基于广义估计方程的缺血性中风病中医证候要素动态变化与NIHSS评分变化纵向相关性分析

Longitudinal Correlation Analysis of TCM Syndrome Dynamic Changes and NIHSS Scores of Ischemia Stroke Based on Generalized Estimating Equations

目的:探讨缺血性中风病中医证候要素动态变化与NIHSS评分之间的关系。方法:以379例缺血性中风病临床数据为基础,在入院时、3、14、28、90 d分别采集《中风病辨证诊断标准》中风、火、痰、瘀、气虚、阴虚阳亢6个证候要素的评分和《美国国立卫生院卒中量表》(NIHSS)评分,运用广义估计方程分析其相关性。结果:NIHSS评分与各证候要素评分变化有相同的变化规律,均随时间变化呈下降趋势;NIHSS评分的改变对证候要素风、火热、痰、气虚、阴虚阳亢评分的改变有影响,NIHSS评分每增加或减少1分,相应证候要素评分分别增加或减少0.403分、0.224分、0.355分、0.376分、0.157分。结论:缺血性中风病的NIHSS评分变化在不同时点与多个不同证候要素评分的变化相关,其相关程度不同。

Objective： To investigate the correlation between TCM syndrome dynamic changes and NIHSS scores of ischemia stroke. Method： The patients with ischemia stroke （ n = 379） were selected and their scores of six syndrome factors （wind, fire, phlegm, stasis, qi-deficiency and hyperactivity of yang due to yin-deficiency） were recorded respectively according to the Diagnostic Standard of Syndrome Differentiation of Stroke and the National Institutes of Health Stroke Scale （NIHSS） at 5 different time points（0, 3, 14, 28, 90 d）. The correlation between syndrome factors and NIHSS scores at different time points were studied by using the methods of generalized estimating equations. Result： The same rule exists between the scores variation of NIHSS and syndrome factors, they all show decreased tendency along the time. The variation of NIHSS scores affect the syndrome factors wind, fire, phlegm, qi-deficiency and hyperactivity of yang due to yin-deficiency when one cent of the NIHSS scores add or decrease the syndrome factors respectively add or decrease 0. 403 cent, 0. 224 cent, 0. 355 cent, 0. 376 cent, 0. 157cent. Conclusion： The variation of NIHSS scores affects the TCM syndrome factors manifestations in ischemia stroke at several time points, the variation degree are different.