脑卒中高危人群和新发脑卒中患者的危险因素及中风先兆的对比研究

摘要

目的：对比脑卒中高危人群和新发脑卒中患者具备的卒中危险因素、卒中前病情变化临床症状的异同，探讨中风先兆的识别以及中医“治未病”的重要意义。方法对79例脑卒中高危人群的临床资料进行前瞻性分析，同时对143例新发脑卒中患者的临床资料进行回顾性分析。对脑卒中高危组发生病情变化、新发脑卒中组发病前病情变化的临床症状运用频数进行描述，采用SPSS 17．0软件包进行聚类分析。结果卒中危险因素方面，两组病人均具备多重危险因素，对血压、血糖、血脂的知晓率和控制达标率低，存在不健康生活方式。病情变化临床症状方面，烦躁易怒、口干口苦、头晕昏沉、神疲乏力、口气臭秽、反应迟钝等在两组中同步高频出现。中风先兆症候要素方面，脑卒中高危组肝阳上亢、风痰、气虚并存，新发脑卒中组痰火、痰浊、风火为著，三者相互转化并延续至中风首发状态。结论中风先兆是中风的高危预警信号，发挥中医中药“治未病”的特色，加强对先兆证的识别和对“风”、“火”、“痰”的干预，从而阻断、延缓中风的发生，降低其发病率、复发率。%Objective Investigate risk factors for stroke and clinical manifestation of predrome of stroke in cerebrovascular events high-risk groups and apoplexy patients, discuss the identification of pre-drome of stroke and reveal the significance of“Prevention first”. Methods Prospective analysis and retro-spective analysis were carried out respectively on the clinical data of 79 cerebrovascular disease high risk patients and 143 apoplexy patients. The clinical symptoms of two groups were described by frequency, SPSS 17. 0 software was used for cluster analysis of two groups. Results Both two groups had aggregation of multiple risk factors. The awareness rate and control rate of blood pressure, blood glucose and blood lip-ids was low. Both had unhealthy life style habits. Symptoms like irritability and restlessness, dry mouth and bitter taste in the mouth, feeling dizzy and dazed, fatigue and lassitude, foul breath, slow response, appeared frequently and synchronized in the two groups. Hyperactivity of liver yang, wind-phlegm and defi-ciency of qi coexisted in high-risk group, Phlegm-fire, phlegm-dampness and wind-fire transformed into each other in new onset stroke group. Wind and fire played a leading role in pre-stroke condition change. Conclusion Aura of stroke is a high early warning signal of stroke, it may eventually develop into stroke. Therefore, the“preventive treatment of disease” theory should be developed to improve the identification of predrome of stroke, and enhance interventions on“wind”,“fire”,“phlegm”, block and delay the occur-rence of stroke, so as to reduce its incidence and recurrence rate.