急性脑梗死患者中医证型与PCT CRP IL-6 TNF-α相关性分析

Analysis of Correlation between TCM Syndromes and PCT, CRP, IL-6 and TNF-α in Patients with Acute Cerebral Infarction

目的观察急性脑梗死患者的PCT、CRP、IL-6、TNF-α炎症指标与不同中医证型的相关性,以期为中医药诊疗急性脑梗死提高新思路并为中医临床辨证论治提供参考依据。方法168例急性脑梗死患者入组,辨证其中医证型,并调研其炎症指标,将急性脑梗死患者168例依照中医辨证分型标准分为5型,研究缺血性脑卒中急性期中医证型与炎症指标的相关性,采用χ^2检验和logistic回归分析方法进行统计学研究。结果缺血性脑卒中急性期中医证型分为5个,本研究中选取168例急性缺血性卒中卒中病人,其中肝阳上亢证35例,气虚血瘀证51例,风痰瘀阻证41例,痰热腑实证26例,阴虚风动证15例。本研究中以气虚血瘀证最多(P<0.05)。风痰瘀阻证与气虚血瘀、痰热腑实证比较差异显著(P<0.05);IL-6、CRP水平肝阳上亢证明显高于痰热腑实证,两者比较差异显著(P<0.05);TNF-α水平痰热腑实证高于其它各组,各组比较有显著差异(P<0.05)。结论PCT、CRP、IL-6、TNF-α水平可作为急性脑梗死中医辨证分型的客观指标,为中西医结合防治急性脑梗死提供可量化的参考指标。

Objective:To observe the correlation between PCT,CRP,IL-6,TNF-αinflammatory index and different TCM syndromes in patients with acute cerebral infarction in order to improve the new thinking of TCM diagnosis and treatment of acute cerebral infarction and provide reference for TCM clinical syndrome differentiation and treatment.Methods:168 patients with acute cerebral infarction were enrolled.Their TCM syndromes were dialectically examined and their inflammatory indexes were investigated.The patients were divided into 5 types according to TCM syndrome differentiation criteria.The acute phase TCM syndrome of ischemic stroke was studied.The correlation between TCM syndrome types and inflammatory index were statistically studied by χ^2 test and logistic regression analysis.Results:There were 5 TCM syndromes in the acute phase of ischemic stroke.In this study,168 patients with acute ischemic stroke were selected,including 35 cases of liver-yang hyperactive syndrome,51 cases of qi-deficiency and blood stasis syndrome,41 cases of wind-phlegm-static blood syndrome,26 cases of phlegm-heat and bowel-repletion and 15 cases of wind formation from yin deficiency.The study showed the syndrome of qi deficiency and blood stasis was the most(P<0.05).There was significant difference between the syndromes of qi deficiency and blood stasis and phlegm-heat and bowel-repletion(P<0.05).The expression of IL-6 and CRP in liver yang hyperactive syndrome was higher than that in phlegm-heat and bowel-repletion.The difference was significant(P<0.05).TNF-αlevel was higher than that of the other groups,and there was significant differences among the groups(P<0.05).Conclusion:The levels of PCT,CRP,IL-6 and TNF-αcan be used as objective indicators for TCM syndrome differentiation of acute cerebral infarction,which provides a quantifiable reference index for the prevention and treatment of acute cerebral infarction by integrated traditional Chinese and western medicine.