脾虚和非脾虚急性缺血性脑卒中患者临床特点和预后的比较研究  

Comparative study on clinical characteristics and prognosis of acute ischemic stroke patients with and without spleen deficiency

作　　者：张月婵 李萌青 韦紫君 周洋[1] 龙燮[1] 李想 张云云[1] ZHANG Yuechan;LI Mengqing;WEI Zijun;ZHOU Yang;LONG Xie;LI Xiang;ZHANG Yunyun(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《现代中西医结合杂志》2022年第19期2636-2639,2646,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市科学技术委员会中医引导项目(19401934900)。

摘　　要：目的通过比较脾虚和非脾虚急性缺血性脑卒中患者的临床特点和预后,探讨脾虚对急性缺血性脑卒中的影响。方法采用巢式病例对照研究方法,选择2019年5—12月于上海中医药大学附属岳阳中西医结合医院神经内科住院治疗的急性缺血性脑卒中患者140例。根据脾虚证诊断标准将患者分为脾虚组70例和非脾虚组70例。比较2组患者卒中危险因素、中风中医证候积分量表评分、病情严重程度[神经功能缺损量表(NIHSS)评分、日常生活活动能力量表(BI)评分、日常生活依赖程度量表(MRS)评分≤2分患者比例]、发病第14天和第3个月的预后(NIHSS减分值、BI增分值、MRS评分≤2分)。结果脾虚组和非脾虚组卒中危险因素伴发率比较差异均无统计学意义(P均>0.05)。脾虚组患者中风中医证候积分量表中症状严重程度评分及对生活影响度评分均显著高于非脾虚组患者(P均<0.05),入院时NIHSS评分明显高于非脾虚组患者(P<0.05),BI评分明显低于非脾虚组患者(P<0.05),2组MRS评分≤2分患者占比比较差异无统计学意义(P>0.05)。发病第14天脾虚组患者NIHSS减分值明显低于非脾虚组(P<0.05),发病第3个月脾虚组患者BI增分值明显低于非脾虚组(P<0.05)。结论与非脾虚急性缺血性脑卒中患者相比,脾虚患者病情重,对生活影响大,预后差。Objective It is to explore the influence of spleen deficiency on acute ischemic stroke by comparing the clinical characteristics and prognosis of acute ischemic stroke patients with and without spleen deficiency.Methods A nested case-control study was conducted to select 140 patients with acute ischemic stroke who were hospitalized in the Department of Neurology of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from May to December 2019.According to the diagnostic criteria of spleen deficiency syndrome,the patients were divided into 70 cases of spleen deficiency group and 70 cases of non spleen deficiency group.The risk factors of stroke,the score of TCM syndrome scale of stroke,the severity of the disease[(scores of NIH stroke scale(NIHSS),score of activity of daily living scale(BI),the proportion of patients with daily living dependence scale(MRS)score≤2)],and the prognosis(NIHSS score reduction,BI score increase,the proportion of patients with MRS score≤2)on the 14th day and the 3rd month of the onset were compared between the two groups.Results There was no significant difference in the incidence of stroke risk factors between the spleen deficiency group and the non spleen deficiency group(P>0.05).The scores of symptom severity and the impact on life in the TCM syndrome scale of stroke in the spleen deficiency group were significantly higher than those in the non spleen deficiency group(all P<0.05),the NIHSS score was significantly higher than those in the non spleen deficiency group at admission(P<0.05),and the BI score was significantly lower than that in the non spleen deficiency group(P<0.05),there was no significant difference in the proportion of patients with MRS score≤2 between the two groups(P>0.05).The NIHSS score of patients in the spleen deficiency group was significantly lower than that in the non spleen deficiency group on the 14th day of the onset(P<0.05),and the BI score of patients in the spleen d

关 键 词：脾虚 缺血性脑卒中 临床特点 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]