缺血预适应与痰证血瘀证缺血性卒中预后关系.docVIP

缺血预适应与痰证血瘀证缺血性卒中预后关系 　　摘要：目的 研究缺血性卒中的中医辨证属痰证、血瘀证者与缺血预处理的关系，以及对缺血性卒中的远期预后影响。方法 对缺血性卒中患者（179例）既往短暂性脑缺血发作（TIA）情况调研；记录发病时中医辨证分型、颅内血流情况（TCD）；以3月后的BI（barthal index）评估预后情况。数据采用SPSS 17.0软件进行统计学处理。结果 证类分布情况，血瘀证109例，既往发作过TIA的患者，辨证属痰证与血瘀证的比例，具有统计学意义（P0.022）； 既往发生过TIA者，左大脑中动脉、左大脑前动脉、基底动脉流速均低于既往无TIA者（P 　　关键词：缺血预适应；痰证；血瘀证；缺血性卒中 　　中图分类号：R743.3 R255.2 文献标识码：B 文章编号：1672-1349（2011）07-0801-02 　　 　　Relationship between Ischemic Preconditioning and the Prognosis of Ischemic Stroke with 　　Phlegm Syndrome and Blood Stasis Syndrome 　　Wang Le，Chen Zhigang，Meng Fanxin，et al 　　Dongfang Hospital，Beijing University of Chinese Medicine（Beijing 100078） 　　Abstract：Objective To investigate the relationship between ischemic preconditioning and the prognosis of ischemic stroke with phlegm syndrome and blood stasis syndrome.Methods The clinical data of 179 ischemic stroke patients with previous medical history of transient ischemic attack（TIA）were analyzed，and traditional Chinese medicine（TCM） syndrome types and hemodynamic changes of transcranial Doppler（TCD）were studied.The prognosis were evaluated by Barthal index（BI） after three months.SPSS17.0 was used to analysis the correlation.ResultsThe dominant syndrome types were blood-stasis syndrome（109/179）.There was significant difference between phlegm syndrome and blood stasis syndrome in patients with previous medical history of TIA（P0.022）.The flow speed of the left middle cerebral artery（L-MCA），left cerebral artery（L-ACA） and basilar artery（BA） in patients with previous medical history of TIA were lower than that in patients without previous medical history of TIA.There was no difference in the prognosis of ischemic stroke between phlegm syndrome and blood stasis syndrome.The prognosis ofpatients with previous medical history of TIA（35.7%） was better than that of patients without previous medical history of TIA（23.8%）.Conclusion The phlegm syndrome was main syndrome types in patients with previous medical history of TIA while blood stasis