基于中医体质分型的Cox风险模型评估缺血性脑卒中复发的价值  

Value of cox risk model based on traditional chinese medicine constitution classification in evaluating ischemic stroke recurrence

作　　者：宋建英[1] 董丹丹 沈晓明[1] SONG Jian-ying;DONG Dan-dan;SHEN Xiao-ming(Department of Brain Disease,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院脑病科,郑州450000

出　　处：《医药论坛杂志》2024年第10期1046-1049,1053,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划省部共建重点项目(SBGJ202102187);河南省中医药科学研究专项课题(重大专项)(20-21ZYZD17)。

摘　　要：目的探索基于中医体质分型的Cox风险模型评估缺血性脑卒中复发的价值。方法回顾性收集并整理2019年6月至2022年6月于河南中医药大学第一附属医院展开治疗的缺血性脑卒中患者的临床详细资料。共120例纳入本研究并进入统计分析。基于患者的缺血性脑卒中是否复发将其分为两组,分别为复发组36例,未复发组84例。分析两组患者一般资料和中医体质的分布情况。Cox回归分析筛选缺血性中风复发的风险因素。结果复发组合并有高血脂的患者显著多于非复发组(P<0.05),复发组饮酒的患者显著高于非复发组(P<0.05);复发组的阴虚质、气虚质、痰湿质和气郁质显著高于非复发组(P<0.05)。单因素Cox分析表明,伴有高血脂的缺血性中风患者复发的风险增加0.513倍(P<0.05),阴虚质、气虚质、痰湿质、气郁质中风体质分别使复发风险增加0.72、0.51、0.79、0.71倍(P<0.05)。多因素Cox回归分析表明,高血脂(Wald=1.374,95%CI:0.827~1.977)、中医体质阴虚质(Wald=1.628,95%CI:0.829~2.473)、气虚质(Wald=1.284,95%CI:0.628~2.473)、痰湿质(Wald=0.728,95%CI:0.273~2.385)为缺血性中风复发的独立风险因素(P<0.05)。结论中医体质分型对评估缺血性脑卒中复发有一定价值,其中,阴虚质、气虚质、痰湿质中医体质为缺血性脑卒中复发啊的独立影像因素。建议临床根据患者中医体质给予早期干预,以减少患者复发风险。Objective To explore the value of Cox risk model based on traditional Chinese medicine constitution classification in evaluating the recurrence of ischemic stroke.Methods Retrospective collection and organization of detailed clinical data of ischemic stroke patients who underwent treatment in traditional Chinese medicine hospitals from June 2019 to June 2022.A total of 120 cases were included in this study and entered statistical analysis.Based on the recurrence of ischemic stroke,patients were divided into two groups:36 in the recurrent group and 84 in the non recurrent group.Analyzed the general information and distribution of traditional Chinese medicine constitution of two groups of patients.Cox regression analysis to screen risk factors for recurrent ischaemic stroke.Results The number of patients with recurrent combination and hyperlipidemia was significantly higher than that of the non recurrent group(P<0.05),and the number of patients who drank alcohol in the recurrent group was significantly higher than that in the non recurrent group(P<0.05);The quality of Yin deficiency,Qi deficiency,phlegm dampness,and Qi stagnation in the recurrent group were significantly higher than those in the non recurrent group(P<0.05).Univariate Cox analysis showed that ischemic stroke patients with hyperlipidemia had a 0.513 fold increased risk of recurrence(P<0.05),while stroke constitution with Yin deficiency,Qi deficiency,phlegm dampness,and Qi stagnation increased the risk of recurrence by 0.72,0.51,0.79,and 0.71 times,respectively(P<0.05).Multivariate Cox regression analysis showed that hyperlipidemia(Wald=1.374,95%CI:0.827-1.977),traditional Chinese medicine constitution Yin deficiency(Wald=1.628,95%CI:0.829-2.473),Qi deficiency(Wald=1.284,95%CI:0.628-2.473),and phlegm dampness(Wald=0.728,95%CI:0.273-2.385)were independent risk factors for ischemic stroke recurrence(P<0.05).Conclusions Traditional Chinese medicine constitution classification has certain value in evaluating the recurrence of ischemic stroke,among which Y

关 键 词：中医体质分型 COX分析 缺血性脑卒中 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]