation process for distinguishing the astringing few, but the empirical research, about 9.05% patients experienced stool stem node mystery symptoms.3.2 symptoms or signs:in this study, the symptom with slanting body fatigue for complaint neurologic deficits appear frequency, was 196 examples, most of 84.48%. Secondly relatively more was central paralysis 97 patients, accounting for 41.81%; words adverse91cases, accounting for 39.22%; numbness and feel abnormal 64 cases, accounting for 27.59%; bulbar paralysis 43 cases, accounting for 18.53%. Appear frequency higher tongue pulse is pale tongue, dark tongue, red tongue, greasy moss, thin white moss, string pulse, smooth pulse, fine pulse.3.3 curative effects:this study showed that eliminating phlegm to invigorate the dredging method can significantly improve patients'symptoms and signs. Compared before and after the treatment, the total effective rate taked of 85.32%. The neurologic deficits symptoms of most patients get considerable recovery, TCM syndrome points have been improved obviously. The efficient of guangzhou university of traditional Chinese medicine first affiliated hospital is 87.30%, and the effective of wuyi hospital by 82.61%, chi-square test, P> 0.05, it explained that in the treatment of phlegm stasis syndrome in patients with acute ischemic stroke using eliminating phlegm to invigorate the dredging method, two hospital had the close total effective.4. Conclusion4.1 TCM syndrome type summarizing for:phlegm stasis for deficiency, phlegm and blood stasis syndrome, wind phlegm and blood stasis syndrome, blood stasis syndrome, debility blood stasis syndrome, liver and kidney deficiency and phlegm and blood stasis syndrome, phlegmy heat stasis resistance syndrome, Yin deficiency syndrome hand, phlegmy heat astringing empirical, liver Yang hyperactivity, context stasis resistance syndrome, phlegm fire shut qiao card, Qi and Yin deficiency of two empty clip stasis, deficiency of phlegm and blood stasis clip heat syndromes, the wind on the fire faze card, phlegmy heat perturbation card on, Yang phlegm stasis, Yang, moisture resistance syndrome, etc. Ischemic stroke(stroke acute phase in meridian) accountted for 6 kinds of main type before issuing, phlegmy wet and blood stasis syndrome is one of the most common elements. Guangdong is located lingnan wet environment, the crowd's physique common on syndrome of spleen wet shing card, constitution for ischemic stroke in old people, more than the viscera function decline, spleen and stomach and water wet function gradually abate, phlegmy wet endogenous, phlegm resistance qi stag, blood line impeded, phlegm and blood stasis caused impeded, therefore for the patients in the acute ischemic stroke, phlegm stasis resistance winding card was the most frequent syndrome.4.2 By eliminating phlegm to invigorate the dredging method for 109 patients with acute ischemic stroke (stroke of mutual and phlegm and blood meridian), it getted better clinical curative effect.The total effective rate is 85.32%, of the 1st affiliated hospital of guangzhou university of Chinese traditional medicine is 87.30%, of wuyi hospital is 82.61%, both was not statistically significant. |
