缺血性卒中与冠心病共患病的临床特征与疗效评价方法  

Clinical Features and Efficacy Evaluation Methods of Comorbidity of Ischemic Stroke with Coronary Heart Disease

作　　者：张润萱 周莉[1] 高颖[1,2,3,4] 许颖智 ZHANG Runxuan;ZHOU Li;GAO Ying;XU Yingzhi(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Institute for Brain Disorder,Beijing University of Chinese Medicine,Beijing 100029,China;Key Laboratory of Chinese Medicine Treatment of Encephalopathy Syndrome,National Administration of Traditional Chinese Medicine,Beijing 100700,China;Beijing Traditional Chinese Medicine Heritage“New 3+3”Program:Dong Jianhua Distinguished Expert Studio,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学中医脑病研究院,北京100029 [3]国家中医药管理局脑病中医证治重点研究室,北京100700 [4]北京中医药薪火传承“新3+3”工程董建华名家研究室,北京100700

出　　处：《世界中医药》2025年第1期75-81,91,共8页World Chinese Medicine

基　　金：国家重点研发计划项目(2022YFC3501101)。

摘　　要：目的:系统分析缺血性卒中与冠心病共患病的临床特征与疗效评价方法。方法:基于国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)及PubMed、ScienceDirect、Web of Science数据库检索缺血性卒中与冠心病共患病自1990年1月至2023年9月的相关文献,统计临床信息、评价指标,运用频数统计分析法归纳缺血性卒中与冠心病共患病的临床特征及疗效评价方法。结果:共纳入文献168篇,其中理论探讨类文献10篇,临床研究类文献158篇,患者8287例。缺血性卒中与冠心病共患病的临床症状按频次排序为半身不遂(58.67%)、胸痛(55.40%)、乏力(38.89%)、头晕(37.10%)、口角㖞斜(36.94%)等,证候要素分布为血瘀(23.53%)、痰湿(22.58%)、气虚(17.97%)、阴虚(15.10%)等。缺血性卒中与冠心病共患病与单患疾病的临床理化指标比较,血脂(20%)、血压(18.67%)、血糖(8%)相关指标差异较大,临床研究疗效评价常用指标有疾病主要症状改善程度(64.58%)、总胆固醇(47.92%)、神经系统功能缺损评分(25.00%)等。结论:缺血性卒中与冠心病共患病的临床症状、证候要素、主要证候、理化指标具有自身的临床特点,疗效评价方法多采用疾病主要症状。Objective:To systematically analyze the clinical characteristics and efficacy evaluation methods of comorbid ischemic stroke and coronary heart disease.Methods:Relevant literature on comorbid ischemic stroke and coronary heart disease from January 1990 to September 2023 was retrieved from the China National Knowledge Infrastructure(CNKI),China Science Periodical Database(CSPD),Chinese Sci-tech Journal Database(CCD),as well as PubMed,ScienceDirect,and Web of Science.Clinical information and evaluation indicators were collected,and frequency statistical analysis was used to summarize the clinical features and efficacy evaluation methods of comorbid ischemic stroke and coronary heart disease.Results:A total of 168 articles were included,consisting of 10 theoretical discussion articles and 158 clinical research articles,with 8287 patients involved.The clinical symptoms of comorbid ischemic stroke and coronary heart disease,ranked by frequency,were hemiplegia(58.67%),chest pain(55.40%),fatigue(38.89%),dizziness(37.10%),and facial droop(36.94%).The distribution of syndrome elements included blood stasis(23.53%),phlegm-dampness(22.58%),qi deficiency(17.97%),and yin deficiency(15.10%).Compared with single diseases,comorbid ischemic stroke and coronary heart disease showed significant differences in clinical physicochemical indicators such as blood lipids(20%),blood pressure(18.67%),and blood glucose(8%).Common efficacy evaluation indicators in clinical studies included the improvement of primary symptoms(64.58%),total cholesterol(47.92%),and neurological deficit scores(25.00%).Conclusion:Comorbid ischemic stroke and coronary heart disease exhibit unique clinical characteristics,including specific symptoms,syndrome elements,primary syndromes,and physicochemical indicators.The efficacy evaluation methods mainly focus on the improvement of primary symptoms.

关 键 词：缺血性卒中与冠心病共患病 临床特征 疗效评价方法 卒中 冠心病 症状 缺血性卒中 

分 类 号：R255.2[医药卫生—中医内科学] R256.2[医药卫生—中医学]