基于关联规则探讨缺血性中风痉挛性偏瘫的证候分布特点

目的探讨缺血性中风痉挛性偏瘫的证候分布特点。方法 5个研究中心于2014年6月至2017年6月共纳入符合标准的患者147例,给予现代康复或中医康复训练,评估入组时和入组21天时改良的Ashworth分级和证候积分,并对证候分布规律进行频数统计和关联规则分析。结果147例患者中,痉挛程度有效改善71例,无效76例。治疗前患者以痰证、血瘀证、火热为主,同时夹杂气虚证候;经康复治疗后,痉挛程度改善有效组的患者转变为气虚证和血瘀证为主要证候,证候复杂程度减少;无效组中,患者仍以痰证和血瘀证为主,且证候组合较复杂。结论痰证和血瘀证是中风病偏瘫痉挛患者的重要病证基础,贯穿痉挛始终;随痉挛程度改善,证候由痰瘀、火热、气虚等多种复杂证候组合逐渐转变为气虚血瘀为主,证候复杂程度呈现出逐渐减轻的趋势。

Effect of traditional Chinese medicine syndromes on hemiplegic spasticity of stroke based on association rule analysis

Objective To explore the distribution of traditional Chinese medicine( TCM) syndromes of the spasticity of ischemic stroke. Methods 147 patients with spastcity induced by ischemic stroke in 5 research centres were recruited to receive modern or traditional Chinese rehabilitation from Jun. 2014 to Jun. 2017. Modified Ashworth Scale( MAS) and TCM syndrome scale were recorded on the first and the 21 st day after grouping and the laws of TCM syndrome distribution were discussed by frequency statistics and association rule analysis. Results According to the improvement degree of spasticitic intensity,71 patients were placed into effective group and the other 76 patients into ineffective group. TCM syndromes distribution of patients before treatment were mainly phlegm syndrome,blood stasis syndrome and heat syndrome,being mixed with qi deficiency. After rehabilitation,the main syndrome in the effective group were qi deficiency syndrome and blood stasis syndrome. And in the ineffective group were nearly the same complicated as before treatment. Conclusion Phlegm syndrome and blood stasis syndrome are the main syndromes of the patients of hemiplegic spasticity of stroke and runed through the process of the disease. As spasticitic intensity improved,the main syndromes turn to qi deficiency and blood stasis syndrome and the complex degree of the syndrome becomes relief gradually.