缺血性中风不同时点单证候动态演变与预后关系研究

目的评价缺血性中风不同时点单证候动态演变与预后的关系。方法提取2004年9月200g年8月在首都医科大学宣武医院、北京中医药大学东直门医院、北京中医药大学东方医院等多中心住院的缺血性中风患者4个时点（发病3d、14d、28d、90d）的中医四诊信息，发病第90天BI评分，对不同时点单证候动态演变与预后的关系进行分析。结果发病第3天和第14天：内风证、血瘀证、气虚证、阴虚证单证候变化组间比较与预后无明显相关；内火证、痰湿证证候消失组较证候不变组、证候新增组预后佳。发病第14天和第28天：阴虚证证候新增组较证候消失组预后差，余单证候变化组间比较与预后无明显相关。发病第28天和第90天：内风证证候新增组较证候不变组预后差；内火证、气虚证证候消失组较证候不变组预后佳；痰湿证、阴虚证单证候变化组间比较与预后无明显相关；血瘀证证候新增组较较证候不变组、证候消失组预后差。结论缺血性中风不同时点不同单证候演变对中风病的预后影响不同，对指导临床具有重要意义。

Relationship between Single Syndrome of Dynamic Evolvement of lschemic Stroke in Different Time Points and Prognosis

Objective To evaluate the relationship between the single syndrome of dynamic evolvement of ischemic stroke in dif- ferent time points and the prognosis of patients. Methods Five hundreds and six patients were studied. Four diagnostic factors of traditional Chinese medicine （TCM）at four time points （3rd,14th,28th,and 90th day）,and the score of Barthal indexscale （BI） at 90th day were recorded. The relationship between the single syndrome of dynamic evolvement in different time points and the prognosis of these patients were analyzed. Results The results showed that at day 3 and day 14,the fire syndrome,phlegm and damp syndrome in syndrome disappearing group displayed better outcome than these in group syndrome non - change and syndrome plus group. And the other single syndrome factor had no significant correlation with prognosis. At day14 and day 28,only yin deficiency in syndrome plus group showed poor prognosis than that in syndrone syndrome disappearing group. At day 28 and day 90, the wind syndrome in syn- drome plus group showed poor prognosis than that in the non- change group, and the fire syndrome and qi deficiency in syndrome disappearing group had better outcome than these in syndrome non- change group, blood stasis syndrome in syndrome plus group had poor prognosis than in syndrone nonchange troup and syndrone disappearing group. Conclusion The dynamic evolvement of ischemic stroke of single syndrome in different time points had different effects on prognosis.