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目的:探讨急性脑血管疾病(ACVD)并发应激性溃疡(SU)的发病特点及其中医辨证分型。方法:对35例并发SU的ACVD患者进行辨证分型,观察脑出血(ACH)、脑梗死(ACI)患者出血部位、出血量、血肿是否破入脑室等与SU发生的关系。结果:ACH并发SU的发生率(32.6%)显著高于ACI并发SU的发生率(6.5%,P<0.05);中医辨证分型中,肝火上扰清窍型和痰热内闭心窍型并发SU的发生率均显著高于其他证型(P均<0.05);脑叶出血者多数未并发SU;脑出血血肿破入脑室并发SU的发生率(76.0%)显著高于血肿未破入脑室者(16.4%,P<0.005);脑出血量≥50ml者并发SU的发生率(52.9%)显著高于出血量<50ml者(28.0%,P<0.05);ACVD患者并发SU的近期(1个月内)病死率(51.4%)显著高于未并发SU者(8.2%,P<0.005)。结论:ACVD并发SU是预示病情严重的标志;中风急性期在综合治疗的基础上,应早期进行中医辨证分型施治,可预防SU的发生,降低病死率,提高治愈率
Objective: To investigate the incidence of acute cerebrovascular disease (ACVD) complicated with stress ulcer (SU) and its syndrome differentiation type. Methods: 35 patients with ACVD complicated with SU were divided into two groups according to syndrome differentiation. The relationship between hemorrhage and cerebral hemorrhage (ACH), bleeding area, hemorrhage volume and hematoma in the brain were observed. Results: The incidence of ACH complicated with SU (32.6%) was significantly higher than that of ACI complicated with SU (6.5%, P <0.05). In traditional Chinese medicine syndrome differentiation, The incidence of concurrent intracardiac secundum complicated with SU was significantly higher in patients with intrauterine heart occlusion (all P <0.05). Most patients with lobar hemorrhage did not have SU concurrently. %) Were significantly higher than those without hematoma (16.4%, P <0.005). The incidence of concurrent SU with cerebral hemorrhage≥50ml (52.9%) was significantly higher than that with hemorrhage <50ml 28.0%, P <0.05). The mortality (51.4%) in patients with ACVD complicated with SU was significantly higher than that without SU (8.2%, P <0.005) ). Conclusions: ACVD complicated with SU is a sign of serious illness; acute stroke in the comprehensive treatment, based on the early diagnosis and treatment of traditional Chinese medicine syndrome can prevent the occurrence of SU, reduce mortality and improve the cure rate