摘要
目的:探讨缺血性中风合并高血糖患者急性期多时点中医证候分布特点,及血糖、中医证候、美国国立卫生研究院院卒中量表(NIHSS)与疾病预后的关系。方法:根据发病3天内血糖是否升高将缺血性中风急性期患者224例分为两组,对3个时点的NIHSS进行均数比较,并将两组分别与6个中医证候做χ2检验。采用Logistic逐步回归研究发病3天内的血糖、NIHSS,及3个时点的中医证候与发病第90天BI的关系。结果:发病3天内高血糖组的NIHSS较血糖正常组高,差异有统计学意义(P<0.05)。发病3天内、第7天高血糖组出现内火的病例数均多于血糖正常组,差异有统计学意义(P<0.01,P<0.05)。发病第14天6个中医证候在血糖正常组、高血糖组的分布无显著性差异。发病3天内的NIHSS评分、发病第7天出现阴虚、发病第14天出现痰湿是缺血性中风患者发病第90天的独立致残因素。结论:缺血性中风始发态高血糖患者神经功能缺损更严重,发病初期高血糖与内火关系密切。起病时神经功能缺损程度及不同时点中医证候均与缺血性中风疾病预后密切相关。
Objective： To investigate the distribution characteristics of TCM syndromes of acute ischemic stroke patients accompanied with hyperglycemia at several time points, and the relations among blood glucose, TCM syndromes, NIHSS and prognosis. Methods： According to whether patients had hyperglycemia within three days or not, two hundred and twenty-two acute ischemic stroke patients were divided into two groups. The means of NIHSS were compared at three time points. Chi-square test was used to research the relations between two groups and six TCM syndromes respectively. The relations among blood glucose and NIHSS within three days of illness, TCM syndromes at three time points, and barthel index（BI） on the 90 th day of illness were assayed by using Logistic regression. Results： NIHSS within 3 days of illness of patients in high blood glucose group was higher than that of normal blood glucose group, and the differences between the two groups was significant（P〈0.05）. The numbers of endogenous fire patients in high blood glucose group were more than that of normal blood glucose group within 3 days and at the 7th day of illness, and the differences between the two groups was significant（P〈0.01, P〈0.05）. There was no significant difference in the distribution of six TCM syndromes between normal blood glucose group and high blood glucose group on the 14 th day of illness. The independent factors causing disability of ischemic stroke patients on the 90 th day of illness were NIHSS within 3 days, yin deficiency on the 7th day and phlegm-damp on the 14 th day of illness. Conclusion： Neurological impairment of acute ischemic stroke patients accompanied with hyperglycemia is more serious than normal blood glucose group within 3 days of illness. There are close relations between hyperglycemia and endogenous fire in the early period of acute ischemic stroke. Neurological impairment at the beginning of disease and TCM syndromes at different time points were highly correlated with the prognosis of ischemic stroke.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2015年第11期4094-4098,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家重点基础研究发展计划(973计划)(No.2003CB517102)
国家科技重大专项"重大新药创制"(No.2009ZX09502-028)
北京市中医药科技项目(No.JJ2012-17)~~
作者简介
通讯作者：高颖，北京市东城区海运仓5号北京中医药大学东直门医院，邮编：100700，电话：010-84013209，E-mail：gaoying973@126．com.
