广东省急性脑梗死中医证型与血常规检验指标的关系探讨

【目的】探讨广东省急性脑梗死(ACI)患者中医证型分布情况及其与血常规检验指标之间的关系,从而为ACI的中医辨证分型提供更加客观的辨证依据。【方法】选取符合纳入标准的385例ACI患者为研究对象,观察不同证型患者的红细胞分布宽度(RDW)、中性粒细胞总数(NEU)、淋巴细胞总数(LYM)、中性粒细胞与淋巴细胞比值(NLR)及平均血小板体积(MPV)等指标水平,探讨ACI患者与血常规检验指标的关系。【结果】(1)中医证型分布情况:在收集的来自广东省的385例ACI患者中,风痰阻络证188例(占48.8%),气虚血瘀证77例(占20.0%),风火上攻证62例(占16.1%),阴虚风动证33例(占8.6%),痰热腑实证25例(占6.5%)。(2)各证型与血常规检验指标的关系:从NEU来看,痰热腑实证及风火上攻证明显高于气虚血瘀证、风痰阻络证及阴虚风动证(P<0.01);从NLR来看,痰热腑实证及风火上攻证明显高于风痰阻络证(P<0.01),且痰热腑实证明显高于气虚血瘀证(P<0.01);而从RDW、LYM、MPV指标来看,各证型之间差异无统计学意义(P>0.05)。【结论】广东省ACI患者中医证型以风痰阻络证为主,气虚血瘀证次之;广东省ACI患者血常规检验指标NEU、NLR的升高可能为痰热证和风火证的参考依据。

Relationship Between Traditional Chinese Medicine Syndrome Types and Blood Routine Examination Indicators of Acute Cerebral Infarction in Guangdong Province

Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types of acute cerebral infarction(ACI)patients in Guangdong Province and to explore their relationship with blood routine examination indicators,so as to provide more objective evidence for the syndrome differentiation of ACI.Methods A total of 385 ACI patients who met the inclusion criteria were selected as the research object.The levels of indicators of red blood cell distribution width(RDW),neutrophils(NEU),lymphocytes(LYM),ratio of neutrophils to lymphocytes(NLR),and mean platelet volume(MPV)in patients with different syndrome types were observed,and the relationship between TCM syndrome types and blood routine test indicators was discussed.Results(1)Among the 385 ACI patients collected from Guangdong province,188(48.8%)cases were differentiated as the syndrome of wind-phlegm blocking collaterals,77(20.0%)cases were differentiated as the syndrome of qi deficiency and blood stasis,62(16.1%)cases were differentiated as the syndrome of upward attack of wind-fire,33(8.6%)cases were differentiated as the syndrome of yin deficiency and wind stirring up,and 25(6.5%)cases were differentiated as the excess syndrome of phlegm-heat in fu-organs.(2)In respect of the blood routine examination indicators in ACI with various syndrome types,ACI patients with the excess syndrome of phlegm-heat in fu-organs and the syndrome of upward attack of wind-fire had higher NEU level than the ACI patients with the syndromes of qi deficiency and blood stasis,wind-phlegm blocking collaterals,and yin deficiency and wind stirring up(P<0.01);ACI patients with the excess syndrome of phlegm-heat in fu-organs and the syndrome of upward attack of wind-fire had higher NLR than the ACI patients with the syndrome of wind-phlegm blocking collaterals(P<0.01),and ACI patients with excess phlegm-heat in fu-organs had higher NLR than the patients with qi deficiency and blood stasis syndrome(P<0.01);the differences of RDW,LYM and MPV in ACI patients with various syndrome types were not statistically significant(P>0.05).Conclusion(1)The TCM syndrome type of ACI patients in Guangdong province is predominated by the syndrome of wind-phlegm blocking collaterals,and then comes with qi deficiency and blood stasis syndrome.The elevation of NEU and NLR can supply the reference for the differentiation of phlegm-heat syndrome and wind-fire syndrome of ACI patients in Guangdong Province.