風痰瘀阻型缺血性中風癥狀特點與血脂及凝血功能的相關(guān)性研究
發(fā)布時間：2018-08-13 16:09
【摘要】：研究目的:通過回顧廣州中醫(yī)藥大學附屬佛山中醫(yī)院腦病科2014至2016年風痰瘀阻型缺血性中風住院患者的情況,探討風痰瘀阻型缺血性中風"痰證"癥狀與血脂指標、"瘀證"癥狀與凝血功能異常的相關(guān)性,希望對風痰瘀阻型缺血性中風的客觀性診斷與治療提供較為可靠的臨床依據(jù)。研究方法:研究通過收集廣州中醫(yī)藥大學附屬佛山中醫(yī)院腦病(神經(jīng))科2014年1月1日至2016年12月31日診斷為風痰瘀阻型缺血性中風患者的臨床病歷資料,統(tǒng)計痰證、瘀證各癥狀出現(xiàn)頻次及其各項血脂與凝血功能水平,統(tǒng)計分析各證候要素在不同臨床指標上是否存在差異性,并分析"痰證"、"瘀證"癥狀與風痰瘀阻型缺血性中風血脂、凝血功能的相關(guān)性,發(fā)掘某些可能存在與相關(guān)指標有著密切聯(lián)系的具體癥狀。使用統(tǒng)計分析軟件SPSS21.0對所選病例的中醫(yī)癥狀與血脂、凝血功能進行相關(guān)性分析,基線研究及各癥狀組間對比使用單因素方差分析(組間比較選用Sidak檢驗),各癥狀與血脂、凝血功能水平的相關(guān)性研究使用spearman相關(guān)性分析。P0.05為有顯著性差異。研究結(jié)果:1.本次納入248例風痰瘀阻型缺血性中風患者,其中男性129例,女性患者119例。納入病例年齡均處于45~75周歲,其中45~55歲年齡段72人,56~65歲年齡段85人,66~75歲年齡段91人。按病程統(tǒng)計,其中急性期患者92例,亞急性期75例,恢復期81例。2.在痰濕癥狀中,"厚膩苔或滑苔"出現(xiàn)頻數(shù)最高,為220次占88.7%,其次為"滑脈",出現(xiàn)188次,占75.8%,出現(xiàn)最少的是"肥胖",共計25次,占10.1%;在瘀血癥狀中,出現(xiàn)頻數(shù)最高的為"紫暗舌",出現(xiàn)128次,占比51.6%,出現(xiàn)最少的為"代結(jié)脈",僅12次,占4.8%。3.在TC水平上,與肥胖組比較,納呆組、厚膩苔或滑苔組、滑脈組有顯著性差異(P0.05);其他痰濕癥狀間無顯著性差異。在TG水平上,與肥胖組比較,納呆組、胖大或齒痕舌組、厚膩苔或滑苔組、滑脈組TG有顯著性差異(P0.05);其他痰濕癥狀間無顯著性差異。在LDL-C水平上,與肥胖組比較,表情淡漠或寡言少語組、"頭悶痛、頭重、頭昏組"、口黏膩組、渴不欲飲組、咳痰或喉中痰鳴組、納呆組、便溏組、胖大或齒痕舌組、厚膩苔或滑苔組、滑脈組LDL-C有顯著性差異(P0.05);其他痰濕癥狀間無顯著性差異。在HDL-C水平上,各痰濕癥狀間無顯著性差異。在APTT、PT水平上,各血瘀癥狀間無顯著性差異。在FIB水平上,與口唇紫暗或暗紅組比較,舌有疲斑瘀點組、舌下脈絡青紫組、舌下脈絡曲張組FIB有顯著性差異(P0.05);其他血瘀癥狀間無顯著性差異。在DD水平上,各血瘀癥狀間無顯著性差異。4.Spearman相關(guān)性分析,發(fā)現(xiàn)"肥胖"與TC、TG、LDL-C水平呈正相關(guān)(P0.05,r0),"咳痰或喉中痰鳴"與TC水平呈正相關(guān)(P0.05,r0),其他各痰濕癥狀與中風患者TC、TG、LDL-C、HDL-C水平無相關(guān)性,P0.05。"舌有癖斑瘀點"與FIB、DD水平呈正相關(guān)(P0.05,r0),"舌下脈絡青紫"與FIB、DD水平呈正相關(guān)(P0.05,r0),"舌下脈絡曲張"與FIB、DD水平呈正相關(guān)(P0.05,r0),其他各血瘀癥狀與中風患者APTT、PT、FIB、DD水平均無相關(guān)性,P0.05。結(jié)論:在風痰瘀血型缺血性中風患者中,"肥胖"與TC、TG、LDL-C水平呈正相關(guān),提示通過TC、TG、LDL-C檢測可能有利于判斷患者的基本體型情況;舌有瘀斑瘀點、舌下脈絡青紫、舌下脈絡曲張與FIB、DD水平呈正相關(guān),提示FIB、DD水平可能有助于判斷患者舌象的瘀滯情況。
[Abstract]:Objective: To investigate the correlation between the symptoms of "phlegm syndrome" and blood lipid index, the symptoms of "blood stasis syndrome" and abnormal coagulation function in ischemic stroke of wind-phlegm-stasis type by reviewing the situation of inpatients with ischemic stroke of wind-phlegm-stasis type from 2014 to 2016 in the Department of Encephalopathy, Foshan Hospital of Traditional Chinese Medicine, affiliated to Guangzhou University of Traditional Chinese Medicine. Methods: The clinical data of patients with ischemic stroke of wind-phlegm-stasis type diagnosed from January 1, 2014 to December 31, 2016 in the Department of Encephalopathy (Neurology) of Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Traditional Chinese Medicine were collected, and the occurrence frequency of phlegm syndrome, blood stasis syndrome and their respective symptoms were analyzed. Statistical analysis was made on the correlation between the symptoms of "phlegm syndrome" and "blood stasis syndrome" and the blood lipid and blood coagulation function of ischemic stroke of wind-phlegm-stasis type. The correlation between TCM symptoms, blood lipids and coagulation function was analyzed by PSS21.0. The baseline study and the comparison of symptoms between groups were analyzed by one-way ANOVA (Sidak test was used for comparison). The correlation between symptoms, blood lipids and coagulation function was analyzed by spearman. P 0.05 was significant difference. 248 cases of wind-phlegm-stasis type of ischemic stroke were enrolled in this study, including 129 males and 119 females. All the cases were aged from 45 to 75 years old, including 72 aged from 45 to 55, 85 aged from 56 to 65, and 91 aged from 66 to 75. According to the course of the disease, 92 cases were in the acute stage, 75 in the subacute stage and 81 in the convalescent stage. Among the wet symptoms, "thick greasy fur or slippery fur" appeared the highest frequency, accounted for 88.7%, followed by "slippery pulse", 188 times, accounted for 75.8%, the least was "obesity", a total of 25 times, accounted for 10.1%; in the blood stasis symptoms, the highest frequency was "purple dark tongue", appeared 128 times, accounted for 51.6%, the lowest was "generation of veins", only 12 times, accounted for 4.8%. Compared with the obese group, there were significant differences in TG levels among Nadian group, thick greasy fur group, slippery fur group and slippery fur group (P 0.05); there were no significant differences in other phlegm-dampness symptoms. DL-C level, compared with the obese group, the expression of indifferent or few words group, "headache, head weight, dizziness group", sticky mouth group, thirst without drink group, sputum or throat phlegm group, Nadai group, feces group, fat or dental scar tongue group, thick fur or slippery fur group, LDL-C slippery pulse group had no significant difference (P 0.05); other phlegm and wet symptoms in HDL-C group. At the level of FIB, there was no significant difference in the symptoms of phlegm and dampness among the three groups. At the level of APTT and PT, there was no significant difference in the symptoms of blood stasis. Spearman correlation analysis found that "obesity" and TC, TG, LDL-C levels were positively correlated (P 0.05, r0), "cough phlegm or throat phlegm tinnitus" and TC levels were positively correlated (P 0.05, r0). Other phlegm-dampness symptoms and stroke patients TC, TG, LDL-C, HDL-C levels were not correlated, P 0.05. Positive correlation (P 0.05, r0), "sublingual vein cyanosis" and FIB, DD levels were positively correlated (P 0.05, r0), "sublingual vein variations" and FIB, DD levels were positively correlated (P 0.05, r0). Other blood stasis symptoms and stroke patients APTT, PT, FIB, DD levels were not correlated, P 0.05. Conclusion: In patients with wind-phlegm-blood stasis type of ischemic stroke, "obesity" and TC, TG, LDL-C levels were positively correlated. It is suggested that TC, TG, LDL-C may be helpful to judge the basic body type of patients; tongue has ecchymosis, sublingual veins blue and purple, sublingual variations and FIB, DD levels are positively correlated, suggesting that FIB, DD levels may be helpful to judge the tongue of patients with stasis.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R255.2
本文編號：2181500
[Abstract]:Objective: To investigate the correlation between the symptoms of "phlegm syndrome" and blood lipid index, the symptoms of "blood stasis syndrome" and abnormal coagulation function in ischemic stroke of wind-phlegm-stasis type by reviewing the situation of inpatients with ischemic stroke of wind-phlegm-stasis type from 2014 to 2016 in the Department of Encephalopathy, Foshan Hospital of Traditional Chinese Medicine, affiliated to Guangzhou University of Traditional Chinese Medicine. Methods: The clinical data of patients with ischemic stroke of wind-phlegm-stasis type diagnosed from January 1, 2014 to December 31, 2016 in the Department of Encephalopathy (Neurology) of Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Traditional Chinese Medicine were collected, and the occurrence frequency of phlegm syndrome, blood stasis syndrome and their respective symptoms were analyzed. Statistical analysis was made on the correlation between the symptoms of "phlegm syndrome" and "blood stasis syndrome" and the blood lipid and blood coagulation function of ischemic stroke of wind-phlegm-stasis type. The correlation between TCM symptoms, blood lipids and coagulation function was analyzed by PSS21.0. The baseline study and the comparison of symptoms between groups were analyzed by one-way ANOVA (Sidak test was used for comparison). The correlation between symptoms, blood lipids and coagulation function was analyzed by spearman. P 0.05 was significant difference. 248 cases of wind-phlegm-stasis type of ischemic stroke were enrolled in this study, including 129 males and 119 females. All the cases were aged from 45 to 75 years old, including 72 aged from 45 to 55, 85 aged from 56 to 65, and 91 aged from 66 to 75. According to the course of the disease, 92 cases were in the acute stage, 75 in the subacute stage and 81 in the convalescent stage. Among the wet symptoms, "thick greasy fur or slippery fur" appeared the highest frequency, accounted for 88.7%, followed by "slippery pulse", 188 times, accounted for 75.8%, the least was "obesity", a total of 25 times, accounted for 10.1%; in the blood stasis symptoms, the highest frequency was "purple dark tongue", appeared 128 times, accounted for 51.6%, the lowest was "generation of veins", only 12 times, accounted for 4.8%. Compared with the obese group, there were significant differences in TG levels among Nadian group, thick greasy fur group, slippery fur group and slippery fur group (P 0.05); there were no significant differences in other phlegm-dampness symptoms. DL-C level, compared with the obese group, the expression of indifferent or few words group, "headache, head weight, dizziness group", sticky mouth group, thirst without drink group, sputum or throat phlegm group, Nadai group, feces group, fat or dental scar tongue group, thick fur or slippery fur group, LDL-C slippery pulse group had no significant difference (P 0.05); other phlegm and wet symptoms in HDL-C group. At the level of FIB, there was no significant difference in the symptoms of phlegm and dampness among the three groups. At the level of APTT and PT, there was no significant difference in the symptoms of blood stasis. Spearman correlation analysis found that "obesity" and TC, TG, LDL-C levels were positively correlated (P 0.05, r0), "cough phlegm or throat phlegm tinnitus" and TC levels were positively correlated (P 0.05, r0). Other phlegm-dampness symptoms and stroke patients TC, TG, LDL-C, HDL-C levels were not correlated, P 0.05. Positive correlation (P 0.05, r0), "sublingual vein cyanosis" and FIB, DD levels were positively correlated (P 0.05, r0), "sublingual vein variations" and FIB, DD levels were positively correlated (P 0.05, r0). Other blood stasis symptoms and stroke patients APTT, PT, FIB, DD levels were not correlated, P 0.05. Conclusion: In patients with wind-phlegm-blood stasis type of ischemic stroke, "obesity" and TC, TG, LDL-C levels were positively correlated. It is suggested that TC, TG, LDL-C may be helpful to judge the basic body type of patients; tongue has ecchymosis, sublingual veins blue and purple, sublingual variations and FIB, DD levels are positively correlated, suggesting that FIB, DD levels may be helpful to judge the tongue of patients with stasis.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R255.2
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