Investigate The Relationship Between Principal Syndrome And Staging And Typing Of Posterior Circulation Infarction

Objective: Stroke is a major clinical event of local and diffuse brain function impairment which is induced by acute cerebral circulation dysfunction. Cerebral infarction (CI) is the general term for cerebral ischemic stroke. According to Oxfordshire Community Stroke Project, cerebral infarction includes total anterior circulation infarction, partial anterior circulation infarction, lacunar infarction and posterior circulation infarction. Posterior circulation infarction is the common type of cerebral ischemic stroke and approximately accounting for 20â„… of ischemic stroke. We use the method of intergrated traditional and western medicine to give a symptom factor mark to every patient which is in different stage or type, and then to find principal syndrome. This study is also to explore the relationship between the principal syndrome and every stage and type of posterior circulation infarction, and privide a new way for syndrome differentiation of TCM .Method: The 350 cases of posterior circulation infarction are selected from hospitalized patients in the Second Hospital of Hebei Medicine University. They are consistent with the cerebral infarction diagnosis standard set by Chinese journal of integrated traditional and western medicine (2006/10) (to try out)[1]. According to the pathogenesis after cerebral infarction and the change of cerebral edema, we separate POCI into earlier stage,crest-time, earlier convaleescence stage, intermediate convalescence stage, later convalescence stage. We divided POCI into three types according to serious degree: mild type, moderate type and severe type. At the same time we collect datas by using a method of comprehensive analysis by the four examination methods (a Chinese Wang Wen wen qie), and on the base of dialectical symptom scale of ZhuWenfeng to give a symptom factor mark. Then we use the principal factor analysis to extract the symptom factors. Analyzing the relationship between principal syndrome and staging and typing of posterior circulation infarction.Results:1 Symptom factor with higher frequency1.1 Symptom factor of disease location in the mild type of earlier stage: liver, meridian, stomach, spleen; symptom factor of disease nature: phlegm syndrome, endogenous wind, yin asthenia syndrome, damp pathogen, hemopenia syndrome, YANG hyperactivity syndrome, blood stasis syndrome, fire syndrome;1.2 Symptom factor of disease location in the moderate and severe type of earlier stage: liver, meridian, heart-spirit; symptom factor of disease nature: phlegm syndrome, endogenous wind, yin asthenia syndrome, hemopenia syndrome, excess symdrome of sroke, damp pathogen, blood stasis syndrome, deficiency of vital energy;1.3 Symptom factor of disease location in the mild type of crest-time: meridian, liver, stomach, spleen; symptom factor of disease nature: phlegm syndrome, endogenous wind,yin asthenia syndrome, damp pathogen, blood stasis syndrome, YANG hyperactivity syndrome, excess symdrome of sroke, fire syndrome, hemopenia syndrome, syndrome of stagnation of QI;1.4 Symptom factor of disease location in the moderate and severe type of crest-time: liver, meridian, heart-spirit, spleen, bladder; symptom factor of disease nature: phlegm syndrome, endogenous wind, excess symdrome of sroke, yin asthenia syndrome, blood stasis syndrome, YANG hyperactivity syndrome, damp pathogen, syndrome of stagnation of QI, fire syndrome;1.5 Symptom factor of disease location in the mild type of earlier convaleescence stage: liver, meridian, large intestine, spleen; symptom factor of disease nature: phlegm syndrome, damp pathogen, yin asthenia syndrome, endogenous wind, blood stasis syndrome, YANG hyperactivity syndrome, deficiency of vital energy, hemopenia syndrome, fire syndrome;1.6 Symptom factor of disease location in the moderate and severe type of earlier convaleescence stage: meridian, liver, large intestine, heart-spirit; symptom factor of disease nature: phlegm syndrome, blood stasis syndrome, yin asthenia syndrome, excess symdrome of sroke, YANG hyperactivity syndrome, hemopenia syndrome, endogenous wind, fire syndrome, syndrome of stagnation of QI, deficiency of vital energy;1.7 Symptom factor of disease location of the mild type of moderate and later convaleescence stage: liver, meridian, large intestine; symptom factor of disease nature: phlegm syndrome, hemopenia syndrome, yin asthenia syndrome, damp pathogen, endogenous wind, YANG hyperactivity syndrome, deficiency of vital energy;1.8 Symptom factor of disease location in the moderate and severe type of moderate and later convaleescence stage: meridian, liver, large intestine, heart-spirit; symptom factor of disease nature: phlegm syndrome, blood stasis syndrome, yin asthenia syndrome, deficiency of vital energy, excess symdrome of sroke, endogenous wind, fire syndrome, damp pathogen.2 Major symptom factor2.1 Acute stage: the mild type of earlier stage: factor 1 reflects the information of endogenous wind, phlegm syndrome, meridian; factor 2 reflects the information of spleen, stomach; factor 3 reflects the information of fire syndrome, YANG hyperactivity syndrome; the moderate and severe type of earlier stage: factor 1 reflects the information of heart-spirit,blood stasis syndrome, endogenous wind, factor 2 reflects the information of phlegm syndrome, YANG hyperactivity syndrome, factor 3 reflects the information of meridian, factor 4 reflects the information of liver; the mild type of crest-time: factor 1 reflects the information of meridian, endogenous wind, phlegm syndrome, factor 2 reflects the information of spleen, damp pathogen, factor 3 reflects the information of fire syndrome, factor 4 reflects the information of hemopenia syndrome, liver; the moderate and severe type of crest-time: factor 1 reflects the information of meridian, endogenous wind, phlegm syndrome, factor 2 reflects the information of liver, yin asthenia syndrome, YANG hyperactivity syndrome, factor 3 reflects the information of heart-spirit, excess symdrome of sroke; 2.2 Convalescent period: the mild type of earlier convaleescence stage: factor 1 reflects the information of blood stasis syndrome, phlegm syndrome, deficiency of vital energy, factor 2 reflects the information of spleen, meridian, factor 3 reflects the information of fire syndrome, factor 4 reflects the information of endogenous wind, factor 5 reflects the information of liver; the moderate and severe type of earlier convaleescence stage: factor 1 reflects the information of heart-spirit, large intestine, excess symdrome of sroke, blood stasis syndrome, phlegm syndrome, factor 2 reflects the information of deficiency of vital energy, YANG hyperactivity syndrome, yin asthenia syndrome, hemopenia syndrome, factor 3 reflects the information of syndrome of stagnation of QI, factor 4 reflects the information of meridian; the mild type of moderate and later convaleescence stage: factor 1 reflects the information of liver, YANG hyperactivity syndrome, yin asthenia syndrome, factor 2 reflects the information of meridian, damp pathogen, phlegm syndrome, factor 3 reflects the information of deficiency of vital energy, hemopenia syndrome, factor 4 reflects the information of endogenous wind; the moderate and severe type of moderate and later convaleescence stage: factor 1 reflects the information of heart-spirit, meridian, phlegm syndrome, excess symdrome of sroke, blood stasis syndrome, factor 2 reflects the information of deficiency of vital energy, factor 3 reflects the information of liver.3 Principal syndrome of TCM3.1 Acute stage: the mild type of earlier stage: obstruction of collateral caused by windphlegm; the moderate and severe type of earlier stage: obstruction of collateral and heart-siprit caused by windphlegm and blood stasis; the mild type of crest-time: obstruction of collateral caused by windphlegm; or with syndrome of fire-heat;the moderate and severe type of crest-time: obstruction of collateral and heart-siprit caused by windphlegm;3.2 Convalescent period:the mild type of earlier convaleescence stage: obstruction of collateral caused by phlegm and blood stasis and deficiency of QI, or with endogenous liver wind, syndrome of fire-heat;the moderate and severe type of earlier convaleescence stage: obstruction of heart-siprit caused by phlegm and blood stasis and deficiency of both vital energy and yin, or with sthenia heat of large intestine; the mild type of moderate and later convaleescence stage: asthenic yin causing predominant yang and obstruction of collateral caused by phlegm, or with syndrome of deficiency of QI; the moderate and severe type of moderate and later convaleescence stage: obstruction of collateral and heart-siprit caused by phlegm and blood stasis, syndrome of deficiency of QI.Conclusion:In the whole course of posterior circulation infarction,we can find the symptom of phlegm stagnating in meridian.And endogenous wind often appears in acute stage, deficiency of both vital energy and yin often appears in convalescent period. Heart-spirit,excess symdrome of stroke often appear in the moderate and severe type. Both acute stage and convalescent period, blood stasis can be finded. As accompanied symptoms and signs, syndrome of fire-heat can be found in acute stage or convalescent period.In a word, staging and typing of posterior circulation infarction has some relationship with principal syndrome of TCM. It can provid a new way and reference for syndrome differentiation of TCM.