【摘要】 目的:通过比较缺血性中风急性期患者不同时点中医证候要素、神经功能缺损程度评分的变化及远期预后不同的差异,探讨该病气虚证与神经功能缺损及预后的相关性,为临床早期干预治疗提供循证学依据。方法:采用前瞻性性观察研究的方法,选取缺血性中风发病72h内符合纳入标准的50例住院患者。根据入组当天《缺血性中风证候要素诊断量表》评分进行始发主要证候要素分组,动态采集各组患者入组当天,发病第7、14、28及90天时《缺血性中风证候要素诊断量表》、美国国立卫生研究院卒中量表(NIHSS)评分及发病第90天日常生活能力量表评分,使用SPSS 24.0软件进行数据统计和分析。结果:各证候要素分组于不同时点的神经功能缺损程度有差异,随着观察时点推移各组均分均呈下降趋势,但气虚组均分在各时点中均高于其他证素组,行双因素方差分析,组间F=13.95,P<0.01,组间差异具有统计学意义,再行直线相关分析,NIHSS在多个时点与气虚证候要素呈正相关。至发病90天统计,气虚组预后不良发生比例最高,各证候要素分组预后结果行Kruskal-Wallis检验,χ2=22.66,P<0.01,差异有显著的统计学意义。结论:缺血性中风急性期意识清楚患者中气虚证者在急性期及恢复期神经功能缺损程度更重,远期预后更差。更多还原

【Abstract】 Objective: By comparing the changes of TCM syndrome scores, neurological deficit scores, and differences in long-term prognosis at different time points in patients with acute ischemic stroke, we investigated the relationship between qi deficiency syndrome and neurological deficit and prognosis in the acute phase of ischemic stroke. Methods: A prospective observational study was used. Fifty hospitalized patients who met the inclusion criteria within 72 hours of onset of ischemic stroke were selected. According to the ‘Ischemic Apoplexy Syndrome Diagnostic Scale’ score on the day of enrollment. The main syndrome components were grouped on the day of enrollment in each group, and the ischemic stroke was recorded on the 7 th, 14 th, 28 th, and 90 th day of onset. The scores of syndromes of diagnosis factors, NIHSS scores and scores of the daily living ability scale at the 90 th day of onset were used to count and analyze the data by SPSS 24.0 software. Results: The degree of neurological deficits at different time points of each syndrome group was different. As the observation time point progressed, the average scores of all groups showed a decreasing trend. However, qi deficiency group was higher than other syndrome groups at each time point, F=13.95, P<0.01, the difference between the groups was statistically significant. Linear correlation analysis was performed again. NIHSS was positively correlated with qi deficiency syndrome at multiple time points. From the 90 days of onset, qi deficiency group had the highest incidence of poor prognosis. The prognosis of each syndrome group was compared by Kruskal-Wallis test, χ2=22.66, P<0.01, with significant statistical difference. Conclusion: The patients with qi deficiency in the acute phase of ischemic stroke have more serious neurological deficits in the acute and convalescent stages and have worse long-term prognosis.更多还原