上海浦东某地脑卒中患者的中医分型特点及治疗情况分析

Analysis of traditional Chinese medicine classification characteristics and treatment of stroke patients in Pudong,Shanghai

目的分析上海浦东某地脑卒中患者的中医分型特点及治疗情况,为该地区中医药防治脑卒中提供参考依据。方法收集2020年10月至2021年9月我院中医科的284例脑卒中患者为研究对象。对研究对象脑卒中进行中医辨证诊断,并依据证型给予辨证论治。分析脑卒中患者的中医证型及治疗效果。结果浦东某地男性脑卒中患者多于女性(P<0.05);不同性别患者的年龄比较,差异具有统计学意义(P<0.05);不同性别患者的偏瘫部位比较,差异无统计学意义(P>0.05)。284例患者的中医证型由多到少依次为风痰阻络证、阴虚风动证、气虚血瘀证、痰湿蒙窍证、痰火闭窍证、肝阳暴亢证及痰热腑实证。治疗后,风痰阻络证、阴虚风动证的美国国立卫生院卒中量表(NIHSS)评分低于治疗前(P<0.05);治疗后,风痰阻络证的Barthel指数(BI)评分高于治疗前(P<0.05)。脑卒中患者的治疗总有效率为91.55%。结论浦东某地脑卒中男性患者多于女性,患病年龄小于女性,偏瘫部位与性别无关,中医证型诊断风痰阻络证型最多。现代医学规范化治疗方案结合中医药辨证论治对卒中预后有明显干预作用,中医治疗使用祛风化痰通络之法最多。

Objective To analyze the characteristics of traditional Chinese medicine classification and treatment of stroke patients in Pudong,Shanghai,and to provide references for the prevention and treatment of stroke with traditional Chinese medicine in this area.Methods A total of 284 stroke patients in the traditional Chinese medicine department of our hospital from October 2020 to September 2021 were collected as the research objects.The stroke of the research object was diagnosed by traditional Chinese medicine syndrome differentiation,and the syndrome differentiation and treatment were given according to the syndrome type.The traditional Chinese medicine syndromes and therapeutic effects of stroke patients were analyzed.Results There was more male stroke patients than female stroke patients in Pudong(P<0.05);there was a statistically significant difference in the age of patients of different genders(P<0.05);there was no significant difference in the location of hemiplegia between patients of different genders(P>0.05).The traditional Chinese medicine syndromes of 284 patients from more to less were wind-phlegm blocking collaterals syndrome,Yin deficiency wind stirring syndrome,Qi deficiency and blood stasis syndrome,phlegm-dampness blocking orifices syndrome,phlegm-fire blocking orifices syndrome,liver-Yang hyperactivity syndrome and phlegm-heat Fu-viscera excess syndrome.After treatment,the National Institutes of Health Stroke Scale(NIHSS)score of wind-phlegm blocking collaterals syndrome and Yin deficiency wind stirring syndrome was lower than that before treatment(P<0.05);after treatment,the Barthel Index(BI)score of wind-phlegm blocking collaterals syndrome was higher than that before treatment(P<0.05).The total effective rate of stroke patients was 91.55%.Conclusion There are more males than females with stroke in a certain area of Pudong,and the age of onset is younger than females.The location of hemiplegia is not related to gender.Traditional Chinese medicine diagnosis of wind-phlegm blocking collaterals syndrome is the most common.The standardized treatment plan of modern medicine combined with syndrome differentiation and treatment of traditional Chinese medicine has obvious intervention effect on the prognosis of stroke,and the method of dispelling wind,resolving phlegm and dredging collaterals is the most used in traditional Chinese medicine treatment.