中风病虚实证候演变及脑电特征与预后的关系研究
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摘要
目的：
研究中风病虚实证候演变及脑电特征与预后的关系,探讨中风病不同证候特征对疾病的影响及在预后判断中的作用,提高对中风病证候的认识,提高辨证施治的准确性。方法：
本研究分为两部分,第一部分以气虚证、痰热证作为中风病虚实证候的代表,探讨中风病虚实证候演变与预后的关系。第二部分以脑对称指数(Revised Brain Symmetry Index, r-BSI)作为脑电特征的代表性指标,研究其在中风病预后判断中的作用,并初步探索中风病虚实证候与r-BSI的关系。
第一部分：中风病虚实证候演变与预后的关系研究
第一章：从数据库中提取706例发病3天内、发病第7、14、28、90天均进行了《缺血性中风证候要素诊断量表》、美国国立卫生研究院卒中量表(National Institute of Health stroke scale, NIHSS)及日常生活活动能力量表(Barthel Index, BI)评分的中风患者临床信息。依据发病72h内是否存在气虚证将中风患者分为气虚证组(330例)和非气虚证组(376例),应用不等距重复测量方差分析比较两组间不同时点NIHSS评分；同时,从数据库中提取发病72小时内判断为痰热证的中风患者294例,依据疾病过程中痰热证是否持续存在将患者分为痰热证持续存在组和痰热证消失组,应用不等距重复测量方差分析比较两组间不同时点NIHSS评分；以发病第90天BI为因变量,BI≥95者427例(60%),为预后良好,BI<95分者279例(40%),为预后不良,以中风病入院时NIHSS评分、各时点证候要素为自变量,应用Logistic回归分析研究中风病不同时点各证候要素与远期预后的关系。
第二章：从数据库中提取234例缺血性中风患者,以各时点证候要素、入院时NIHSS评分、既往病史、发病年龄及性别为自变量,发病第21天BI为因变量,进一步探讨中风病虚实证候在近期预后判断中的作用。
第二部分：中风病急性期脑电特征指标脑对称指数与预后的关系研究
对29例发病72小时内入院的缺血性中风患者进行《缺血性中风证候要素诊断量表》、NIHSS、BI、改良Rankin量表(mRS)的多时点动态评价,同时在发病72小时内进行脑电监测。参考国外研究中关于r-BSI的计算方法,获得脑电特征指标r-BSI,应用方差分析比较正常人与中风患者、中风患者不同脑电分级间的r-BSI大小；并以中风病患者发病第21、90天的临床结局为因变量(BI>60或BI≤60; mRS<3或mRS≥3),各时点证候要素、入院时NIHSS评分和格拉斯哥昏迷评分(glasgow coma scale, GCS)为自变量,应用线性回归及决策树等方法探讨中风病急性期脑电特征指标与预后的关系；计算成对脑对称指数pairwise derived Brain Symmetry Index(pdBSI),应用折线变化图观察同一患者不同导联及不同患者同一导联的pdBSI变化趋势,观察其在病情判断、病灶定位中的应用；基于以上研究,进一步探索中风病虚实证候与脑电特征指标r-BSI的相关性。
结果：
第一部分：
第一章：重复测量方差分析结果显示,发病72h内存在气虚证的中风患者其NIHSS评分各时点均高于非气虚证者(P<0.01),气虚证组与非气虚证组内各时点问NIHSS评分均有差异(P<0.01和P<0.05),表现为随着时间的后延,NIHSS评分逐渐降低；痰热证与神经功能缺损程度及预后存在一定的相关性,与痰热证消失的中风患者相比,痰热证持续存在者神经功能缺损程度较重(P=0.000<0.01),随时间的延后,NIHSS评分逐渐降低,各时点均有差异(P=0.000<0.01)；进一步筛选与中风病预后相关的证候要素,发现中风病发病第7、14天气虚证的存在是预测发病90天预后不良的独立危险因素,发病第7、14天B值分别为：-0.524和-0.493,即中风病急性期存在气虚证的患者,发病90天BI较低,预后较差。
第二章：在充分考虑入院时NIHSS评分、既往病史及年龄等预后影响因素的情况下,发病第7、10天内风证、发病第10天气虚证与发病第21天BI密切相关,相关系数分别为-0.905、-1.425和-0.895,即中风病急性期发病第7天存在内风证、第10天存在内风证、气虚证的患者,其近期预后较差。
第二部分：
与健康人(0.060)比较,中风患者r-BSI值较高(0.107),二者具有明显统计学差异(P=0.000<0.001)；r-BSI大小与基于临床医师判断的脑电图分级相一致,判断为重度异常脑电图的患者其r-BSI值(0.1084)较轻度异常者(0.1035)高,具有统计学差异(P=0.011)；比较不同临床结局中风患者r-BSI,r-BSI越高,预后越差；应用线性回归方程进一步探讨r-BSI与预后的关系,发现发病72小时内r-BSI、NIHSS与入院第21天BI.mRS及第90天mRS密切相关,是预测其预后的独立危险因素,决策树分析显示发病72小时内r-BSI>0.111,6分 结论：
1.准确把握证候的动态时空性,益于研究疾病传变、转化与转归的规律提示诊治思维过程中要树立恒动观念。
2.中风病虚实证候演变与预后关系密切。中风病急性期存在气虚证的患者神经功能缺损程度较重,气虚证的存在与预后不良关系密切,中风病急性期应积极采取扶助正气治疗。中风病过程中痰热证的变化与预后关系密切,痰热证持续存在,则神经功能缺损程度较重。提示中风病的治疗应注重早期扶助正气,同时积极清热化痰,正确处理正虚邪实的关系,祛邪而不伤正,调整机体达到阴平阳密的状态。
3.脑电特征指标r-BSI对中风病预后判断具有一定作用,可协助临床医生更加准确的判断患者预后,提高临床疗效,中风病急性期r-BSI越高,预后越差。pdBSI在中风病病灶定位中具有一定参考意义,病灶部位对应导联此值较高,随着脑电频率的增加,pdBSI敏感性逐渐降低。
4.中风病急性期气虚证与脑电r-BSI之间有一定相关性,存在气虚证的患者r-BSI较高,为气虚证在中风病预后判断中的作用提供了一定的客观指标支持。
创新点：
1.重复测量方差分析方法的应用前提即对同一研究对象的某个测量指标在不同时点的多次重复测量结果,且不同时点数据间存在一定的自相关性。本研究将重复测量方差分析方法应用于中风病证候研究中,探讨了中风病证候对疾病的影响,该方法既能充分考虑某一证候在不同时点的自相关性,又能体现中风病证候多时点的动态变化特征。
2.本研究根据中风病虚实证候的证候特征不同,从中风病急性期气虚证的有无及中风病过程中痰热证消失与否对疾病的预后影响方面进行了探讨,对中风病证候特征有了更深入的认识,对临床实践具有一定的指导意义。
3.将脑电特征指标r-BSI作为评价大脑内在功能状态的客观指标,探讨了r-BSI在中风病预后判断中的作用,并比较了气虚证与非气虚证r-BSI值大小,初步探索了中风病证候与脑电特征之间的关系。
Objective:
Explore the correlations among stroke syndrome, electroencephalogram (EEG) and prognosis of stroke patients, and study on the effect of syndrome and EEG on stroke patients'prognosis. Enhance the cognition of stroke syndrome and improve the accuracy of therapy due to syndrome differentiation.
Method:
The research was divided into two parts, the first part is about the correlation between deficiency-excess syndrome evolution and prognosis in stroke patients, selecting the qi deficiency syndrome (QDS) and phlegm-heat syndrome as representation. The second part is about the effect of EEG on stroke prognosis, selecting the (Revised Brain Symmetry Index, r-BSI) as representation, and preliminarily exploring the correlation between deficiency-excess syndrome and r-BSI.
Part1:Study on the correlation between deficiency-excess syndrome evolution and prognosis of stroke.
Chapter1:Recruited were706stroke patients with complete clinical information including diagnostic scale scoring of elements such as wind, fire, phlegm, blood stasis, qi deficiency, and yin deficiency, scoring of The National Institutes of Health Stroke Scale (NIHSS) within72h from attack, on the7th,14th,28th, and90th day after attack, and Barthel index (BI) scoring on the90th day. They were assigned to the qi deficiency syndrome (QDS) group (330cases) and the non-QDS group (376cases). The NIHSS scores at different time points were compared between the two groups using analysis of variance of repeated measure data. Then294phlegm-heat syndrome were extracted from data base, Then the effect of phlegm-heat syndrome on neurological deficit degree of stroke were explored with application of Repeated Measures analysis of variance. On the90th day of attack,427patients with BI≥95(accounting for60%) had favorable prognosis, while279with BI＜95(accounting for40%) had unfavorable prognosis. The correlation between each syndrome element and the long-term prognosis of stroke patients was studied by using Logistic regression analysis.
Chapter2:234ischemic stroke patients were extracted from database, each syndrome element, NIHSS at admission, medical history, age and gender as the dependent variable, and BI as the independent variable, effect of deficiency-excess syndrome on short-term prognosis were also explored.
Part2:Study on the correlation between EEG feature-r-BSI and prognosis of stroke patients.
Twenty-nine patients presenting with acute ischemic stroke (AIS) and persistent neurological deficits at EEG recording were incrementally included. Two a posteriori groups were arbitrarily created based on patient outcomes and evaluated with the modified Rankin Scale (mRS) and BI on21or90days (BI>60or BI≤60and mRS<3or mRS≥3). Student's T-tests were used to compare the differences of the r-BSI between normal subjects and stroke patients, differences between patients with different EEG scale and patients with different outcomes. In addition, we explored the correlation of EEG and prognosis of stoke patients with application of liner regression and Decision Tree. Based on the above research, we further explored the correlation between syndrome and EEG.
Results:
Part1:Chapter1:The results of Repeated measures analysis of variance showed that, Higher NIHSS score was found in patients of QDS than those of non-QDS at each time point (P<0.01). Statistical difference existed in NIHSS score between the two groups at each time point (P<0.01, P<0.05). Stroke patients with phlegm-heat syndrome have higher NIHSS score than patients without the syndrome (P=0.000<0.01), and there appears a decreased NIHSS score with time points delay(P=0.000<0.01). QDS on the7th and14th day were independed risk factor of90th-day BI, and were negatively correlated with the B value being-0.524and-0.493respectively, QDS in acute ischemic stroke means a lower90th-day BI, and an unfavorable prognosis.
Chapter2:The results of Logistic regression showed that, the wind on the7th day, the wind and QDS on the10th day were independed risk factor of21th-day BI, and were negatively correlated with the B value being-0.905、-1.425and-0.895respectively, The wind and QDS in acute ischemic stroke means an unfavorable prognosis.
Part2:Compared with healthy controls(0.060), the r-BSI of stroke patients is0.0107, there is a significant statistical difference(P=0.000<0.01).The size of r-BSI is consistent with EEG classification, higher EEG classification with higher r-BSI. Student's T-tests and liner regression implied that r-BSI at admission was correlated with mRS and BI at both21d and90d. There is also difference in r-BSI between patients with QDS and patients with non-QDS (P=0.04).
Conclusion:
1. Accurately grasping the characteristics of symptoms dynamic time and space is benifit to study the change, transformation and outcome of disease. There should be constant dynamic consept should be established in diagnosis and treatment of disease.
2. There are close relationship between syndrome change and prognosis. Stroke patients of QDS had more severe neurological impairment degree than those of non-QDS, QDS of acute-stage was closely correlated with unfavorable prognosis, early actively invigorating healthy qi is essesial in acute-stage. Phlegm-heat syndrome in patients who have suffered stroke has an effect on the degree of neurological deficiency, disappearance of phlegm-heat syndrome may improve the degree of neurological deficit observed in stroke patients. Early invigorating healthy qi and removing the phlegm-heat, and correctly handling the correlation between deficiency-excess, to ajust the body into a normal state.
3. It is significant of EEG feature for predicting the prognosis of stroke patients. A higher r-BSI predicts a poorer short-term prognosis for stroke patients. Acute EEG monitoring may be of prognostic value for patients'outcomes.
4. There are some correlation between syndrome and EEG. There is also difference in r-BSI between patients with QDS and patients with non-QDS (P=0.04).The research provided some data support for the importance of QDS in prognosis predicting of stroke patients.
Highlight of innovation:
1. This study brought new ideas for the use of repeated measures analysis of variance,. It is the repeated measurements at different points of a measure of the same object. There is self-correlation between the point data. We applied the method in syndrome study of stroke patients.
2. According to the characteristics of Stroke Symptom, we explored the correlation of syndrome and prognosis. Higher NIHSS score was found in patients of QDS than those of non-QDS at each time point. Stroke patients with phlegm-heat syndrome have higher NIHSS score than patients without the syndrome.
3. We used the EEG feature to predict the prognosis of stroke patients and explored the correlation between syndrome and EEG.
研究中风病虚实证候演变及脑电特征与预后的关系,探讨中风病不同证候特征对疾病的影响及在预后判断中的作用,提高对中风病证候的认识,提高辨证施治的准确性。方法：
本研究分为两部分,第一部分以气虚证、痰热证作为中风病虚实证候的代表,探讨中风病虚实证候演变与预后的关系。第二部分以脑对称指数(Revised Brain Symmetry Index, r-BSI)作为脑电特征的代表性指标,研究其在中风病预后判断中的作用,并初步探索中风病虚实证候与r-BSI的关系。
第一部分：中风病虚实证候演变与预后的关系研究
第一章：从数据库中提取706例发病3天内、发病第7、14、28、90天均进行了《缺血性中风证候要素诊断量表》、美国国立卫生研究院卒中量表(National Institute of Health stroke scale, NIHSS)及日常生活活动能力量表(Barthel Index, BI)评分的中风患者临床信息。依据发病72h内是否存在气虚证将中风患者分为气虚证组(330例)和非气虚证组(376例),应用不等距重复测量方差分析比较两组间不同时点NIHSS评分；同时,从数据库中提取发病72小时内判断为痰热证的中风患者294例,依据疾病过程中痰热证是否持续存在将患者分为痰热证持续存在组和痰热证消失组,应用不等距重复测量方差分析比较两组间不同时点NIHSS评分；以发病第90天BI为因变量,BI≥95者427例(60%),为预后良好,BI<95分者279例(40%),为预后不良,以中风病入院时NIHSS评分、各时点证候要素为自变量,应用Logistic回归分析研究中风病不同时点各证候要素与远期预后的关系。
第二章：从数据库中提取234例缺血性中风患者,以各时点证候要素、入院时NIHSS评分、既往病史、发病年龄及性别为自变量,发病第21天BI为因变量,进一步探讨中风病虚实证候在近期预后判断中的作用。
第二部分：中风病急性期脑电特征指标脑对称指数与预后的关系研究
对29例发病72小时内入院的缺血性中风患者进行《缺血性中风证候要素诊断量表》、NIHSS、BI、改良Rankin量表(mRS)的多时点动态评价,同时在发病72小时内进行脑电监测。参考国外研究中关于r-BSI的计算方法,获得脑电特征指标r-BSI,应用方差分析比较正常人与中风患者、中风患者不同脑电分级间的r-BSI大小；并以中风病患者发病第21、90天的临床结局为因变量(BI>60或BI≤60; mRS<3或mRS≥3),各时点证候要素、入院时NIHSS评分和格拉斯哥昏迷评分(glasgow coma scale, GCS)为自变量,应用线性回归及决策树等方法探讨中风病急性期脑电特征指标与预后的关系；计算成对脑对称指数pairwise derived Brain Symmetry Index(pdBSI),应用折线变化图观察同一患者不同导联及不同患者同一导联的pdBSI变化趋势,观察其在病情判断、病灶定位中的应用；基于以上研究,进一步探索中风病虚实证候与脑电特征指标r-BSI的相关性。
结果：
第一部分：
第一章：重复测量方差分析结果显示,发病72h内存在气虚证的中风患者其NIHSS评分各时点均高于非气虚证者(P<0.01),气虚证组与非气虚证组内各时点问NIHSS评分均有差异(P<0.01和P<0.05),表现为随着时间的后延,NIHSS评分逐渐降低；痰热证与神经功能缺损程度及预后存在一定的相关性,与痰热证消失的中风患者相比,痰热证持续存在者神经功能缺损程度较重(P=0.000<0.01),随时间的延后,NIHSS评分逐渐降低,各时点均有差异(P=0.000<0.01)；进一步筛选与中风病预后相关的证候要素,发现中风病发病第7、14天气虚证的存在是预测发病90天预后不良的独立危险因素,发病第7、14天B值分别为：-0.524和-0.493,即中风病急性期存在气虚证的患者,发病90天BI较低,预后较差。
第二章：在充分考虑入院时NIHSS评分、既往病史及年龄等预后影响因素的情况下,发病第7、10天内风证、发病第10天气虚证与发病第21天BI密切相关,相关系数分别为-0.905、-1.425和-0.895,即中风病急性期发病第7天存在内风证、第10天存在内风证、气虚证的患者,其近期预后较差。
第二部分：
与健康人(0.060)比较,中风患者r-BSI值较高(0.107),二者具有明显统计学差异(P=0.000<0.001)；r-BSI大小与基于临床医师判断的脑电图分级相一致,判断为重度异常脑电图的患者其r-BSI值(0.1084)较轻度异常者(0.1035)高,具有统计学差异(P=0.011)；比较不同临床结局中风患者r-BSI,r-BSI越高,预后越差；应用线性回归方程进一步探讨r-BSI与预后的关系,发现发病72小时内r-BSI、NIHSS与入院第21天BI.mRS及第90天mRS密切相关,是预测其预后的独立危险因素,决策树分析显示发病72小时内r-BSI>0.111,6分
1.准确把握证候的动态时空性,益于研究疾病传变、转化与转归的规律提示诊治思维过程中要树立恒动观念。
2.中风病虚实证候演变与预后关系密切。中风病急性期存在气虚证的患者神经功能缺损程度较重,气虚证的存在与预后不良关系密切,中风病急性期应积极采取扶助正气治疗。中风病过程中痰热证的变化与预后关系密切,痰热证持续存在,则神经功能缺损程度较重。提示中风病的治疗应注重早期扶助正气,同时积极清热化痰,正确处理正虚邪实的关系,祛邪而不伤正,调整机体达到阴平阳密的状态。
3.脑电特征指标r-BSI对中风病预后判断具有一定作用,可协助临床医生更加准确的判断患者预后,提高临床疗效,中风病急性期r-BSI越高,预后越差。pdBSI在中风病病灶定位中具有一定参考意义,病灶部位对应导联此值较高,随着脑电频率的增加,pdBSI敏感性逐渐降低。
4.中风病急性期气虚证与脑电r-BSI之间有一定相关性,存在气虚证的患者r-BSI较高,为气虚证在中风病预后判断中的作用提供了一定的客观指标支持。
创新点：
1.重复测量方差分析方法的应用前提即对同一研究对象的某个测量指标在不同时点的多次重复测量结果,且不同时点数据间存在一定的自相关性。本研究将重复测量方差分析方法应用于中风病证候研究中,探讨了中风病证候对疾病的影响,该方法既能充分考虑某一证候在不同时点的自相关性,又能体现中风病证候多时点的动态变化特征。
2.本研究根据中风病虚实证候的证候特征不同,从中风病急性期气虚证的有无及中风病过程中痰热证消失与否对疾病的预后影响方面进行了探讨,对中风病证候特征有了更深入的认识,对临床实践具有一定的指导意义。
3.将脑电特征指标r-BSI作为评价大脑内在功能状态的客观指标,探讨了r-BSI在中风病预后判断中的作用,并比较了气虚证与非气虚证r-BSI值大小,初步探索了中风病证候与脑电特征之间的关系。
Objective:
Explore the correlations among stroke syndrome, electroencephalogram (EEG) and prognosis of stroke patients, and study on the effect of syndrome and EEG on stroke patients'prognosis. Enhance the cognition of stroke syndrome and improve the accuracy of therapy due to syndrome differentiation.
Method:
The research was divided into two parts, the first part is about the correlation between deficiency-excess syndrome evolution and prognosis in stroke patients, selecting the qi deficiency syndrome (QDS) and phlegm-heat syndrome as representation. The second part is about the effect of EEG on stroke prognosis, selecting the (Revised Brain Symmetry Index, r-BSI) as representation, and preliminarily exploring the correlation between deficiency-excess syndrome and r-BSI.
Part1:Study on the correlation between deficiency-excess syndrome evolution and prognosis of stroke.
Chapter1:Recruited were706stroke patients with complete clinical information including diagnostic scale scoring of elements such as wind, fire, phlegm, blood stasis, qi deficiency, and yin deficiency, scoring of The National Institutes of Health Stroke Scale (NIHSS) within72h from attack, on the7th,14th,28th, and90th day after attack, and Barthel index (BI) scoring on the90th day. They were assigned to the qi deficiency syndrome (QDS) group (330cases) and the non-QDS group (376cases). The NIHSS scores at different time points were compared between the two groups using analysis of variance of repeated measure data. Then294phlegm-heat syndrome were extracted from data base, Then the effect of phlegm-heat syndrome on neurological deficit degree of stroke were explored with application of Repeated Measures analysis of variance. On the90th day of attack,427patients with BI≥95(accounting for60%) had favorable prognosis, while279with BI＜95(accounting for40%) had unfavorable prognosis. The correlation between each syndrome element and the long-term prognosis of stroke patients was studied by using Logistic regression analysis.
Chapter2:234ischemic stroke patients were extracted from database, each syndrome element, NIHSS at admission, medical history, age and gender as the dependent variable, and BI as the independent variable, effect of deficiency-excess syndrome on short-term prognosis were also explored.
Part2:Study on the correlation between EEG feature-r-BSI and prognosis of stroke patients.
Twenty-nine patients presenting with acute ischemic stroke (AIS) and persistent neurological deficits at EEG recording were incrementally included. Two a posteriori groups were arbitrarily created based on patient outcomes and evaluated with the modified Rankin Scale (mRS) and BI on21or90days (BI>60or BI≤60and mRS<3or mRS≥3). Student's T-tests were used to compare the differences of the r-BSI between normal subjects and stroke patients, differences between patients with different EEG scale and patients with different outcomes. In addition, we explored the correlation of EEG and prognosis of stoke patients with application of liner regression and Decision Tree. Based on the above research, we further explored the correlation between syndrome and EEG.
Results:
Part1:Chapter1:The results of Repeated measures analysis of variance showed that, Higher NIHSS score was found in patients of QDS than those of non-QDS at each time point (P<0.01). Statistical difference existed in NIHSS score between the two groups at each time point (P<0.01, P<0.05). Stroke patients with phlegm-heat syndrome have higher NIHSS score than patients without the syndrome (P=0.000<0.01), and there appears a decreased NIHSS score with time points delay(P=0.000<0.01). QDS on the7th and14th day were independed risk factor of90th-day BI, and were negatively correlated with the B value being-0.524and-0.493respectively, QDS in acute ischemic stroke means a lower90th-day BI, and an unfavorable prognosis.
Chapter2:The results of Logistic regression showed that, the wind on the7th day, the wind and QDS on the10th day were independed risk factor of21th-day BI, and were negatively correlated with the B value being-0.905、-1.425and-0.895respectively, The wind and QDS in acute ischemic stroke means an unfavorable prognosis.
Part2:Compared with healthy controls(0.060), the r-BSI of stroke patients is0.0107, there is a significant statistical difference(P=0.000<0.01).The size of r-BSI is consistent with EEG classification, higher EEG classification with higher r-BSI. Student's T-tests and liner regression implied that r-BSI at admission was correlated with mRS and BI at both21d and90d. There is also difference in r-BSI between patients with QDS and patients with non-QDS (P=0.04).
Conclusion:
1. Accurately grasping the characteristics of symptoms dynamic time and space is benifit to study the change, transformation and outcome of disease. There should be constant dynamic consept should be established in diagnosis and treatment of disease.
2. There are close relationship between syndrome change and prognosis. Stroke patients of QDS had more severe neurological impairment degree than those of non-QDS, QDS of acute-stage was closely correlated with unfavorable prognosis, early actively invigorating healthy qi is essesial in acute-stage. Phlegm-heat syndrome in patients who have suffered stroke has an effect on the degree of neurological deficiency, disappearance of phlegm-heat syndrome may improve the degree of neurological deficit observed in stroke patients. Early invigorating healthy qi and removing the phlegm-heat, and correctly handling the correlation between deficiency-excess, to ajust the body into a normal state.
3. It is significant of EEG feature for predicting the prognosis of stroke patients. A higher r-BSI predicts a poorer short-term prognosis for stroke patients. Acute EEG monitoring may be of prognostic value for patients'outcomes.
4. There are some correlation between syndrome and EEG. There is also difference in r-BSI between patients with QDS and patients with non-QDS (P=0.04).The research provided some data support for the importance of QDS in prognosis predicting of stroke patients.
Highlight of innovation:
1. This study brought new ideas for the use of repeated measures analysis of variance,. It is the repeated measurements at different points of a measure of the same object. There is self-correlation between the point data. We applied the method in syndrome study of stroke patients.
2. According to the characteristics of Stroke Symptom, we explored the correlation of syndrome and prognosis. Higher NIHSS score was found in patients of QDS than those of non-QDS at each time point. Stroke patients with phlegm-heat syndrome have higher NIHSS score than patients without the syndrome.
3. We used the EEG feature to predict the prognosis of stroke patients and explored the correlation between syndrome and EEG.
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