中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2011年
6期
329-332
,共4页
李京%曹锐%朱宏勋%胡文忠
李京%曹銳%硃宏勛%鬍文忠
리경%조예%주굉훈%호문충
脑梗死,急性%证候要素%神经功能%凝血因子%相关性
腦梗死,急性%證候要素%神經功能%凝血因子%相關性
뇌경사,급성%증후요소%신경공능%응혈인자%상관성
Acute cerebral infarction%Traditional Chinese medicine syndrome element%Neurologic function%Coagulation factor%Correlation
目的 探讨脑梗死急性期中医证候要素与神经功能及凝血功能的相关性.方法 选择223例脑梗死急性期患者,按<中风病辨证诊断标准>进行证候评分,参照美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损程度评分(NDS),同时检测凝血因子凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)含量.研究中医证候与NDS及凝血功能的相关性.结果 223例急性脑梗死患者依据中医证候要素分为风证(147例,占65.92%)、火证(100例,占44.84%)、痰证(123例,占55.16%)、血瘀证(78例,占34.98%)、气虚证(31例,占13.90%)、阴虚阳亢证(25例,占11.21%),其中以风证、痰证、火证为主.风证、火证、痰证和气虚证证候积分与NDS均呈正相关(r1=0.207、P1=0.002,r2=0.284、P2=0.000,r3=0.245、P3=0.000,r4=0.152、P4=0.023);气虚证证候积分与PT呈负相关(r=-0.170,P=0.011);痰证、血瘀证、气虚证证候积分与APTT均呈负相关(r1=-0.182、P1=0.006,r2=-0.148、P2=0.027,r3=-0.211、P3=0.001);余证候与NDS及凝血因子均无相关性.结论 脑梗死急性期以风证、痰证、火证对患者神经功能缺损影响较大,气虚证亦有影响.痰证、血瘀证及气虚证与患者凝血功能密切相关,其分值可反映患者的凝血功能状态.
目的 探討腦梗死急性期中醫證候要素與神經功能及凝血功能的相關性.方法 選擇223例腦梗死急性期患者,按<中風病辨證診斷標準>進行證候評分,參照美國國立衛生研究院卒中量錶(NIHSS)進行神經功能缺損程度評分(NDS),同時檢測凝血因子凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、纖維蛋白原(FIB)含量.研究中醫證候與NDS及凝血功能的相關性.結果 223例急性腦梗死患者依據中醫證候要素分為風證(147例,佔65.92%)、火證(100例,佔44.84%)、痰證(123例,佔55.16%)、血瘀證(78例,佔34.98%)、氣虛證(31例,佔13.90%)、陰虛暘亢證(25例,佔11.21%),其中以風證、痰證、火證為主.風證、火證、痰證和氣虛證證候積分與NDS均呈正相關(r1=0.207、P1=0.002,r2=0.284、P2=0.000,r3=0.245、P3=0.000,r4=0.152、P4=0.023);氣虛證證候積分與PT呈負相關(r=-0.170,P=0.011);痰證、血瘀證、氣虛證證候積分與APTT均呈負相關(r1=-0.182、P1=0.006,r2=-0.148、P2=0.027,r3=-0.211、P3=0.001);餘證候與NDS及凝血因子均無相關性.結論 腦梗死急性期以風證、痰證、火證對患者神經功能缺損影響較大,氣虛證亦有影響.痰證、血瘀證及氣虛證與患者凝血功能密切相關,其分值可反映患者的凝血功能狀態.
목적 탐토뇌경사급성기중의증후요소여신경공능급응혈공능적상관성.방법 선택223례뇌경사급성기환자,안<중풍병변증진단표준>진행증후평분,삼조미국국립위생연구원졸중량표(NIHSS)진행신경공능결손정도평분(NDS),동시검측응혈인자응혈매원시간(PT)、활화부분응혈활매시간(APTT)、섬유단백원(FIB)함량.연구중의증후여NDS급응혈공능적상관성.결과 223례급성뇌경사환자의거중의증후요소분위풍증(147례,점65.92%)、화증(100례,점44.84%)、담증(123례,점55.16%)、혈어증(78례,점34.98%)、기허증(31례,점13.90%)、음허양항증(25례,점11.21%),기중이풍증、담증、화증위주.풍증、화증、담증화기허증증후적분여NDS균정정상관(r1=0.207、P1=0.002,r2=0.284、P2=0.000,r3=0.245、P3=0.000,r4=0.152、P4=0.023);기허증증후적분여PT정부상관(r=-0.170,P=0.011);담증、혈어증、기허증증후적분여APTT균정부상관(r1=-0.182、P1=0.006,r2=-0.148、P2=0.027,r3=-0.211、P3=0.001);여증후여NDS급응혈인자균무상관성.결론 뇌경사급성기이풍증、담증、화증대환자신경공능결손영향교대,기허증역유영향.담증、혈어증급기허증여환자응혈공능밀절상관,기분치가반영환자적응혈공능상태.
Objective To investigate the correlations between traditional Chinese medicine(TCM) syndrome elements and neurologic function and between them and coagulation function in patients with acute cerebral infarction (ACI).Methods Two hundred and twenty-three patients with ACl were enrolled. The syndromes of this disease were scored according to Stroke Diagnostic CHteria for Differentiation of Syndromes.Neurologie function deficit score (NDS) was scored according to stroke scale of the National Institutes of Health (NIHSS).The prothrombin time (PT),activated partial thromboplastin time (APTT) and fibrinogen (FIB) contents were detected.The correlations between TCM syndrome elements and NDS and between them and coagulation function were investigated.Results Two hundred and twenty-three patients with ACI were divided into six syndromes:wind syndrome(风证,n=147,65.92%),fire syndrome (火证,n=100,44.84%),tan syndrome(痰证,,n=123,55.16%),blood stasis syndrome(血瘀证,n=78,34.98%),deficiency of qi syndrome(气虚证,n=31,13.90%),and yin deficiency causing hyperactivity of yang syndrome(阴虚阳亢证,n=25,11.21%).The wind,tan and fire syndromes were the main syndrome elements related to ACI.The scores of wind,fire,tan and deficiency of qi syndromes were positively related to NDS(r1=0.207,P1=0.002;r2=0.284,P2=0.000;r3=0.245,P3=0.000;r4=0.152,P4=0.023).The score of deficiency of qi syndrome was negatively correlated with PT(r=-0.170,P=0.011);and the scores of tan,blood stasis,and deficiency of qi syndromes were negatively correlated with APTT (r1=-0.182,P1=0.006;r2=-0.148,P2=0.027;r3=-0.211,P3=0.001).Other syndromes were not correlated to NDS or coagulation factors.Conclusion The neurologic function deficiency due to ACI is more likely influenced by wind,tan,and fire syndromes;deficiency of qi syndrome also has some effects.The syndromes of tan,blood stasis,and deficiency of qi are closely correlated with coagulation function,and their scores may reflect the clotting function in patients with ACI.
