首页|204例急性脑梗死瘀血阻络证患者危险因素分布及相关生化指标比较

204例急性脑梗死瘀血阻络证患者危险因素分布及相关生化指标比较

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目的 探讨急性脑梗死瘀血阻络证及其兼证与常见危险因素及相关生化指标的关联性.方法 统计204例急性脑梗死瘀血阻络证患者脑血管病危险因素、中医证型分布情况,比较不同中医证型患者相关生化指标水平.结果 204例急性脑梗死瘀血阻络证患者中,脑血管病危险因素占比由高到低依次为缺乏运动(83.82%)、高血压(74.51%)、年龄≥60岁(67.16%)等,中医证型占比由高到低分别为瘀血阻络兼风痰火亢证(36.76%)、瘀血阻络兼痰湿蒙神证(25.49%)、瘀血阻络兼气虚血瘀证(18.14%)等.瘀血阻络兼气虚血瘀证患者血压(blood pressure,BP)水平显著低于其他中医证型(P<0.05);瘀血阻络兼风痰火亢证患者血红蛋白(hemoglobin,HGB)水平明显高于其他中医证型(P<0.05);瘀血阻络兼风火上扰证患者白蛋白(albumin,ALB)、空腹血糖(fasting blood glucose,FBG)水平明显高于其他中医证型(P<0.05);瘀血阻络兼痰湿蒙神证患者直接胆红素(direct bilirubin,DBIL)水平明显高于其他中医证型(P<0.05);瘀血阻络证兼痰热腑实证患者总胆固醇(total cholesterol,TC)水平明显低于其他中医证型(P<0.05),高密度脂蛋白(high density lipoprotein,HDL)水平明显高于其他中医证型(P<0.05).结论 ①急性脑梗死瘀血阻络证多见于60岁以上患者,缺乏运动、饮食偏颇、合并有高血压为本病的突出危险因素.②在中医证型分布上,瘀血阻络兼风痰火亢证占比最多,提示本病发病与风、痰、瘀3种致病因素密切相关.③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,HGB可作为瘀血阻络兼风痰火亢证辨证参考指标,ALB、FBG可作为瘀血阻络兼风火上扰证辨证参考指标,DBIL可作为瘀血阻络兼痰湿蒙神证辨证参考指标,TC、HDL可作为瘀血阻络兼痰热腑实证辨证参考指标.
Comparison of Risk Factors Distribution and Related Biochemical Indicators in 204 Patients with Acute Cerebral Infarction with Syndrome of Static Blood Blocking Collaterals
Objective To explore the correlation between the syndrome of static blood blocking collaterals and its concurrent symptoms in acute cerebral infarction and common risk factors and related biochemical indica-tors.Methods The risk factors of cerebrovascular disease and the distribution of traditional Chinese medicine(TCM)syndrome types in 204 patients with acute cerebral infarction with syndrome of static blood blocking collat-erals were statistically analyzed,and the levels of relevant biochemical indicators in patients with different TCM syndrome types were compared.Results Among 204 patients with acute cerebral infarction with syndrome of stat-ic blood blocking collaterals,the risk factors for cerebrovascular disease ranked from high to low,including lack of exercise(83.82%),hypertension(74.51%),and age≥60 years old(67.16%).The proportion of TCM syndrome types from high to low is as follows:syndrome of static blood blocking collaterals combined with hyperactivity of wind-phlegm-fire(36.76%),syndrome of static blood blocking collaterals combined with phlegm-damp clouding or-ifices(25.49%),syndrome of static blood blocking collaterals combined with blood stasis due to qi deficiency(18.14%),etc.The blood pressure(BP)level of patients with syndrome of static blood blocking collaterals com-bined with blood stasis due to qi deficiency was significantly lower than that of other TCM syndrome types(P<0.05).The hemoglobin(HGB)level of patients with syndrome of static blood blocking collaterals combined with hyperactivity of wind-phlegm-fire was significantly higher than that of other TCM syndrome types(P<0.05).The albumin(ALB),fasting blood glucose(FBG)levels of patients with syndrome of static blood blocking collaterals combined with upward disturbance of wind-fire were significantly higher than those of other TCM syndrome types(P<0.05).The direct bilirubin(DBIL)level of patients with syndrome of static blood blocking collaterals com-bined with phlegm-damp clouding orifices was significantly higher than that of other TCM syndrome types(P<0.05).The total cholesterol(TC)level of patients with syndrome of static blood blocking collaterals combined with excessive fu-viscera caused by phlegm-heat was significantly lower than that of other TCM syndrome types(P<0.05),and the high density lipoprotein(HDL)level was significantly higher than that of other TCM syndrome types(P<0.05).Conclusion ① Acute cerebral infarction with syndrome of static blood blocking collaterals was more common in patients over 60 years old,with lack of exercise,dietary bias,and hypertension as prominent risk factors for this disease.② In terms of TCM syndrome type distribution,the syndrome of static blood blocking col-laterals combined with hyperactivity of wind-phlegm-fire accounts for the largest proportion,suggest that the onset of this disease is closely related to the three pathogenic factors of wind,phlegm,and blood stasis.③ Systolic and di-astolic blood pressure could be used as reference indicators for the differentiation of static blood blocking collater-als combined with blood stasis due to qi deficiency syndrome,HGB could be used as a reference indicator for the differentiation of static blood blocking collaterals combined with hyperactivity of wind-phlegm-fire syndrome,ALB and FBG could be used as reference indicators for the differentiation of static blood blocking collaterals combined with upward disturbance of wind-fire syndrome,DBIL could be used as a reference indicator for the differentiation of static blood blocking collaterals combined with phlegm-damp clouding orifices syndrome,TC and HDL could be used as reference indicators for the differentiation of static blood blocking collaterals combined with excessive fu-viscera caused by phlegm-heat syndrome.

acute cerebral infarctionsyndrome of static blood blocking collateralsrisk factorbiochemical in-dicatortraditional Chinese medicine syndrome type

马钟丹妮、邓奕辉

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广东省珠海市中西医结合医院内分泌科,广东珠海 519000

湖南中医药大学中西医结合学院,长沙 410208

急性脑梗死 瘀血阻络证 危险因素 生化指标 中医证型

2024

中西医结合研究
华中科技大学

中西医结合研究

影响因子:0.649
ISSN:1674-4616
年,卷(期):2024.16(6)