4.Exploring Chinese medicine and Western medicine group modules in acute phase of ischemic stroke disease.
Wei YANG ; Ming-Quan LI ; Yang LI ; Lei-Lei SUN ; Yan-Ming XIE ; Chong-Hui GUO ; Yan ZHUANG
China Journal of Chinese Materia Medica 2018;43(3):618-626
Under the theoretical guidance of "combination of disease and syndrome, correspondence between syndrome and prescription, and dynamic space-time", 11 135 acute ischemic stroke patients were collected from hospital information system(HIS) of many 3A grade hospitals of traditional Chinese medicine. Complex network analysis was adopted to obtain the core syndrome elements in different periods of acute ischemic stroke patients, and it was found that the core syndrome elements were blood stasis syndrome, phlegm, endogenous wind, Yin deficiency, Qi deficiency, heat, hyperactivity of liver Yang, liver, and kidney of patients in hospital for the first day, and during 8-14 d in hospitalization, the core syndrome elements were blood stasis, phlegm, Yin deficiency, Qi deficiency, endogenous wind, hyperactivity of liver Yang, liver, and kidney. The data with "improved" and "cured" treatment outcomes were adopted for complex network analysis and correlation analysis to identify the Chinese and Western medicine group modules in patients with different disease conditions in different phases after hospitalization. It was found that the Chinese and Western medicine modules within 14 d after hospitalization mainly included "blood-activating and stasis-dissolving module "consisted by "anti-platelet drug + circulation-improving medicine(or anticoagulant drug and anti-fibrinogen drug, et al) + blood-activating and stasis-dissolving drugs", as well as "stasis-dissolving and phlegm-reducing module" consisted by "anti-platelet drugs + circulation-improving medicine(or anticoagulant drug and anti-fibrinogen drug, et al) + phlegm refreshing drug". The core Chinese and Western medicine modules in patients with urgent and general conditions within 7 d after hospitalization mainly used "blood-activating and stasis-dissolving module" and "stasis-dissolving and phlegm-reducing module". Three or more Chinese medicine and Western medicines module with more than 1% utilization rate was not found in the patients with critical disease condition in admission. The urgent, general and critically ill patients in admission mainly used "blood-activating and stasis-dissolving module" in 8-14 d. From the real world medical big data research, it was found that the combined use of Chinese and Western medicines were consistent with "combination of disease and syndrome, correspondence between syndrome and prescription, and dynamic space-time" theory, and multiple multidimensional dynamic Chinese medicine and Western medicine group modules of "patient-syndrome-drug-time-effective" at the acute ischemic stroke stage were dug out, forming the method of Chinese and Western medicine combination research based on electrical medical big data.
Brain Ischemia
;
diagnosis
;
therapy
;
Humans
;
Medicine, Chinese Traditional
;
Stroke
;
diagnosis
;
therapy
;
Syndrome
;
Yin Deficiency
6.Fatal ischemic stroke in a case of progressive moyamoya vasculopathy associated with uncontrolled thyrotoxicosis.
Bon D KU ; Key Chung PARK ; Sung Sang YOON
The Korean Journal of Internal Medicine 2015;30(4):543-546
No abstract available.
Adult
;
Brain Ischemia/diagnosis/*etiology
;
Cerebral Angiography
;
Fatal Outcome
;
Female
;
Humans
;
Hyperventilation/complications
;
Moyamoya Disease/*complications/diagnosis/therapy
;
Risk Factors
;
Stroke/diagnosis/*etiology
;
Thyroid Crisis/*complications/diagnosis/therapy
7.Effect of integrative medical therapy on the prognosis of patients suffering from yin syndrome type acute ischemic stroke.
Li-Xin WANG ; Ye-Feng CAI ; Jian-Wen GUO
Chinese Journal of Integrated Traditional and Western Medicine 2011;31(2):195-199
OBJECTIVETo observe the effect of integrative medical therapy on the prognosis of patients suffering from yin syndrome type acute ischemic stroke (YS-AIS).
METHODSA multi-center, prospective, random and parallel controlled clinical trial was carried on 606 patients of YS-AIS. Excepting the 15 patients being excluded and dropped out in the trial period, all patients were assigned to the treatment group (274 patients) treated with integrated medical protocol (i. e. Chinese medical therapy plus conventional Western medical treatment), and the control group (263 patients) treated with conventional Western medical treatment plus placebo. Patients' quality of life (QOL) and their disability level were assessed by scoring based on SS-QOL and modified Rankin scale (mRS) respectively at the terminal of the 21-day treatment (T1) and at the ends of 60-day (T2) and 90-day (T3) following-ups.
RESULTSPatients' disability level, showed by mRS scores, was not significantly different between the two groups at T1 and T2 (P > 0.05), but with significant difference at T3 (P < 0.05). The recovery in the treatment group were more significant. Although the SS-QOL scores showed no statistical significant difference between groups (P > 0.05), improvement of QOL could be seen in the treatment group and the difference between groups was more significant as the time went by.
CONCLUSIONIntegrative medical therapy could reduce the severe disability rate in patients after YS-AIS, and showed an improving trend on patients' QOL at T3.
Aged ; Female ; Humans ; Integrative Medicine ; Ischemia ; therapy ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Prognosis ; Prospective Studies ; Stroke ; diagnosis ; therapy
8.Early diagnosis and treatment of acute mesentric ischemia for 42 cases in single center.
Zhao ZHANG ; Guo-xun LI ; Xi-mo WANG ; Dan WANG ; Ke-yu HAN ; Dong XU ; Tao JIANG
Chinese Journal of Surgery 2012;50(12):1068-1071
OBJECTIVETo investigate the early diagnosis and treatment of acute mesenteric ischemia.
METHODSForty-two patients with acute mesenteric ischemia from June 2007 to November 2011 were reviewed retrospectively. All patients were diagnosed with DSA and (or) CT and (or) surgery. In this group, there were 32 cases of acute occlusion of meseteric ischemia (AOMI), 9 cases of superior mesenteric venous thrombosis (SMVT) and 1 case of non-occlusive mesenteric ischemia. The patients were treated using comprehensive treatment including early intervention treatment and application of the principle of damage control. The survival of all patients was followed up for 6 months or more in outpatient.
RESULTS(1) Of the 32 AOMI cases, 4 cases healing by systemic anticoagulation; The 19 cases received interventional treatment, including 10 cases received simply interventional treatment, surgery after the failure of intervention in 5 cases, 3 patients died without surgery and postoperative interventional treatment one cases were cured; Eight cases received surgery treatment; One case gave up. (2) Of the 9 SMVT cases, 2 cases healing by systemic anticoagulation; The 6 cases received interventional treatment, including 1 cases received simply interventional treatment, surgery after the failure of intervention in 1 cases, 4 cases to consider intestinal necrosis received interventional treatment again after surgery; One patient died without treatment. (3) Eight cases received delay abdomen close treatment with the principle of damage control surgery. The overall mortality rate of 23.8% (10/42). Interventional treatment of 26 cases, 4 deaths, a mortality rate of 15.3%; The abdomen delayed close of 8 cases, 1 death.
CONCLUSIONSThe results show that early diagnosis and treatment is critical to reduce AMI mortality. Comprehensive treatment of early intervention treatment and application of the principle of damage control can significantly reduce the mortality of AMI.
Adult ; Aged ; Aged, 80 and over ; Early Diagnosis ; Female ; Humans ; Ischemia ; diagnosis ; therapy ; Male ; Mesenteric Ischemia ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Vascular Diseases ; diagnosis ; therapy ; Young Adult
9.Painless Aortic Dissection Presenting as Acute Ischemic Stroke: Administ-ra-tion of Tissue lasminogen Activator.
Seung Ho LEE ; Dong Rul OH ; Hyung Kook KIM ; Young Min OH ; Mi Jin LEE ; Se Kyung KIM
Journal of the Korean Society of Emergency Medicine 2002;13(2):222-225
Acute aortic dissection is a catastrophic, often life threatening event that usually presents as a sudden, severe, exquisitely painful, ripping sensation in the chest or back. Painless dissection occurs in approximately 5% of the patients, and the diagnosis may often be delayed. It can be associated with neurologic sequelae, such as ischemic stroke, spinal cord ischemia, ischemic peripheral neuropathy, in as many as one-third of the patients. As an initial manifestation, neurologic deficit is seen in about 20% of patients. The diagnosis of ischemic stroke in patients who present within a 3-hour time window is generally made on clinical grounds before administration of thrombolytic therapy. The etiology of the stroke is not definitely determined until well after the patient has received recombinant tissae plasminogen activator. It is likely that poor outcomes will occur in ischemic stroke resulting from aortic dissection if r-tPA is administered intravenously. Therefore, it is important to clinically recog-nize this possibility. We report the case of a patient who presented with symptoms consistent with acute ischemic stroke and was given r-tPA. Further investigation demon-strated an aortic dissection as the cause of her stroke.
Diagnosis
;
Humans
;
Neurologic Manifestations
;
Peripheral Nervous System Diseases
;
Plasminogen Activators
;
Sensation
;
Spinal Cord Ischemia
;
Stroke*
;
Thorax
;
Thrombolytic Therapy