急性缺血性中风痰热证患者大动脉粥样硬化型与非大动脉粥样硬化型的临床特征比较OA
Comparison of clinical characteristics between large-artery atherosclerotic and non-large-artery atherosclerotic subtypes in acute ischemic stroke patients with phlegm-heat syndrome
目的 探索急性缺血性中风痰热证大动脉粥样硬化型(LAA)与非 LAA 患者的临床特征,为治疗本病提供参考.方法 采用横断面研究方法,依托中国中风中医药注册登记平台(CASES-TCM),纳入2022 年9 月—2025 年2 月明确病因分型的急性缺血性中风痰热证患者,将患者分为LAA 组与非 LAA 组,比较两组的一般资料、中医四诊信息、神经功能缺损情况与实验室指标.结果 共纳入196 例患者,LAA 组 110 例、非 LAA 组 86 例,两组患者在年龄、性别分布、入院当天《改良 Rankin 量表》评分的差异无统计学意义(P>0.05).在中医临床表征方面,乏力、小便黄赤及饮水呛咳的出现频率在 LAA 组与非 LAA 组间差异有统计学意义(P<0.05):乏力,LAA 组发生率为73.64%(81/110),高于非LAA 组的56.98%(49/86);小便黄赤,LAA 组为43.64%(48/110),高于非 LAA 组的 27.91%(24/86);饮水呛咳,LAA 组为 31.82%(35/110),高于非 LAA 组的17.44%(15/86).在舌脉特征方面,以下指标在两组间差异存在统计学意义(P<0.05):LAA 组舌下络脉青紫发生率为 46.36%(51/110),高于非 LAA 组的 30.23%(26/86);LAA 组舌有瘀斑瘀点为11.82%(13/110),低于非LAA 组的24.42%(21/86).两组中风严重程度分布及评分差异无统计学意义(P>0.05).实验室检查指标水平差异无统计学意义(P>0.05).结论 在急性缺血性中风痰热证患者中,LAA 组与非 LAA 组在部分临床表征及舌脉特征差异上存在统计学意义,其中LAA 组患者乏力、小便黄赤、饮水呛咳的发生率更高,舌下络脉青紫表现更为突出,而非 LAA 组舌有瘀斑瘀点的发生率更高,以上结果可为临床诊疗提供一定的参考.
Objective To explore the clinical characteristics of patients with large-artery atherosclerosis type(LAA)and non-LAA with phlegm-heat syndrome in acute ischemic stroke and to provide a reference for the treatment of this disease.Methods Based on the China Stroke Registry for Patients with Traditional Chinese Medicine registration platform,a cross-sectional study was conducted to enroll patients with acute ischemic stroke and phlegm-heat syndrome with clear etiological classification from September 2022 to February 2025.The patients were divided into the LAA and non-LAA groups,and the demographic data,four traditional Chinese medicine(TCM)diagnosis information,neurological deficits,and laboratory indicators of the two groups were compared.Results A total of 196 patients were enrolled,with 110 and 86 patients in the LAA and non-LAA groups,respectively.No significant differences in age,sex,and modified Rankin Scale score at admission were observed between the two groups(P>0.05).In terms of TCM clinical manifestation,the frequency of weakness(81/110,73.64%),deep-colored urine(48/110,43.64%),choking cough after drinking(35/110,31.82%)in the LAA group were significantly higher than those in the non-LAA group(P<0.05):weakness(49/86,56.98%),deep-colored urine(24/86,27.91%),and choking cough after drinking(15/86,17.44%).Among tongue and pulse manifestations,cyanotic sublingual vessels(51/110,46.36%)were significantly more common in the LAA group than in the non-LAA group(26/86,30.23%).In contrast,petechia or ecchymosis on the tongue was significantly lower in the LAA group(13/110,11.82%)than in the non-LAA group(21/86,24.42%)(P<0.05).No significant differences in stroke severity or scores were observed between the two groups(P>0.05),nor were any significant differences in laboratory parameters(P>0.05).Conclusion Significant differences were observed in some TCM clinical manifestation and tongue and pulse manifestations between the LAA and non-LAA groups in patients with acute ischemic stroke with phlegm-heat syndrome.The incidence of weakness,deep-colored urine,choking cough after drinking,and cyanotic sublingual vessels is higher in the LAA group,whereas the incidence of petechia or ecchymosis on the tongue is relatively higher in the non-LAA group.These results provide a reference for the clinical diagnosis and treatment of the disease.
阙淬林;赖新星;周琮人;牟雨琳;高颖
北京中医药大学东直门医院 北京 100700||北京中医药大学北京中医药大学东直门医院 北京 100700||北京中医药大学中医脑病研究院北京中医药大学东直门医院 北京 100700||北京中医药大学北京中医药大学东直门医院 北京 100700||北京中医药大学北京中医药大学东直门医院 北京 100700||北京中医药大学中医脑病研究院
医药卫生
缺血性中风大动脉粥样硬化型临床特征神经功能痰热证
ischemic strokelarge-artery atherosclerosis typeclinical characteristicsneurological functionphlegm-heat syndrome
《北京中医药大学学报》 2026 (4)
565-572,8
国家重点研发计划项目(No.2022YFC3501100)中央高水平中医医院临床科研业务费资助项目(No.DZMG-ZJXY-23011)北京中医药大学研究生自主科研课题(No.ZJKT2024040) National Key R&D Program of China(No.2022YFC3501100)
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