急性脑梗死不同中医证候与炎症、凝血指标的相关性分析OA

Objective:To explore the characteristics of traditional Chinese medicine(TCM)syndromes in patients with acute cerebral infarction(ACI),and to analyze the relationship between different TCM syndromes and inflammatory,coagulation indicators as well as prognosis.Methods:An observational study was conducted on 177 patients with ACI admitted to the Emergency Department of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine.All patients underwent cranial MRI or CT examination,and inflammatory and coagulation-re-lated indicators were recorded.The prognosis and differences in various indicators among different syndromes were compared,and the correlation between TCM syndromes and inflammatory and coagulation indicators was analyzed.Results:1)Blood stasis syndrome,phlegm-dampness syndrome and internal wind syndrome accounted for the highest proportion in acute cerebral infarction.Qi deficiency syndrome and yin deficiency syndrome were associat-ed with poor prognosis.The top combinations of TCM syndromes in patients with ACI were phlegm-dampness syn-drome+blood stasis syndrome,internal wind syndrome+phlegm-dampness syndrome+blood stasis syndrome,blood stasis syndrome,and blood stasis syndrome+qi deficiency syndrome in sequence.2)The white blood cell count(WBC)in patients with blood stasis syndrome was significantly higher than that in non-blood stasis syndrome pa-tients;the C-reactive protein(CRP)level in patients with qi deficiency syndrome was significantly higher than that in non-qi deficiency syndrome patients.The activated partial thromboplastin time(APTT)in patients with in-ternal wind syndrome was significantly higher than that in non-internal wind syndrome patients,while the pro-thrombin time(PT)was significantly lower.The fibrinogen(Fib)level in patients with qi deficiency syndrome was significantly higher than that in non-qi deficiency syndrome patients.Further correlation analysis showed that in-ternal wind syndrome was negatively correlated with PT and positively correlated with APTT;blood stasis syn-drome was positively correlated with WBC;qi deficiency syndrome was positively correlated with WBC,neutrophil count(NE),CRP and Fib.After adjusting for common confounding factors,Logistic regression analysis indicated that elevated CRP level was an independent related factor for qi deficiency syndrome,and elevated APTT level might be associated with the occurrence of internal wind syndrome.Conclusion:Deficiency syndromes,especially qi deficiency syndrome,in patients with ACI are associated with poor prognosis.There is a correlation between TCM syndromes and inflammatory and coagulation indicators.Patients in the acute phase of cerebral infarction are more likely to have disorders of inflammation and coagulation function,and this tendency is more significant in qi deficiency syndrome.