Study On The Relationship Of TCM Syndromes And Correlative Test Indexes And NIHSS Score In Acute Cerebral Infarction

bjective: To investigate the relationship between different TCM syndromes of acute cerebral infarction(ACI)and blood homocysteine(Hcy),hypersensitivity-C-reactive protein(hs-CRP),uric acid(UA),cystatin C(Cys-C),blood lipids,D-dimer(DD),fibrinogen(Fib)and National Institutes of Health Stroke Scale(NIHSS)scores,Providing an objective reference index for the TCM syndrome differentiation of acute cerebral infarction,evaluating the evolution and prognosis of various syndromes of traditional Chinese medicine,making the TCM classification and treatment of acute cerebral infarction more accurate and objective,and further analyze the main syndromes and basic pathogenesis of acute cerebral infarction,Prevention of Acute Cerebral Infarction by TCM treatment,and provides a basis for prevention and treatment of cerebral infarction with integrated traditional Chinese and western medicine.Methods : Refer to "Diagnostic criteria for cerebral infarction and cerebral hemorrhage with integrated Chinese and Western medicine(trial)" and "Ischemic stroke syndrome diagnostic scale",formulate unified inclusion criteria,exclusion criteria,and use retrospective analysis.In 596 patients with acute cerebral infarction,TCM syndrome differentiation was performed to determine the syndrome type,and test indexes such as Hcy,hsCRP,UA,TC,TG,HDL-C,LDL-C,Cys-C,DD,Fib,and NIHSS scores were collected.SPSS17.0 was used for data entry and statistics to compare the scores of Hcy,hsCRP,UA,TG,HDL-C,LDL-C,Cys-C,DD,Fib,and NIHSS scores of each TCM syndrome type.At the same time,the correlation between relevant test indexes and NIHSS scores was compared.Results: 1.Of the 596 patients with acute cerebral infarction,327 were wind phlegm stasis syndrome(54.87%),106 cases were qi deficiency and blood stasis syndrome(17.79 %),66 cases(11.07%)were wind and fire disturbance syndrome,49 cases(8.22%)were phlegm heat syndrome,48 cases(8.05%)were Yin deficiency wind movement syndrome,among which wind phlegm stasis syndrome accounted for the highest proportion.2.There was a statistically significant difference in smoking,drinking and hypertension in different genders of ACI patients(P < 0.05).3.There was no significant difference in the combination of hypertension,diabetes,smoking and alcohol consumption among the TCM syndromes of ACI(P > 0.05).4.The relationship between TCM Syndrome types and related Test Indexes of ACI:Comparison of Hcy among ACI syndrome types: wind phlegm stasis syndrome,Qi deficiency and blood stasis syndrome were significantly higher than other syndrome types(P < 0.05).Comparison of Cys-C among different syndromes of ACI: there was no significant difference between each syndrome type by test(P > 0.05).Comparison of UA among different syndromes of ACI: the average level of UA in syndrome of phlegm-heat and fu-organs was significantly higher than qi deficiency and blood stasis syndrome,wind-fire disturbance syndrome,and Syndrome of Yin deficiency and Wind Movement(P<0.05).TG comparison among ACI syndrome types: wind phlegm stasis syndrome was significantly higher than qi deficiency and blood stasis syndrome,Yin deficiency wind movement syndrome,wind fire disturbance syndrome(P < 0.01 or P < 0.05),The syndrome of phlegm-heat and fu-organs was higher than that of the syndrome of disturbance of wind and fire and the syndrome of Yin deficiency and wind movement(P < 0.01 or P < 0.05).Comparison of TC of different types of ACI:there was no significant difference between each syndrome type(P > 0.05).Compared with HDL-C of different types of ACI:The syndrome of qi deficiency and blood stasis was significantly lower than that of the other four syndrome types(P < 0.01).Comparison of LDL-C among different types of ACI:Wind phlegm stasis syndrome was significantly higher than that of wind fire upper disturbance syndrome and yin deficiency wind movement syndrome(P < 0.01).Comparison of DD among ACI syndrome types: wind phlegm stasis syndrome,Qi deficiency and blood stasis syndrome were significantly higher than other syndrome types(P < 0.01).Compared with Fib among ACI syndromes,Qi deficiency and blood stasis syndrome were significantly higher than the other four syndromes(P<0.01 or P<0.05),Wind and phlegm stasis is higher than phlegm and heat,wind and fire disturbance syndrome and yin deficiency wind movement syndrome(P < 0.05).Comparison of FDP among ACI syndromes: wind phlegm stasis syndrome was significantly higher than other syndrome types(P < 0.05).hs-CRP was compared among different types of ACI:The syndrome of phlegm and heat and the syndrome of wind and fire were significantly higher than that of yin deficiency wind movement syndrome and qi deficiency and blood stasis syndrome(P < 0.05).5.Comparison of NIHSS scores of different TCM Syndrome types in ACI : The NIHSS score of phlegm-heat and fu-organs syndrome was significantly higher than that of qi deficiency and blood stasis syndrome,wind and fire disturbance syndrome,Yin deficiency wind movement syndrome(P < 0.05).6.The NIHSS score of acute cerebral infarction was positively correlated with Hcy?Fib?hs-CRP in patients with acute cerebral infarction,but there was no significant correlation with the level of UA?DD?FDP?TG?TC?HDL-C?LDL-C?Cys-C.Conclusions:1.The distribution of ACI in TCM syndromes is regular,in which wind phlegm stasis syndrome is the highest,Qi deficiency and blood stasis syndrome is the second,suggesting that the pathogenesis of ACI may be closely related to wind,phlegm and blood stasis.It may be effective to control acute cerebral infarction by the Chinese medicine treatment of wind-extinguishing and removing phlegm and removing stasis.2.Men with smoking,drinking history and hypertension are more at risk of cerebral infarction.3.The distribution of TCM syndromes in ACI is not related to age,sex,smoking,alcohol consumption,hypertension or diabetes.4.The levels of Hcy,TG,LDC-L,DD and FDP in patients with ACI can be used as reference markers for stasis syndrome and phlegm syndrome.hs-CRP can be used as a reference index for syndrome differentiation of phlegm heat syndrome and wind-fire syndrome.UA and NIHSS scores can be used as the reference index of syndrome differentiation of phlegm and heat;Fib and HDL-C can be used as a reference index of Qi deficiency and blood stasis.5.There was a significant positive correlation between the degree of neurological impairment and the level of Hcy?Fib?hs-CRP in patients with ACI,but no significant correlation with the level of UA,DD,FDP,Cys-C,TG,TC,HDL-C,and LDL-C.