急性缺血性中风中经络构音障碍患者的证候特点及Frenchay评定分析

The Syndrome Characteristics and Frenchay Score Evaluation in Meridian Dysarthria Patients Suffered from Acute Ischemic Apoplexy

目的观察急性缺血性中风中经络构音障碍患者证候分布、Frenchay评定及其神经功能缺损程度,探讨急性缺血性中风中经络构音障碍的临床特点。方法将120例急性缺血性中风中经络构音障碍患者辨证分为5个组:肝阳暴亢、风痰阻络、痰热腑实、气虚血瘀、阴虚风动,同时根据美国国立卫生研究院卒中量表(NIHSS)进行评分与Frenchay构音障碍评定。结果急性缺血性中风中经络构音障碍患者风痰阻络占30.0%、气虚血瘀占25.0%,两者占的比例最多,其次为阴虚风动(16.7%)、肝阳暴亢(15.0%)和痰热腑实(13.3%);风痰阻络、气虚血瘀的轻度、中度、重度以上构音障碍的比例分别为25.0%、33.3%、41.7%和40.0%、33.3%、36.7%,与肝阳暴亢(50.0%、38.9%、11.1%)、痰热腑实(50.0%、37.5%、12.5%)、阴虚风动(60.0%、35.0%、5.0%)的分布频率明显不同,差异有显著性意义(P<0.005);痰热腑实型的神经功能缺损明显重于其余各组,差异亦有显著性意义(P<0.05)。结论急性缺血性中风中经络构音障碍患者以风痰阻络、气虚血瘀证型为主,而且两者出现中、重度构音障碍较多;而痰热腑实型以神经功能缺损最严重。

Objective To observe the syndrome distribution and Frenchay score evaluation as well as the neurological functional deficit scales in meridian dysarthria patients suffered from acute ischemic apoplexy,and to explore the clinical syndrome characteristics.Methods 120 ACI patients with dysarthria were randomly divided into 5 groups by differentiation of symptoms and signs,including liver-yang hyperactivity group,wind-phlegm group,phlegm-heat accumulation group,qi deficiency and blood stasis group and yin deficiency and wind act group.All patients were evaluated with national institutes of health stroke scale（NIHSS） and dysarthria Frenchay score.Results The incidence of wind-phlegm accunted for 30.0% and 25.0% in qi deficiency and blood stasis group.Both of them were the most common syndrome in meridian dysarthria patients suffered from acute ischemic apoplexy.The rate of yin deficiency and wind act,liver-yang hyperactivity and phlegm-heat accumulation were respectively up to 16.7%,15.0% and 13.3%.The proportion of ACI patients with different degrees of dysarthria（mild,moderate and severe） respectively reached 25.0%（mild）,33.3%（moderate）,41.7%（severe） in wind-phlegm group and 40.0%（mild）,33.3%（moderate）,36.7%（severe） in qi deficiency and blood stasis group,which were different from liver-yang hyperactivity group（presenting 50.0% in mild cases,38.9% in moderate cases and 11.1% in severe cases）,phlegm-heat accumulation group（presenting 50.0% in mild cases,37.5% in moderate cases and 12.5% in severe cases） and yin deficiency and wind act group（presenting 60.0% in mild cases,35.0% in moderate cases and 5.0% in severe cases）.The differences were significant（P0.005）.The degrees of neurological functional deficit in phlegm-heat accumulation group were more severe than those in other groups,there were significant differences（P 0.05）.Conclusion The meridian dysarthria occurs frequently in both wind-phlegm group and qi deficiency and blood stasis group,presenting more moderate and severe cases.The most severe neurological functional deficit is wildly found in phlegm-heat accumulation group.