复发性脑梗死患者中医证候与颈动脉斑块风险分级的相关性分析  

Correlation Analysis of TCM Syndromes and Carotid Plaque Risk Classification in Patients with Recurrent Cerebral Infarction

作　　者：李鹏[1] 胡杰 吕祥龙[1] Li Peng;Hu Jie;lu Xianglong(Chuzhou Hospital of Intergrated Traditional Chinese and Western Medicine,Anhui,Chuzshou 239000,China)

机构地区：[1]安徽省滁州市中西医结合医院,安徽滁州239000

出　　处：《中国中医急症》2023年第4期628-630,638,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：安徽省中医药传承创新科研项目(2020ccyb27);滁州市科技计划项目(2021ZD028)。

摘　　要：目的 探讨复发性脑梗死患者的中医证候特点,并分析与颈动脉斑块风险分级的关系。方法 选取复发性脑梗死110例患者,均行颈动脉B超,根据检查结果将颈动脉风险程度分为低度风险组、中度风险组、高度风险组,此外,还从中医证候的维度对患者进行分析,将其和颈动脉斑块风险分级加以对比,以探索二者之间的联系;采用Logistic探讨证候特征、颈动脉斑块分级与脑梗死复发的关系。结果 复发性脑梗死患者中医证候以痰、瘀居多,复发性脑梗死复合证候要素以痰瘀为基本证候组合,患者还会表现出气虚证及风证,通过Pearson-χ^(2)论证,发现在复发性脑梗死患者中,颈动脉斑块低度风险组与中度风险组风证的构成比高于高度风险组(P=0.016 <0.05、P=0.001 <0.05);颈动脉斑块高度风险组中医证候要素(痰、瘀)的构成比高于中度风险组(P=0.002 <0.05、P=0.012 <0.05)。Logistic分析,中医证候(痰证、瘀证)、高风险颈动脉斑块是引起脑梗死复发的危险因素。结论 复发性脑梗死患者主要中医证候要素是痰、瘀,高度风险的颈动脉斑块是脑梗死复发的危险因素之一,此外,对于高度风险组而言,颈动脉斑块和痰、瘀证候要素关系密切。所以,必须要对痰、瘀证候要素进行严格的控制,降低颈动脉斑块风险程度等可控因素可能是中西医结合防治脑梗死复发的重要举措。Objective:To investigate the characteristics of TCM syndromes in patients with recurrent cerebral infarction and to analyze the relationship between the characteristics and carotid plaque risk classification.Methods:A total of 110 patients with recurrent cerebral infarction were selected,all of whom underwent carotid ultrasound and were classified into low risk,moderate risk and high risk groups according to the examination results.The relationship between the TCM syndromes and carotid plaque risk classification was explored through analyzing patients from the dimension of TCM syndromes and compared them with carotid plaque risk classification.In addition,Logistic was applied to explore the relationship between syndrome characteristics,carotid plaque classification and cerebral infarction recurrence.Results:The compound syndromes of recurrent cerebral infarction included phlegm and stasis as the basic combination of syndromes,and usually patients also showed qi deficiency and wind syndrome.Through Pearson-X^(2),it was found that in patients with recurrent cerebral infarction,the constituent ratios of wind syndrome in the low risk group and the moderate risk group of carotid plaque were higher than that in the high risk group(P=0.016<0.05,P=0.001<0.05);the constituent ratio of TCM syndrome elements(phlegm and stasis)in the high risk group of carotid plaque was higher than that in the moderate risk group(P=0.002<0.05,P=0.012<0.05).Logistic analysis showed that TCM syndromes(phlegm and stasis)and high-risk carotid plaque were risk factors for recurrent cerebral infarction.Conclusion:The main TCM syndrome elements in patients with recurrent cerebral infarction are phlegm and stasis,and high-risk carotid plaque is one of the risk factors for recurrence of cerebral infarction;moreover,for the high-risk group,carotid plaque and phlegm and stasis syndrome elements are closely related.Therefore,strict control of phlegm and stasis syndrome is necessary,and controllable factors such as reducing the degree of carotid plaque

关 键 词：脑梗死 复发 中医证候 颈动脉斑块 风险分级 

分 类 号：R743.9[医药卫生—神经病学与精神病学]