Xin Xi-yan, Gao Ying, Ma Bin
Department of Neurology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011 Dec;31(12):1627-31.
To explore the correlation between stroke of qi deficiency syndrome (QDS) and the neurological impairment degree, and to study its correlation between QDS and its long-term prognosis.
Recruited were 706 stroke patients with complete clinical information including diagnostic scale scoring of elements such as wind, fire, phlegm, blood stasis, qi deficiency, and yin deficiency, scoring of The National Institutes of Health Stroke Scale (NIHSS) within 72 h from attack, on the 7th, 14th, 28th, and 90th day after attack, and Barthel index (BI) scoring on the 90th day. They were assigned to the QDS group (330 cases) and the non-QDS group (376 cases). The NIHSS scores at different time points were compared between the two groups using analysis of variance of repeated measure data. The correlation between each syndrome element and the long-term prognosis of stroke was studied using Logistic regression analysis.
Higher NIHSS score was found in patients of QDS than those of non-QDS at each time point (P < 0.01). Statistical difference existed in NIHSS score between the two groups at each time point (P < 0.01, P < 0.05). Besides, NIHSS score decreased gradually as time went by. The occurrence frequencies of blood stasis syndrome and phlegm syndrome were higher at each time point. On the 90th day after attack, 427 patients with BI > or = 95 (accounting for 60%) had favorable prognosis, while 279 with BI < 95 (accounting for 40%) had unfavorable prognosis. QDS at each time point was negatively correlated with the 90th-day BI, with the B value being -0.496, -0.714, -0.867, -0.567, and -0.764, respectively.
Stroke patients of QDS had more severe neurological impairment than those of non-QDS. Stroke patients of acute-stage QDS was closely correlated with unfavorable prognosis on the 90th day after attack. Early actively invigorating healthy qi plays an important role in improving the long-term prognosis of stroke patients.
探讨气虚证中风与神经功能缺损程度的相关性，研究气虚证与中风远期预后的关系。
纳入706例具有完整临床资料的中风患者，包括风、火、痰、瘀、气虚、阴虚等证素诊断量表评分，发病72小时内、发病后第7天、14天、28天、90天的美国国立卫生研究院卒中量表（NIHSS）评分，以及发病后第90天的Barthel指数（BI）评分。将患者分为气虚证组（330例）和非气虚证组（376例）。采用重复测量资料的方差分析比较两组不同时间点的NIHSS评分。采用Logistic回归分析研究各证素与中风远期预后的相关性。
气虚证组患者各时间点的NIHSS评分均高于非气虚证组（P<0.01）。两组各时间点的NIHSS评分差异有统计学意义（P<0.01，P<0.05）。此外，NIHSS评分随时间逐渐降低。各时间点血瘀证和痰证的出现频率较高。发病后第90天，BI≥95分的427例患者（占60%）预后良好，BI<95分的279例患者（占40%）预后不良。各时间点的气虚证与第90天的BI呈负相关，B值分别为-0.496、-0.714、-0.867、-0.567和-0.764。
气虚证中风患者的神经功能缺损比非气虚证患者更严重。急性期气虚证中风患者与发病后第90天的不良预后密切相关。早期积极补气对改善中风患者的远期预后具有重要作用。
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