梗塞型腦中風急性期患者中醫證型與其預後關係之探討(2-2)

謝慶良
中國醫藥大學
自98年1月21至98年10月9日止共收案梗塞型腦中風急性期患者97人，完成發病時和發病12週（12週±3天）後第二次評估的有80位。80位梗塞型腦中風急性期患者中風證71位（89.0%），氣虛證51位（63.8%），痰證47位（58.8%），火熱證16位（20.0%），血瘀證8位（10.0%），陰虛陽亢證6位（7.5%），1位（1.3%）證型不成立。發病後12週（12週±3天）時比發病時NIHSS分數的減少氣虛證比非氣虛證，風•氣虛證比非風•氣虛證，風•火熱•氣虛證比非風•火熱•氣虛證大。根據研究的結果推論梗塞型腦中風的發病原因以風、痰和氣虛為主，這些結果與我們先前的風、痰和血瘀稍微不同，有必要增加病例數進一步探討。又初步結果顯示梗塞型腦中風急性期以氣虛證型預後較好。因此，本研究的目的是延續上年度的計畫探討梗塞型腦中風急性期中醫證型與其預後之關係。我們預計再蒐集80位梗塞型腦中風急性期患者。他們都是第一次腦中風患者，於發病後72小時內分別完成填寫Glasgow Coma Scale （GCS）、Modified Rankin Scale（MRS）、美國國家衛生研究院中風評量表（National Institutes of Health Stroke Scale，NIHSS）、巴氏量表（Barthel Index，BI）和生活功能獨立執行測量表（Functional Independence Measure，FIM）。另外，由兩位資深中醫師取得一致後填寫中風病辨證量表，並確定其中醫證型。12週（12週±3天）後再分別填寫GCS、MRS、NIHSS、BI和FIM表。我們預期研究結果可得得到梗塞型腦中風急性期中醫證型與其預後之關係。
關鍵字：梗塞型腦中風；急性期；中醫證型；預後

The study on the relationship between Chinese Medicine pattern and its prognosis in patient with acute stage of cerebral infarct (2-2)

Ching-Liang Hsieh
China Medical University
A total of 97 patients with acute stage of cerebral infarct were collected from January 21, 2009 to October 9, 2009. The 80 patients were finished two assessments at onset and at 12 weeks (12 weeks±3 days) after onset. Wind pattern is 71 (89.0%), Qi-vacuity 51 (63.8%), Phlegm pattern 47 (58.8%), Fire-hot pattern 16 (20.0%), Blood-stasis pattern 8 (10.0%), and Yin-Vacuity pattern 6 (7.5%), and one patient is no pattern in 80 patients with acute stage of cerebral infarct. The reduction of NIHSS score between at 12 weeks (12 weeks±3 days) after onset and at onset in Qi-vacuity pattern, WindoQi-vascuity pattern, and WindoFire-hotoQi-vascuity pattern were greater than non-Qi-vacuity pattern, non-WindoQi-vascuity pattern and non-WindoFire-hotoQi-vascuity pattern. According to these results, suggesting that the main etiology of cerebral infarct was wind, Phlegm and Qi-vascuity, and these results partly controversy to our previous results of Wind, Phlegm and Blood stasis, therefore, the number of patients with acute stage of cerebral infarct increased for further study is need. In addition, the elementary results indicated that the prognosis in the Qi-vascuity pattern is better than in the non-Qi-vasculity pattern in the patients with acute stage of cerebral infarct. Therefore, the purpose of the present study was continuous the project of last year to investigate the relationship between CMP and its prognosis, we increased 80 patients with acute stage of cerebral infarct. All of them, the stroke is first attack, and the Glasgow Coma Scale (GCS), Modified Rankin Scale (MRS), National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI) and Functional Independence Measure (FIM) were finished within 72 h after onset of stroke. In addition, the Chinese Medicine pattern (CMP) was confirmed by two experience Chinese Medicine doctors and finished the CMP chart of stoke. The score of GCS, MRS, NIHSS, BI and FIM were written again after 12 weeks (12 week±3 days). We predict the results that can obtain the relationship between CMP and the prognosis of CMP in patients with acute stage of cerebral infarct.
關鍵字：Cerebral infarct; Acute stage; Chinese Medicine Pattern; Prognosis