Study On The Distribution Of Syndrome Factors Between Large Artery Atherosclerosis Type And Small Artery Occlusion Type In Acute Ischemic Stroke

ObjectivesProspective study on the related cases of large artery atherosclerosis and small artery occlusion in acute ischemic stroke,to explore the similarities and differences of TCM syndrome elements distribution between large artery atherosclerosis and small artery occlusion in acute ischemic stroke.SignificanceObjective to explore the distribution characteristics of TCM syndrome elements of large artery atherosclerosis and small artery occlusion in acute ischemic stroke,and find the similarities and differences between them,so as to provide reference for clinical syndrome differentiation and treatment of two types of acute ischemic stroke.Methods1.Through the literature review of large artery atherosclerotic stroke and small artery occlusion stroke,referring to the "syndrome factor differentiation to learn" of Professor wen-feng zhu,combined with the related symptoms of ischemic stroke in "Diagnostics of traditional Chinese Medicine""traditional Chinese medicine new medicine clinical research guiding principles(try ouut)".The main points of symptoms of the two diseases were extracted and made into "syndrome factor symptom clinical questionnaire".2.A prospective study was conducted on 60 patients who were definitely diagnosed as"large artery atherosclerosis" and "small artery occlusion" in acute stage of ischemic stroke from September 2020 to December 2020 in dongzhimen hospital of Beijing university of traditional Chinese medicine,dongfang hospital of Beijing university of traditional Chinese medicine,wangjing hospital.3.The original data were quantized and input into the computer.SPSS 21.0 was used for statistical analysis.Results1.In 30 patients of acute ischemic stroke patients with small artery occlusion type,18 syndromes were exrtacted and sorted out after clinical symptomsand,the syndromes with a frequency of more than 5%ranged from high to low:a total of 3 disease locacion syndromes including lver,mind,meridian,and a total of 7 disease nature syndromes including Yin deficiency,heat,dampness,yang hyperactivity,blood stasis,blood deficiency,phlegm,all of 10 kind of symptoms.2.In 30 patients of acute ischemic stroke patients with large atherosclerosis type,18 syndromes were exrtacted and sorted out after clinical symptomsand,the syndromes with a frequency of more than 5%ranged from high to low:a total of 3 disease locacion syndromes including lver,meridian,mind,and a total of 7 disease nature syndromes including dampness,phlegm,yin deficiency,yang hyperactivity,blood deficiency,blood stasis,wind,all of 10 kind of symptoms.3.Through statistical analysis,it was found that the syndrome elements of phlegm and meridians in the large artery occlusion group of acute ischemic stroke were greater than those in the small artery occlusion group;the syndrome elements of heat in the small artery occlusion group of acute ischemic stroke were greater than those in the large artery atherosclerosis group.There was no significant difference in other syndrome elements.4.The syndromes were divided into two categorieswhich is deficiency syndrome elem ent and solid syndrome element.The acute small artery occlusion type stroke group account for 64.12%of solid syndrome elements and 35.88%of deficiency syndrome elements;The acute large artery atherosclerosis type stroke group account for 66.67%of solid syndrome elements and 33,33%of deficiency syndrome elements.Conclusion1.The proportion of solid syndrome elements is higher than that of deficiency syndrome elements in the two groups of small artery occlusion type and large artery atherosclerosis type in the acute stage of ischemic stroke,indicating that the standard excess is more prominent in the acute stage.Liver,heart and meridians account for a relatively high proportion of disease location syndrome elements,while phlegm,dampness,blood stasis,yin deficiency,blood deficiency and hyperactivity of Yang are the main disease type syndrome elements,suggesting that the acute stage of ischemic stroke involves multiple viscera.In the process of treatment,we should treat both the symptoms and the root causes,and pay attention to soothing the liver,relieving depression and regulating emotion,calming the liver and calming the wind,resolving phlegm,eliminating dampness and dredging collaterals.2.By extracting the syndrome elements of small artery occlusion type and large artery atherosclerosis type in the acute stage of ischemic stroke,it was found that there was a slight difference in the distribution of syndrome elements between the two groups.The syndrome elements "heat" of small artery occlusion group was larger than that of atherosclerosis group,and the syndrome elements "meridians" and "phlegm"of large artery occlusion group were smaller.It is suggested that the treatment of ischemic stroke should be based on syndrome differentiation.For small artery occlusion stroke,we should pay attention to nourishing yin and clearing heat.For large artery atherosclerosis stroke,we should pay attention to the application of phlegm resolving method,and improve the symptoms of neurological deficit in time.