急性缺血性中风末梢微循环特点及与中医证候的相关性研究

Characteristics of the terminal microcirculation in acute ischemic stroke and its correlation with traditional Chinese medicine syndrome

目的观察急性缺血性中风患者的末梢微循环特点及其与中医证候之间的相关性。方法纳入符合标准的急性缺血性中风患者96例,对所有患者行NIHSS评分、中医症状与体征积分、缺血性中风证候要素评分及激光散斑血流成像检查,统计并分析数据的分布及相关性。结果急性缺血性中风患者的末梢血液灌注量与年龄、NIHSS积分、中医症状与体征积分均呈直线负相关(P <0. 05);证候要素上与气虚证存在显著直线负相关(P <0. 01),气虚组的末梢血液灌注量低于非气虚组(P <0. 05)。余证候积分无统计学上的相关性(P> 0. 05);证候表现及分布上,以痰湿证候为最多,其次为内火证和气虚证。结论急性缺血性中风患者的年龄越大、神经功能缺损程度越重或气虚证候越明显,则其末梢微循环越差,且在此阶段内表现最明显的证候为痰湿证。

Objective To investigate the characteristics of the terminal microcirculation in acute ischemic stroke patients and its relationship with traditional Chinese medicine(TCM)syndrome.Methods A total of96qualified patients with acute ischemic stroke were recruited.For all the participants,we tested their neurologic function through the scales of NIHSS and TCM symptom scores,ischemic stroke syndrome elements score and laser speckle imaging,and the distribution and correlation of data were statistically and analyzed.Results Patients’terminal microcirculation had negative correlations with their age,neurologic function and the syndrome of qi deficiency(P<0.05),and had negative correlations with qi deficiency syndrome in syndrome elements(P<0.01).The terminal blood perfusion of patients with qi deficiency was lower than patients without qi deficiency(P<0.05).There were no statistical correlations of other syndrome elements scores(P>0.05).For the distribution of syndromes,phlegm-damp syndrome was the most common syndrome,followed by the syndromes of internal-fire and qi deficiency.Conclusion For acute ischemic stroke patients,the older they are,the more severe the degree of neurological deficit will be,or the more obvious appearance of qi deficiency syndrome,the worse the peripheral microcirculation will be.And during the stage of acute ischemic stroke,the most obvious syndrome is phlegm-damp syndrome.