合并高血压的脑梗死急性期患者中医病性证素与脑梗死部位相关性研究

Correlation between TCM Syndromes and Site of Cerebral Infarction in Patients with Acute Cerebral Infarction Complicated with Hypertension

目的探讨合并高血压的脑梗死急性期患者中医病性证素的分布及与患者脑梗死部位的相关性。方法收集162例脑梗死急性期患者的中医四诊等临床资料,参照《缺血性中风证候要素诊断量表》判断患者病性证素,同时应用头颅MRI影像确定患者脑梗死部位,分析脑梗死急性期患者中医病性证素分布情况、梗死部位特点及其相关性。结果162例脑梗死急性期患者前3位病性证素为气虚40例(24.69%)、痰湿38例(23.46)、内火35例(21.60%);在合并同型半胱氨酸血症方面,高血压组(34.29%)明显高于非高血压组(22.81%),差异有统计学意义(P<0.05);在不同年龄患者中,中年人阴虚证出现率(18.37%)较老年人(6.42%)更高,差异有统计学意义(P<0.05);不同性别的脑梗死急性期患者病性证素分布差异无统计学意义(P>0.05);内风证出现频率方面,高血压组(17.15%)较非高血压组(3.51%)更高,两者分布差异有统计学意义(P<0.05);梗死部位分布方面,高血压组后循环梗死发病率(32.38%)较非高血压组(17.54%)高,非高血压组前循环梗死(71.93%)较高血压组(56.19%)高,两组分布差异有统计学意义(P<0.05);脑梗死合并高血压患者后循环气虚证(35.29%)较前循环(16.95%)多见,多部位脑梗死患者内风证(32.26%)较单部位梗死(10.81%)多见,以上差异均具有统计学意义(P<0.05)。结论脑梗死急性期患者主要中医病性证素以气虚、痰湿、内火为主;高血压、同型半胱氨酸血症与脑梗死的发生密切相关;不同年龄脑梗死急性期患者的病性证素分布呈现差异;高血压组患者较非高血压组患者出现内风证的比例更高。合并高血压的脑梗死急性期患者的中医病性证素与脑梗死部位存在一定相关性。

Objective:To investigate the distribution of TCM syndromes in patients with acute cerebral infarction complicated with hypertension and its correlation with the site of cerebral infarction.Methods:Clinical data of 162 cases of patients with acute phase of cerebral infarction,such as four diagnoses in traditional Chinese medicine,were collected.“Ischemia Stroke Syndrome Elements Diagnostic Scale”was referred to determine the patient′s disease syndrome elements,and head MRI images were used to determine the location of the patient′s cerebral infarction and analyze the distribution of TCM disease syndrome elements in patients with acute cerebral infarction,as well as the characteristics of the infarct location and their correlation.Results:Among 162 patients with acute cerebral infarction,the top three syndromes were qi-deficiency(40 cases,24.69%),phlegm dampness(38 cases,23.46%),endogenous fire(35 cases,21.60%).In terms of homocysteinemia,the hypertensive group(34.29%)was significantly higher than the non-hypertensive group(22.81%),and the difference was statistically significant(P<0.05).Among patients of different ages,the incidence rate of yin deficiency syndrome in middle-aged patients(18.37%)was higher than that in elderly patients(6.42%),and the difference was statistically significant(P<0.05).There was no significant difference in the distribution of syndromes in acute stage of cerebral infarction between different genders(P>0.05).The frequency of endogenous wind syndrome was higher in the hypertensive group(17.15%)than that in the non-hypertensive group(3.51%),and the distribution difference was statisticallysignificant(P<0.05).The incidence of posterior circulation infarction(32.38%)in the hypertensive group washigher than that in the non-hypertensive group(17.54%),and the incidence of anterior circulation infarction(71.93%)in the non-hypertensive group was higher than that in the hypertensive group(56.19%),with statisticalsignificance(P<0.05).In patients with cerebral infarction complicated with hypertension,posterior circulation qideficiency syndrome(35.29%)was more common than anterior circulation syndrome(16.95%),and endogenouswind syndrome(32.26%)was more common than single site infarction(10.81%)in patients with multi-site cere-bral infarction,with statistical significance(P<0.05).Conclusion:The main TCM syndromes in acute cerebral in-farction patients were qi deficiency,phlegm dampness and endogenous fire.Hypertension and homocysteinemia areclosely related to the occurrence of cerebral infarction.The distribution of syndromes of different age patients withacute cerebral infarction was different.The proportion of endogenous wind syndrome is higher in hypertensivegroup than non-hypertensive group.There is a certain correlation between the syndrome elements of TCM diseaseand the location of cerebral infarction in patients with acute cerebral infarction combined with hypertension.