CISS卒中分型与中医证候要素相关性分析及其预后评判的意义初探

The study on the relationship of CISS with Chinese syndrome factor and the prognosis of ischemic stroke patients

关键词:  缺血性卒中亚型  辨证分型  证候要素

Key words:  CISS  syndrome differentiation for classification  syndrome factor

摘要:

[目的]研究中国缺血性卒中亚型(CISS)卒中分型与中医证候要素及预后判断的相关性。[方法]1)收集72h内的新发卒中患者的中医四诊信息及心电图、心脏彩超、经颅多普勒(TCD)、计算机断层扫描(CT)或核磁共振成像(MRI)等检查结果。2)将中医辨证分型与CISS分型结果做Spearman相关性分析。[结果])中医证类以血瘀(179例)、痰(105例)为主。2)心源性卒中预后较差(22.7%),穿支动脉疾病预后较好(3.5%);火证预后结局不良(20.5%),血瘀证(16.2%)预后较好者居多。3)火证(相关系数0.49,P=0.009)、血瘀证(相关系数0.55,P=0.004)与心源性卒中具有相关性;而痰证与大动脉粥样硬化性卒中相关(相关系数0.38,P=0.001),风证与穿支动脉疾病相关(相关系数0.47,P=0.009)。[结论]辨证分型中的血瘀证、痰证分别与心源性卒中、大动脉粥样硬化性卒中相关,火证与心源性卒中相关。CISS分型与中医证类对于卒中综合征的描述具有一定的相似性。

Abstract:

[Objective] To explore the correlation of CISS and Chinese syndrome factor.[Methods] 1) Collecting the medical information of fresh stroke patients such as ECG/TCD/CT/MRI.2) The Spearman correlation analysis was applied to analysis the CISS and Chinese syndrome factor.[Results] 1) Blood Stasis(179 cases),sputum(105 cases) were the major Chinese syndrome factors in this study.2) The cardiac stroke patients had the worst prognosis(22.7%) in the study.PAD patients had better prognosis(3.5%),and syndrome factor of heat had worse prognosis(20.5%),while blood stasis had better prognosis(16.2%).3) Heat(r=0.49,P=0.009)/blood stasis(r=0.55,P=0.004)were related to cardiac stroke meanwhile sputum(r=0.38,P=0.001) related to the atherosclerotic stroke syndrome factor of wind was related to PAD(r=0.47,P=0.009).[Conclusion] Blood stasis is related to cardiac stroke meanwhile sputum is related to the atherosclerotic stroke.Compared with the CISS subtyping of stroke syndrome,the Chinese differential diagnosis of stroke syndrome is similar to the CISS subtype method.