风痰瘀阻型缺血性中风症状特点与血脂及凝血功能的相关性研究
发布时间：2018-08-13 16:09
【摘要】：研究目的:通过回顾广州中医药大学附属佛山中医院脑病科2014至2016年风痰瘀阻型缺血性中风住院患者的情况,探讨风痰瘀阻型缺血性中风"痰证"症状与血脂指标、"瘀证"症状与凝血功能异常的相关性,希望对风痰瘀阻型缺血性中风的客观性诊断与治疗提供较为可靠的临床依据。研究方法:研究通过收集广州中医药大学附属佛山中医院脑病(神经)科2014年1月1日至2016年12月31日诊断为风痰瘀阻型缺血性中风患者的临床病历资料,统计痰证、瘀证各症状出现频次及其各项血脂与凝血功能水平,统计分析各证候要素在不同临床指标上是否存在差异性,并分析"痰证"、"瘀证"症状与风痰瘀阻型缺血性中风血脂、凝血功能的相关性,发掘某些可能存在与相关指标有着密切联系的具体症状。使用统计分析软件SPSS21.0对所选病例的中医症状与血脂、凝血功能进行相关性分析,基线研究及各症状组间对比使用单因素方差分析(组间比较选用Sidak检验),各症状与血脂、凝血功能水平的相关性研究使用spearman相关性分析。P0.05为有显著性差异。研究结果:1.本次纳入248例风痰瘀阻型缺血性中风患者,其中男性129例,女性患者119例。纳入病例年龄均处于45~75周岁,其中45~55岁年龄段72人,56~65岁年龄段85人,66~75岁年龄段91人。按病程统计,其中急性期患者92例,亚急性期75例,恢复期81例。2.在痰湿症状中,"厚腻苔或滑苔"出现频数最高,为220次占88.7%,其次为"滑脉",出现188次,占75.8%,出现最少的是"肥胖",共计25次,占10.1%;在瘀血症状中,出现频数最高的为"紫暗舌",出现128次,占比51.6%,出现最少的为"代结脉",仅12次,占4.8%。3.在TC水平上,与肥胖组比较,纳呆组、厚腻苔或滑苔组、滑脉组有显著性差异(P0.05);其他痰湿症状间无显著性差异。在TG水平上,与肥胖组比较,纳呆组、胖大或齿痕舌组、厚腻苔或滑苔组、滑脉组TG有显著性差异(P0.05);其他痰湿症状间无显著性差异。在LDL-C水平上,与肥胖组比较,表情淡漠或寡言少语组、"头闷痛、头重、头昏组"、口黏腻组、渴不欲饮组、咳痰或喉中痰鸣组、纳呆组、便溏组、胖大或齿痕舌组、厚腻苔或滑苔组、滑脉组LDL-C有显著性差异(P0.05);其他痰湿症状间无显著性差异。在HDL-C水平上,各痰湿症状间无显著性差异。在APTT、PT水平上,各血瘀症状间无显著性差异。在FIB水平上,与口唇紫暗或暗红组比较,舌有疲斑瘀点组、舌下脉络青紫组、舌下脉络曲张组FIB有显著性差异(P0.05);其他血瘀症状间无显著性差异。在DD水平上,各血瘀症状间无显著性差异。4.Spearman相关性分析,发现"肥胖"与TC、TG、LDL-C水平呈正相关(P0.05,r0),"咳痰或喉中痰鸣"与TC水平呈正相关(P0.05,r0),其他各痰湿症状与中风患者TC、TG、LDL-C、HDL-C水平无相关性,P0.05。"舌有癖斑瘀点"与FIB、DD水平呈正相关(P0.05,r0),"舌下脉络青紫"与FIB、DD水平呈正相关(P0.05,r0),"舌下脉络曲张"与FIB、DD水平呈正相关(P0.05,r0),其他各血瘀症状与中风患者APTT、PT、FIB、DD水平均无相关性,P0.05。结论:在风痰瘀血型缺血性中风患者中,"肥胖"与TC、TG、LDL-C水平呈正相关,提示通过TC、TG、LDL-C检测可能有利于判断患者的基本体型情况;舌有瘀斑瘀点、舌下脉络青紫、舌下脉络曲张与FIB、DD水平呈正相关,提示FIB、DD水平可能有助于判断患者舌象的瘀滞情况。
[Abstract]:Objective: To investigate the correlation between the symptoms of "phlegm syndrome" and blood lipid index, the symptoms of "blood stasis syndrome" and abnormal coagulation function in ischemic stroke of wind-phlegm-stasis type by reviewing the situation of inpatients with ischemic stroke of wind-phlegm-stasis type from 2014 to 2016 in the Department of Encephalopathy, Foshan Hospital of Traditional Chinese Medicine, affiliated to Guangzhou University of Traditional Chinese Medicine. Methods: The clinical data of patients with ischemic stroke of wind-phlegm-stasis type diagnosed from January 1, 2014 to December 31, 2016 in the Department of Encephalopathy (Neurology) of Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Traditional Chinese Medicine were collected, and the occurrence frequency of phlegm syndrome, blood stasis syndrome and their respective symptoms were analyzed. Statistical analysis was made on the correlation between the symptoms of "phlegm syndrome" and "blood stasis syndrome" and the blood lipid and blood coagulation function of ischemic stroke of wind-phlegm-stasis type. The correlation between TCM symptoms, blood lipids and coagulation function was analyzed by PSS21.0. The baseline study and the comparison of symptoms between groups were analyzed by one-way ANOVA (Sidak test was used for comparison). The correlation between symptoms, blood lipids and coagulation function was analyzed by spearman. P 0.05 was significant difference. 248 cases of wind-phlegm-stasis type of ischemic stroke were enrolled in this study, including 129 males and 119 females. All the cases were aged from 45 to 75 years old, including 72 aged from 45 to 55, 85 aged from 56 to 65, and 91 aged from 66 to 75. According to the course of the disease, 92 cases were in the acute stage, 75 in the subacute stage and 81 in the convalescent stage. Among the wet symptoms, "thick greasy fur or slippery fur" appeared the highest frequency, accounted for 88.7%, followed by "slippery pulse", 188 times, accounted for 75.8%, the least was "obesity", a total of 25 times, accounted for 10.1%; in the blood stasis symptoms, the highest frequency was "purple dark tongue", appeared 128 times, accounted for 51.6%, the lowest was "generation of veins", only 12 times, accounted for 4.8%. Compared with the obese group, there were significant differences in TG levels among Nadian group, thick greasy fur group, slippery fur group and slippery fur group (P 0.05); there were no significant differences in other phlegm-dampness symptoms. DL-C level, compared with the obese group, the expression of indifferent or few words group, "headache, head weight, dizziness group", sticky mouth group, thirst without drink group, sputum or throat phlegm group, Nadai group, feces group, fat or dental scar tongue group, thick fur or slippery fur group, LDL-C slippery pulse group had no significant difference (P 0.05); other phlegm and wet symptoms in HDL-C group. At the level of FIB, there was no significant difference in the symptoms of phlegm and dampness among the three groups. At the level of APTT and PT, there was no significant difference in the symptoms of blood stasis. Spearman correlation analysis found that "obesity" and TC, TG, LDL-C levels were positively correlated (P 0.05, r0), "cough phlegm or throat phlegm tinnitus" and TC levels were positively correlated (P 0.05, r0). Other phlegm-dampness symptoms and stroke patients TC, TG, LDL-C, HDL-C levels were not correlated, P 0.05. Positive correlation (P 0.05, r0), "sublingual vein cyanosis" and FIB, DD levels were positively correlated (P 0.05, r0), "sublingual vein variations" and FIB, DD levels were positively correlated (P 0.05, r0). Other blood stasis symptoms and stroke patients APTT, PT, FIB, DD levels were not correlated, P 0.05. Conclusion: In patients with wind-phlegm-blood stasis type of ischemic stroke, "obesity" and TC, TG, LDL-C levels were positively correlated. It is suggested that TC, TG, LDL-C may be helpful to judge the basic body type of patients; tongue has ecchymosis, sublingual veins blue and purple, sublingual variations and FIB, DD levels are positively correlated, suggesting that FIB, DD levels may be helpful to judge the tongue of patients with stasis.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R255.2
本文编号：2181500
[Abstract]:Objective: To investigate the correlation between the symptoms of "phlegm syndrome" and blood lipid index, the symptoms of "blood stasis syndrome" and abnormal coagulation function in ischemic stroke of wind-phlegm-stasis type by reviewing the situation of inpatients with ischemic stroke of wind-phlegm-stasis type from 2014 to 2016 in the Department of Encephalopathy, Foshan Hospital of Traditional Chinese Medicine, affiliated to Guangzhou University of Traditional Chinese Medicine. Methods: The clinical data of patients with ischemic stroke of wind-phlegm-stasis type diagnosed from January 1, 2014 to December 31, 2016 in the Department of Encephalopathy (Neurology) of Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Traditional Chinese Medicine were collected, and the occurrence frequency of phlegm syndrome, blood stasis syndrome and their respective symptoms were analyzed. Statistical analysis was made on the correlation between the symptoms of "phlegm syndrome" and "blood stasis syndrome" and the blood lipid and blood coagulation function of ischemic stroke of wind-phlegm-stasis type. The correlation between TCM symptoms, blood lipids and coagulation function was analyzed by PSS21.0. The baseline study and the comparison of symptoms between groups were analyzed by one-way ANOVA (Sidak test was used for comparison). The correlation between symptoms, blood lipids and coagulation function was analyzed by spearman. P 0.05 was significant difference. 248 cases of wind-phlegm-stasis type of ischemic stroke were enrolled in this study, including 129 males and 119 females. All the cases were aged from 45 to 75 years old, including 72 aged from 45 to 55, 85 aged from 56 to 65, and 91 aged from 66 to 75. According to the course of the disease, 92 cases were in the acute stage, 75 in the subacute stage and 81 in the convalescent stage. Among the wet symptoms, "thick greasy fur or slippery fur" appeared the highest frequency, accounted for 88.7%, followed by "slippery pulse", 188 times, accounted for 75.8%, the least was "obesity", a total of 25 times, accounted for 10.1%; in the blood stasis symptoms, the highest frequency was "purple dark tongue", appeared 128 times, accounted for 51.6%, the lowest was "generation of veins", only 12 times, accounted for 4.8%. Compared with the obese group, there were significant differences in TG levels among Nadian group, thick greasy fur group, slippery fur group and slippery fur group (P 0.05); there were no significant differences in other phlegm-dampness symptoms. DL-C level, compared with the obese group, the expression of indifferent or few words group, "headache, head weight, dizziness group", sticky mouth group, thirst without drink group, sputum or throat phlegm group, Nadai group, feces group, fat or dental scar tongue group, thick fur or slippery fur group, LDL-C slippery pulse group had no significant difference (P 0.05); other phlegm and wet symptoms in HDL-C group. At the level of FIB, there was no significant difference in the symptoms of phlegm and dampness among the three groups. At the level of APTT and PT, there was no significant difference in the symptoms of blood stasis. Spearman correlation analysis found that "obesity" and TC, TG, LDL-C levels were positively correlated (P 0.05, r0), "cough phlegm or throat phlegm tinnitus" and TC levels were positively correlated (P 0.05, r0). Other phlegm-dampness symptoms and stroke patients TC, TG, LDL-C, HDL-C levels were not correlated, P 0.05. Positive correlation (P 0.05, r0), "sublingual vein cyanosis" and FIB, DD levels were positively correlated (P 0.05, r0), "sublingual vein variations" and FIB, DD levels were positively correlated (P 0.05, r0). Other blood stasis symptoms and stroke patients APTT, PT, FIB, DD levels were not correlated, P 0.05. Conclusion: In patients with wind-phlegm-blood stasis type of ischemic stroke, "obesity" and TC, TG, LDL-C levels were positively correlated. It is suggested that TC, TG, LDL-C may be helpful to judge the basic body type of patients; tongue has ecchymosis, sublingual veins blue and purple, sublingual variations and FIB, DD levels are positively correlated, suggesting that FIB, DD levels may be helpful to judge the tongue of patients with stasis.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R255.2
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