| 204例急性脑梗死瘀血阻络证患者的危险因素及相关生化指标的调查分析 |
| Risk factors and related biochemical indicators in 204 patients with acute cerebral infarctionInvestigation and analysis |
| DOI： |
| 中文关键词: 急性脑梗死 瘀血阻络证 危险因素 生化指标 相关性分析 |
| 英文关键词: Acute cerebral infarction Blood stasis and collateral obstruction syndrome Test indicators Risk factors Relevance |
| 基金项目:国家自然科学基金面上项目(81874416),湖南省科技计划重点项目,(2017SK2111),中西医结合“国内一流”培育学科资助。 |
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| 中文摘要: |
| 目的：探讨急性脑梗死瘀血阻络证及其兼证与常见的危险因素及相关血生化指标的关联性。方法：采用面对面调查方式收集204例急性脑梗死瘀血阻络证患者的发病危险因素、中医证候类型及相关生化指标。 结果： ①急性脑梗死主要危险因素有年龄、运动、饮食偏颇、合并高血压。②瘀血阻络兼风痰火亢证(37%)占比最多。③有家族史、高血压病史、高血脂症病史、既往有卒中病史的脑梗死患者兼风痰火亢证多见；糖尿病史、心脏病史的脑梗死患者兼痰热腑实证多见。④收缩压与舒张压在瘀血阻络兼气虚血瘀证显著升高 (P<0.05)。血红蛋白在瘀血阻络兼风痰火亢证及兼气虚血瘀证明显的升高 (P<0.05)。白蛋白、血糖在瘀血阻络兼风火上扰证中显著升高 (P<0.01)。D-BIL在瘀血阻络兼痰湿蒙神证组中显著升高 (P<0.01)。总胆固醇在瘀血阻络兼痰热腑实证组明显的升高 (P<0.05)。HDL与瘀血阻络兼痰热腑实证非常相关 (P<0.01)。结论：①急性脑梗死瘀血阻络证多见于60岁以上患者。②缺乏运动、饮食偏颇、合并有高血压为此次研究突出的危险因素。③在中医证型分布上,瘀血阻络兼风痰火亢证占比最多,提示发病与风、痰、瘀三种致病因素密切相关。④有家族史、高血压病史、高脂血症病史、既往有卒中史的急性脑梗死患者多见于兼风痰火亢证；糖尿病史、心脏病史的患者兼痰热腑实证可能性大。⑤收缩压与舒张压可作为瘀血阻络兼气虚血瘀证辨证参考指标,血红蛋白可作为瘀血阻络兼风痰火亢证及兼气虚血瘀证辨证参考指标,白蛋白、血糖可作为瘀血阻络兼风火上扰证辨证的重要参考指标,D-BIL在瘀血阻络兼痰湿蒙神证辨证的重要参考指标,总胆固醇、HDL可作为瘀血阻络兼痰热腑实证辨证的参考指标。 |
| 英文摘要: |
| Objective: To explore the correlation between blood stasis and collateral obstruction syndrome and common risk factors and related blood biochemical indexes in acute cerebral infarction. Methods: 303 patients with acute cerebral infarction were collected by face-to-face investigation, including risk factors, TCM syndromes and related biochemical indicators. Results: The main risk factors of acute cerebral infarction were age, exercise, diet bias and hypertension. (2) Blood stasis obstructing collaterals and excessive wind, phlegm and fire syndrome (37%) accounted for the most. (3) Cerebral infarction patients with family history, hypertension history, hyperlipidemia history, stroke history and excessive wind-phlegm-fire syndrome are more common; cerebral infarction patients with diabetes history and heart disease history are more common with phlegm-heat-viscera syndrome. (4) Systolic and diastolic blood pressure increased significantly in the syndrome of blood stasis and collateral obstruction combined with Qi deficiency and blood stasis (P < 0.05). Hemoglobin increased markedly in the syndrome of blood stasis obstructing collaterals and excessive wind, phlegm and fire, and the syndrome of Qi deficiency and blood stasis (P < 0.05). Albumin and blood sugar increased significantly in the syndrome of blood stasis and wind-fire disturbance (P < 0.01). D-BIL was significantly increased in the group of blood stasis and collateral obstruction combined with phlegm dampness and Mengshen syndrome (P < 0.01). Total cholesterol increased significantly in the blood stasis and collateral obstruction plus phlegm-heat-fu syndrome group (P < 0.05). HDL was highly correlated with blood stasis, obstruction of collaterals and phlegm-heat-fu syndrome (P < 0.01). CONCLUSION: The syndrome of blood stasis and collateral obstruction in acute cerebral infarction is more common in patients over 60 years old. (2) Lack of exercise, biased diet and hypertension were the risk factors of cerebral infarction prominence in this study. (3) Distribution regularity of TCM syndromes in patients with acute cerebral infarction, in which blood stasis blocking collaterals and excessive wind-phlegm-fire syndrome accounted for the most, suggesting that the onset of acute cerebral infarction was closely related to wind, phlegm and blood stasis. (4) Cerebral infarction patients with family history, hypertension history, hyperlipidemia history and previous stroke history are more likely to have hyperactivity of wind, phlegm and fire; cerebral infarction patients with diabetes history and heart disease history are more likely to have phlegm, heat and viscera syndrome. (5) Systolic pressure and diastolic pressure can be used as reference indexes for syndrome differentiation of blood stasis obstructing collaterals and Qi deficiency and blood stasis syndrome, hemoglobin can be used as reference indexes for syndrome differentiation of blood stasis obstructing collaterals and wind-phlegm-fire hyperactivity syndrome and Qi deficiency and blood stasis syndrome, albumin and blood sugar can be used as important reference indexes for syndrome differentiation of blood stasis obstructing collaterals and wind-fire disturbance syndrome, and D-BIL can be used as important reference indexes for syndrome differentiation of blood stasis obstructing collaterals and PHLE L can be used as a reference index for syndrome differentiation of blood stasis, obstruction of collaterals and phlegm-heat-fu organs. |
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