进展性脑梗死不同中医证型与发病危险因素及预后的相关性研究

发布时间：2018-05-08 01:19

本文选题：进展性脑梗死 + 中医证型　；参考：《南京中医药大学》2016年硕士论文

【摘要】：研究目的通过对150例进展性脑梗死病例进行回顾性分析,目的是研究进展性脑梗死的中医证型分布特点、证型与年龄的关系、证型与发病危险因素及证型与预后的相关性,以提高临床对进展性脑梗死患者的早期识别、早期干预能力,尽可能改善患者的预后。研究方法对所有符合诊断标准的患者,制定统一调查表,将各项临床资料详细登记。对入选病例,在不同时间进行中医辨证分型和NIHSS评分。使用Excel 2007软件建立临床资料数据库,对中医证型、年龄分布、发病危险因素、临床生化检查、各种证型在不同年龄和不同时期的NIHSS评分、不同证型的预后等用SPSS 13.0统计软件进行统计分析。研究结果不同证型的年龄分布累计图和年龄分布百分比累计图提示进展性脑梗死的发生有年龄差异。不同证型的发病时间有显著性差异,中医证型的分布也有显著性差异。不同证型之间的常见发病危险因素及血脂、凝血功能等生化检查指标有统计学差异。相同中医证型在不同年龄、不同时间段的NIHSS评分比较部分有统计学差异。不同证型的预后对比有统计学差异。结论随着年龄增大,发生进展性脑梗死的风险也在增加。中医证型分布,发生率由高到低分别为瘀血阻络证、痰瘀阻络证、肝阳上亢证、风痰阻络证、阴虚风动证、气虚血瘀证。痰瘀阻络证、瘀血阻络证与颈动脉斑块密切相关,而肝阳上亢证和阴虚风动证与高血压、糖尿病密切相关。LDL、PT在不同证型之间有明显差异,尤其是有瘀血存在的证候中PT、APTT比较有明显差异。风痰阻络证和瘀血阻络证治疗前后NIHSS评分有显著性差异。痰瘀阻络证、气虚血瘀证患者的预后较差,而瘀血阻络证和肝阳上亢证的预后相对较好。
[Abstract]:Objective to study the distribution characteristics of TCM syndromes, the relationship between syndromes and age, the relationship between syndromes and risk factors, and the relationship between syndromes and prognosis by retrospective analysis of 150 patients with progressive cerebral infarction. In order to improve the early identification and early intervention ability of patients with progressive cerebral infarction, and improve the prognosis of patients as much as possible. Methods A uniform questionnaire was made for all patients who met the diagnostic criteria and all clinical data were recorded in detail. For the selected cases, TCM syndrome differentiation and NIHSS score were carried out at different time. Excel 2007 software was used to set up a database of clinical data. The clinical data were collected from TCM syndromes, age distribution, risk factors, clinical biochemical examination, and NIHSS scores of different syndromes at different ages and periods. The prognosis of different syndromes was analyzed by SPSS 13.0 statistical software. Results the cumulative age distribution and the percentage of age distribution in different syndromes showed that there was an age difference in the occurrence of progressive cerebral infarction. There were significant differences in the onset time of different syndromes and the distribution of TCM syndromes. There were statistical differences in common risk factors, blood lipid, coagulation function and other biochemical indexes among different syndromes. The NIHSS scores of the same TCM syndromes were statistically different in different ages and different time periods. The prognosis of different syndromes was statistically different. Conclusion the risk of progressive cerebral infarction increases with age. The distribution of TCM syndromes from high to low were blood stasis syndrome, phlegm stasis syndrome, liver yang hyperactivity syndrome, wind phlegm blocking collaterals syndrome, Yin deficiency wind movement syndrome, qi deficiency and blood stasis syndrome. Phlegm and blood stasis, blood stasis and collaterals obstruction were closely related to carotid plaque, while hyperactivity of liver-yang and wind-movement of yin deficiency were closely related to hypertension and diabetes mellitus. In particular, there were significant differences in PTT APTT among the syndromes with blood stasis. There was significant difference in NIHSS score between wind phlegm blocking collaterals syndrome and blood stasis blocking collaterals syndrome before and after treatment. The prognosis of patients with phlegm and blood stasis syndrome and qi deficiency and blood stasis syndrome is poor, while the prognosis of blood stasis syndrome and liver yang hyperactivity syndrome is relatively good.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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