后循环短暂性脑缺血发作患者中医证型与糖化血红蛋白、D-二聚体水平的相关性分析
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摘要
目的:探讨后循环短暂性脑缺血发作(transient ischemic attack,TIA)中医证型分布规律及其与糖化血红蛋白(HbA1c,Hemoglobin A1c)、D-二聚体(D-Dimer)水平的相关性。方法:通过对符合纳入标准的200例后循环TIA患者进行辨证分型,分为肝阳上亢证、气血亏虚证、肾精不足证、痰湿中阻证、瘀血阻窍证5种证型,分别检测后循环TIA患者HbA1c、D-二聚体水平,然后进行组间比较,分析各证型组HbA1c、D-二聚体水平情况。结果:各证型组HbA1c、D-二聚体水平比较差异有统计学意义(P<0.05)。肝阳上亢证型组、肾精不足证型组与痰湿中阻证型组、瘀血阻窍证型组相比,HbA1c水平差异有统计学意义(P<0.05),余证型间的比较差异无统计学意义(P>0.05)。肾精不足证型组、瘀血阻窍证型组与肝阳上亢证型组、气血亏虚证型组、痰湿中阻证型组相比,D-二聚体水平差异有统计学意义(P<0.05),余证型间的比较差异无统计学意义(P>0.05)。结论:该研究发现中医证型和HbA1c、D-二聚体水平之间存在一定的相关性,可将HbA1c、D-二聚体水平作为中医辨证分型的参考指标之一,结合中医治未病思想,通过对危险因子进行相关的风险评估,及时提前进行干预治疗及有效的健康管理,防患于未然。
Objective: To investigate the distribution of TCM syndromes in transient ischemic attack(TIA) and its correlation with glycosylated hemoglobin(HbA1c) and D-dimer levels.Methods: According to the syndrome differentiation of 200 patients with post-circulation TIA who met the inclusion criteria, they were divided into five syndromes: liver-yang upper phlegm syndrome, Qi and blood deficiency syndrome, kidney essence deficiency syndrome, phlegmdampness syndrome, and blood stasis syndrome, the levels of HbA1c and D-dimer in patients with post-circulation TIA were detected, and then compared between groups, the levels of HbA1c and D-dimer in each syndrome group were analyzed.Results: There were significant differences in the levels of HbA1c and D-dimer in each syndrome group(P<0.05), there was a significant difference in the level of HbA1c between the liver-yang stagnation syndrome group and the spleen-deficiency syndrome type group and the phlegm-dampness syndrome group and the phlegm-stagnation syndrome group(P<0.05), the difference was not statistically significant(P>0.05). There was a statistically significant difference in the level of D-Dimer between the kidney essence deficiency syndrome type group, the blood stasis resistance syndrome type group and the liver Yang upper phlegm syndrome type group, the Qi and blood deficiency syndrome type group, and the phlegm-dampness syndrome type group(P<0.05), the difference between the syndrome types was not statistically significant(P>0.05). Conclusion: This study found that there is a certain correlation between TCM syndrome types and HbA1c, D-dimer levels, and HbA1c and D-dimer levels can be used as one of the reference indicators for TCM syndrome differentiation, combined with TCM treatment of disease By taking risk assessments related to risk factors, timely intervention treatment and effective health management, prevent problems before they occur.
Objective: To investigate the distribution of TCM syndromes in transient ischemic attack(TIA) and its correlation with glycosylated hemoglobin(HbA1c) and D-dimer levels.Methods: According to the syndrome differentiation of 200 patients with post-circulation TIA who met the inclusion criteria, they were divided into five syndromes: liver-yang upper phlegm syndrome, Qi and blood deficiency syndrome, kidney essence deficiency syndrome, phlegmdampness syndrome, and blood stasis syndrome, the levels of HbA1c and D-dimer in patients with post-circulation TIA were detected, and then compared between groups, the levels of HbA1c and D-dimer in each syndrome group were analyzed.Results: There were significant differences in the levels of HbA1c and D-dimer in each syndrome group(P<0.05), there was a significant difference in the level of HbA1c between the liver-yang stagnation syndrome group and the spleen-deficiency syndrome type group and the phlegm-dampness syndrome group and the phlegm-stagnation syndrome group(P<0.05), the difference was not statistically significant(P>0.05). There was a statistically significant difference in the level of D-Dimer between the kidney essence deficiency syndrome type group, the blood stasis resistance syndrome type group and the liver Yang upper phlegm syndrome type group, the Qi and blood deficiency syndrome type group, and the phlegm-dampness syndrome type group(P<0.05), the difference between the syndrome types was not statistically significant(P>0.05). Conclusion: This study found that there is a certain correlation between TCM syndrome types and HbA1c, D-dimer levels, and HbA1c and D-dimer levels can be used as one of the reference indicators for TCM syndrome differentiation, combined with TCM treatment of disease By taking risk assessments related to risk factors, timely intervention treatment and effective health management, prevent problems before they occur.
引文
[1]后循环缺血专家共识组专家.中国后循环缺血的专家共识[J].中华内科杂志,2006,45(9):786-787.
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[9]宋咏梅.痰湿体质形成的影响因素[J].山东中医药大学学报,2002,26(3):100-101.
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[11]王莉,黄瀚宇,沈娟,等.糖化血红蛋白检测在糖尿病诊断中的应用进展[J].世界最新医学信息文摘,2018,18(2):33-35.
[12]王笠,李琳,王达,等.糖化血红蛋白的检测和临床应用[J].上海医学检验杂志,2003,18(2):119-121.
[13]张宏信.中医治未病结合健康管理干预治疗糖尿病前期临床研究[J].亚太传统医药,2015,11(20):108-109.
[14]徐东升,黄伟,陈炜,等.短暂性脑缺血发作患者的纤维蛋白原和D-二聚体的变化及临床意义[J].医学理论与实践,2015,28(24):3311-3312.
[15]丁志刚.血浆D-二聚体水平评估后循环短暂性脑缺血发作近期发生脑梗死的价值[J].现代中西医结合杂志,2017,26(13):1449-1451.
[2]华敏,沈华超,何冬梅,等.382例眩晕或头晕患者病因及临床特点分析[J].江苏医药,2015,41(9):1073-1074.
[3]樊春秋,陈瑾,黄小钦,等.1000例眩晕患者的疾病谱[J].中风与神经疾病杂志,2016,33(5):445-447.
[4]Nouh A,Remke J,Ruland S.Ischemic posterior circulation stroke:a review of anatomy,clinical presentations,diagnosis,and current management[J].Front Neurol,2014,5:30.
[5]凌志鹃,曹海涛,朱沂,等.后循环脑梗死患者预后分析[J].中华脑血管病杂志,2011,5(5):394-399.
[6]吴菁,陈伟,董幼镕,等.119例小脑梗死的临床分析[J].中国临床神经科学,2016,24(6):654-662.
[7]周仲英.中医内科学[M].2版,北京:中国中医药出版社,2007:300-301.
[8]短暂性脑缺血发作中国专家共识组.短暂性脑缺血发作的中国专家共识更新版(2011年)[J].中华内科杂志,2011,50(6):530-533.
[9]宋咏梅.痰湿体质形成的影响因素[J].山东中医药大学学报,2002,26(3):100-101.
[10]王东坡,叶超,陈婧,等.论痰湿体质的发病趋势及其综合调理[J].北京中医药大学学报,2011,34(8):517-519.
[11]王莉,黄瀚宇,沈娟,等.糖化血红蛋白检测在糖尿病诊断中的应用进展[J].世界最新医学信息文摘,2018,18(2):33-35.
[12]王笠,李琳,王达,等.糖化血红蛋白的检测和临床应用[J].上海医学检验杂志,2003,18(2):119-121.
[13]张宏信.中医治未病结合健康管理干预治疗糖尿病前期临床研究[J].亚太传统医药,2015,11(20):108-109.
[14]徐东升,黄伟,陈炜,等.短暂性脑缺血发作患者的纤维蛋白原和D-二聚体的变化及临床意义[J].医学理论与实践,2015,28(24):3311-3312.
[15]丁志刚.血浆D-二聚体水平评估后循环短暂性脑缺血发作近期发生脑梗死的价值[J].现代中西医结合杂志,2017,26(13):1449-1451.