中风病气虚证与神经功能缺损程度及远期预后的关系研究

目的探讨中风病气虚证与神经功能缺损程度及远期预后的关系。方法选取发病72 h内、发病第7、14、28、90天中风病证候要素（风、火、痰、血瘀、气虚、阴虚）诊断量表评分、美国国立卫生研究院卒中量表（The National Institutes of Health Stroke Scale,NIHSS）评分及发病第90天日常生活能力量表（Barthel in-dex,BI）评分的临床信息俱全的中风病患者706例,分为气虚证组（330例）及非气虚证组（376例）。采用两样本重复测量数据方差分析比较气虚证组与非气虚证组不同时点NIHSS评分;应用Logistic回归分析探讨中风病不同时点各证候要素与远期预后的关系。结果各时点气虚证组患者NIHSS评分均高于非气虚证组患者（P〈0.01）;两组组内各时点NIHSS评分比较,差异均有统计学意义（P〈0.01,P〈0.05）,且随时间的延后,NIHSS评分逐渐降低。血瘀证与痰证在各时点出现频次均较高。发病第90天,BI≥95分者427例（60%）,预后良好;BI〈95分者279例（40%）,预后不良。各时点气虚证均与发病第90天BI指数呈负相关,B值依次为-0.496、-0.714、-0.867、-0.567、-0.764。结论中风病气虚证患者神经功能缺损程度较非气虚证患者更重;中风病急性期气虚证与发病第90天预后不良有密切关系,早期积极扶助正气治疗对改善中风病远期预后具有重要作用。

Study on the Correlation between Stroke of Qi Deficiency Syndrome and the Neurological Impairment Degree and Its Long-term Prognosis

Objective 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.Methods 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 af...