| Research backgroundIschemic stroke is a disorder of blood supply to the brain,Ischemic necrosis or softening of ischemic brain tissue induced by ischemia and hypoxia,In recent years,the incidence and mortality of ischemic stroke increased year by year,The global burden of disease study shows that ischemic stroke has become the leading cause of death in China since 2010.The study of Western medicine,that is,gene and protein level,has become a hot topic,Gene translation protein;Traditional Chinese medicine for the understanding of ischemic stroke from the macro point of view of the syndrome and physical level,Constitution is the internal basis of syndrome,Both the theory of body constitution and genomics have genetic nature,which are affected by congenital factors and acquired environmental effects,These similarities determine the connection between them,There is a certain relationship between gene and protein,syndrome and constitution,Therefore,it is necessary to study the pathogenesis of the disease from the aspects of constitution,syndrome,gene and protein level,so as to provide a reference for clinical treatment and Prevention.Research purposesTo study the characteristics syndromes,constitution,related Inflammatory mediators proteins and MTHFR C677T polymorphisms in patients with ischemic stroke and their correlations,To provide the corresponding clinical research basis for the intervention of ischemic stroke patients from the aspects of constitution,syndrome,protein and gene.Research methodsObject of studyResearch methodThe number of patients with ischemic stroke is 61 who were distributed over seven national clinical units from November 1,2016 to January 10,2017(Beijing University of Traditional Chinese Medicine Dongzhimen Hospital,Beijing Tiantan Hospital Affiliated to Capital University of Medical Sciences,Guangdong Provincial Hospital,Changchun University of Traditional Chinese Medicine Affiliated Hospital,Henan First Affiliated Hospital of Traditional Chinese Medicine,First Affiliated Hospital of Henan College of Traditional Chinese Medicine,Beijing University of Traditional Chinese Medicine,Dongyuan Hospital,Taiyuan Hospital).Research designObservational study.Data collection informationThe collected data information mainly includes:demographic information,basic disease information,stroke onset information,TCM syndrome,Chinese medicine constitution,living ability,life behavior,psychological information,imaging examination,laboratory test,biological sample information.Qality controlFor participants,the aspects research of following project,CRF data collection table,and biological sample collection were trained accordingly.And the quality of whole research process should be strictly controlled.Through strict check and management,the qualified CRF data collection table information would be imputed and checked two times into the ischemic data acquisition platform exploited jointly by the research group and the Beijing University of Science and Technology.Satistical analysisIn this study,SPSS 21.0 statistical software was used to analyze the data.All statistical analysis tests were adopted on two-sided hypothesis test,assuming that the test level were taken α = 0.05,that is,P≤0.05 would be considered to have statistical significance.The principles of described indicators and hypothesis test in the description and deduction of statistical data were as follows:5.1 Hardy-Weinberg’s Equilibrium examines whether the heredity of the patients is balanced;5.2 Measurement data are operated by normality test,and the normal distribution data were analyzed by two independent sample T-tests.The results are shown in x±s,while non-normal data between two groups are adopted Mann-Whitney U test,three groups are used Kruskal-Wallis H test.The correlation between two variables was analyzed by correspondence analysis,Multiple correspondence analysis was used to analyze the correlation between the four variables.5.3 Logistic regression model was used to determine the risk factors for ischemic stroke,aortic and small arterial ischemic stroke,phlegm-dampness constitution and non-phlegm-dampness constitution.Research result1 A total of 61 cases,the average age of the patients was 64.13±7.525,the maximum age is 80,the minimum age is 47;of which 45 cases of male patients and 16 female patients;29 cases of patients with smoking,drinking history in 21 cases;41 cases of patients with hypertension,18 with diabetes,15 cases of hyperlipidemia patients in 11 cases,5 cases of patients with coronary heart disease,homocysteine.2 There are 30 cases with the highest frequency who are diagnosed with phlegm stasis syndrome in the 61 total patients,followed by qi deficiency and blood stasis in 11 cases.Phlegm-dampness constitution is a high incidence of ischemic stroke patients,a total of 20 cases,followed by blood stasis in 11 cases.3 Statistical analysis of TCM syndromes in patients with different TCM types of ischemic stroke showed:the proportion of phlegm and dampness constitution was highest in patients with phlegm and blood stasis syndrome,and the proportion of qi deficiency constitution was highest in patients with qi deficiency and blood stasis syndrome,and the proportion of yin deficiency constitution was highest in patients with syndrome of stirring wind due to yin deficiency.4 The distribution of type of the TCM constitution in patients with ischemic stroke in different TCM syndrome showed:patients with phlegm and dampness constitution,blood stasis,normal constitution may be wind phlegm blood stasis blocking syndrome.Patients with qi deficiency constitution tended to be qi deficiency and blood syndrome.Patients with syndrome of stirring wind due to yin deficiency may manifest in yin deficiency constitution.5 Analysis of the relationship between TCM constitution and traditional Chinese medicine syndrome showed that the qi deficiency constitution after disease were mainly qi deficiency and blood stasis syndrome,and phlegm-dampness and physical condition appeared to be wind phlegm stasis syndrome.6 The Z test showed the statistically significant differences in the comparison of Serum MMP-9 and serum IL-6 of the patients between wind phlegm and blood stasis syndrome and qi deficiency blood stasis syndrome.The level of MMP-9 in patients with qi deficiency and blood stasis syndrome was significantly higher than that in patients with wind phlegm and blood stasis syndrome;The level of IL-6 in patients with phlegm and blood stasis syndrome was significantly higher than that in patients with qi deficiency and blood stasis syndrome.7 Logistic regression analyzed the influencing factors of phlegm-dampness constitution and non-phlegm-dampness constitution patients,drinking,CT genotype were susceptible factor in phlegm-dampness constitution patients.8 There were statistically significant differences(P<0.05)in patients with aorta or small arterial wind phlegm and blood stasis syndrome and non-wind phlegm and blood stasis syndrome in the distribution of MMP-9,IL-6 by Z test,and the levels of MMP-9,IL-6 in patients with aorta arterial wind phlegm and blood stasis syndrome were apparently higher than these in small arterial.9 There were statistically significant differences(P<0.05)in patients with aorta or small arterial wind phlegm and blood stasis syndrome and non-wind phlegm and blood stasis syndrome by χ2 test.10 Analysis of the relationship between TCM constitution and MTHFR gene polymorphism showed that the genotype of MTHFR C677T was found to be CT genotype after the onset of disease for phlegm dampness constitution patients.11 Analysis of the relationship between TCM syndrome and MTHFR gene polymorphism showed that patients with wind phlegm stasis syndrome after the onset of disease are easy to show TT genotype;and patients with stirring wind due to yin deficiency tended to take place miscellaneous diseases and mutations miscellaneous mutations and manifest CT genotype.12 This study showed that the three factors affecting the incidence of ischemic stroke were:hypertension,smoking,drinking;the living habits between male and female patients,say,smoking,drinking have significant statistical differences(P<0.05).13 Analysis of the relationship between syndrome,constitution,inflammation related protein and MTHFR gene polymorphism in four patients:Correlation between phlegm dampness and phlegm stasis syndrome;Qi deficiency and Qi deficiency is related to blood stasis syndrome,The relationship between constitution and syndrome and inflammatory related protein and MTHFR gene polymorphism was weak.Conclusion1 From the analysis of the relationship between syndromes and physical fitness,phlegm-dampness constitution and normal constitution patients after the onset of symptoms prone to wind phlegm stasis syndrome;Qi deficiency after the disease is easy to show symptoms of qi and blood stasis,Prompted before the onset of the disease,such as for the physical conditioning,may have a certain effect on the prevention of ischemic stroke.2 The relationships between syndrome and MMP-9,IL-6 show:Wind phlegm stasis syndrome and IL-6 levels are related,Qi deficiency and blood stasis syndrome and MMP-9 levels are related.3 The relationship between polymorphism and MTHFR gene polymorphism shows that TT genotype is prone to wind phlegm stasis syndrome,CT genotype patients after the onset of disease is easy to show the stirring wind due to yin deficiency.4 The relationship between physical and MTHFR gene polymorphism shows that CT genotype is susceptible to phlegm and dampness constitution.To provide a basis for the further understanding of the pathogenesis of ischemic stroke,and to provide intervention strategies for clinical treatment and Prevention. |
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