中风病证候要素与急性脑梗死大小血管病因相关性研究

Study on Correlation between TCM Symptoms and Vascular Size in Acute Cerebral Infarction

目的：运用多因素分析方法,研究中风病证候要素与急性脑梗死大小血管病变的相关性。方法：收集2010—2013年急性脑梗死140例患者的临床资料,中风病证候要素采用积分法,对痰证、火证、血瘀证、热证、风证依据积分分值判定为：〈7分设定为无,7~14分为轻度,15~22分为中度,≥23分为重度。病因诊断通过网络分型系统对卒中病因做出诊断,筛选出有统计学差异的单因素变量,进入有序多因素logist回归分析。结果：单因素分析提示,高血压、糖尿病、痰证积分值、火证积分值、血瘀证积分值、热证积分值、风证积分值等因素与急性脑梗死病变血管的大小相关,其χ2值和P值分别为17.111,0.047、6.847,0.036、3.0142,0.0154、2.987,0.049、5.0172,0.0364、4.087,0.0412、2.471,0.0135,有统计学差异。有序多因素logist回归分析结果：血糖水平（χ2=5.606,P=0.018）、痰证积分值（χ2=5.304,P=0.021）、血瘀证积分值（χ2=4.569,P=0.033）、热证积分值（χ2=4.098,P=0.043）、风证积分值（χ2=3.912,P=0.048）。结论：中风病急性期,血糖水平越高,以及痰证、热证和风证积分值越大,影响小血管病变的风险越大;血瘀证积分值越大,影响小血管病变的风险越小,而影响大血管病变的风险越大。

Objective：To study the correlation between TCM symptoms and vascular size in the acute cerebral infarction. Methods ：The clinical data of 140 patients with acute cerebral infarction from 2010 to 2013 was collected. Stroke syndrome elements were analyzed by using the integral method, phlegm, fire, blood stasis, heat syndrome and wind syndrome score points were classified into 〈 7 points set to none ;7 - 14,15 -22 were divided into mild to moderate;≥ 23 points were severe. Etiological diagnosis was made by a network of systems for the diagnosis of stroke etiology. Screened statistically significant univariate variables were analyzed into ordinal regression logist. Results ： Univariate analysis of factors showed significant differences in hypertension, diabetes, phlegm integral value, fire certificate integral value, the integral value of blood stasis, heat syndrome integral value, such as wind syndrome integral value and its χ2 values and P values were 17.111,0.047 ;6. 847,0. 036 ;3. 0142,0. 0154 ;2. 987,0.049 ; 5. 0172,0. 0364 ;4. 087,0. 0412 ;2. 471,0. 0135 respectively. Ordinal logist regression analysis showed that statistical differences in blood glucose levels （χ2 = 5. 606, P = 0. 018 ）, phlegm integral value（ χ2 = 5. 304, P = 0. 021 ）, blood stasis syndrome integral value （ χ2 = 4. 569, P = 0.033） heat syndrome integral value （ χ2 = 4. 098, P = 0. 043 ） and wind syndrome integral value （ χ2 = 3. 912 ,P = 0. 048）. Conclusion：In the acute stage of stroke,the higher the blood sugar levels and the greater the score points in phlegm, heat syndrome,wind syndrome, the greater the impact on small vascular disease risk. Blood stasis syndrome was that the larger the value, the smaller the impact of small vessel disease risk, and the greater the risks of macrovascular disease.