서론
2007 1)
10 59.6
급성기 중풍환자의 舌診과 National Institute of Health Stroke Scale과의 상관성 연구 - 다기관 임상연구
이인환, 신애숙, 곽자영, 조승연, 박성욱, 박정미, 고창남, 조기호, 배형섭
경희대학교 한의과대학 심계내과학교실
The Relationship between Tongue Diagnosis and National Institute of Health Stroke Scale in Acute Stroke Patients - Multi Center Trials
In-Whan Lee, Ae-Sook Shin, Ja-Young Gwak, Seung-Yeon Cho, Seong-Uk Park, Jung-Mi Park, Chang-Nam Ko, Ki-Ho Cho, Hyung-Sup Bae
Department of Cardiocascular & Neurologic Disease(Stroke Center), College of Oriental Medicine, Kyung-Hee University
Objectives : We questioned whether the tongue diagnosis is effective for judging seriousness of cerebrovascular accidents. This study is about the relationship between tongue diagnosis and National Institute of Health Stroke Scale(NIHSS) in acute stroke patients.
Methods : 738 subjects were recruited from the patients admitted to the department of internal medicine at Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center from April 2007 to August 2008. We looked at the tongue as in three dimensions of tongue color, tongue fur color and tongue body. And, we calculated NIHSS means according to the subtypes of three dimensions.
Results :
1. In the Tongue color, from the most commom to least common colors were pale red, red, pale, bluish purple, and ect. The NIHSS mean score of red is significantly higher than pale and pale red.
2. In the Tongue fur color, white fur was the most common, and then yellow fur, etc. There is no significant difference among three subtypes in the NIHSS mean score.
3. In the Tongue body, etc. is the most common, followed by teeth-marked tongue, enlarged tongue, blood patchy tongue, and mirror tongue. The NIHSS mean score of teeth-marked tongue is significantly lower than blood patchy tongue and mirror tongue.
Conclusions : The tongue color and the tongue body are useful indexes for judging seriousness of cerebrovascular accidents presented by NIHSS. But in our study, the tongue fur color was not useful. Further study is necessary on the tongue fur.
Key Words : National Institute of Health Stroke Scale(NIHSS), Tongue Diagnosis, Tongue color, Tongue fur color, Tongue body
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결과
1. 일반적 특징
738 65.46±12.29
Mean of Age (Mean±S.D) 65.46±12.29
Sex (N(%)) Male 432(58.54)
Female 306(41.46)
Classification of Diagnosis (N(%))
ICH* 75(10.16)
SAH 6(0.81)
Cerebral Infarction (TOAST classification)
LAA 141(19.11)
CE§ 46(6.23)
SVO 449(60.84)
SOE¶ 4(0.54)
SUE** 2(0.27)
Etc. 3(0.41)
Clinical stroke 12(1.63)
NIHSS (Mean±S.D)++ 3.77±4.01
*ICH : IntraCerebral Hemorrhage, SAH : SubArachnoid Hemorrage, LAA : Large Artery Atherosclerosis, §CE : CardioEmbolism, SVO : Small Vessel Occlusion, ¶SOE : Stroke of other determined etiology, **SUE : Stroke of Undetermined etiology, ++NIHSS : National Institute of Health Stroke Scale
Table 1. General Characteristics (Total N=738)
, 432 , 306 . ICH(IntraCerebral Hemorrhage) 10.16%, SAH(SubArachnoid Hemorrage) 0.81%, Cerebral Infarction 87.4%, Clinical stroke 1.63%
Cerebral Infarction
. TOAST Cerebral Infarction
SVO(Small Vessel Occlusion) 60.84%
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NIHSS 3.77±4.01 (Table 1).
2. 舌質色의 빈도와 舌質色에 따른 NIHSS의 비교
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Tongue color Pale Pale red Red Bluish purple Etc.
Frequency(N(%)) 143(19.38) 343(46.48) 230(31.17) 14(1.90) 8(1.08)
NIHSS(Mean±S.D) 3.14±3.09 3.42±3.69 4.72±4.80 , 3.92±3.73 2.50±2.33
Statistical significance was calculated by One-way ANOVA for continuous variables, and Scheffe's test was used for Post Hoc.
P<0.05 : Significantly different from Pale.
P<0.05 : Significantly different from Pale red.
Table 2. Frequency of Tongue color and Comparison of NIHSS according to Tongue color
Tongue fur color Yellow fur White fur Etc.
P value
Frequency(N(%)) 307(41.60) 319(43.22) 112(15.18)
NIHSS(Mean±S.D) 3.79±3.66 3.97±4.31 3.13±3.97 0.153
Statistical significance was calculated by One-way ANOVA for continuous variables.
Table 3. Frequency of Tongue fur color and Comparison of NIHSS according to Tongue fur color
Tongue body Teeth-marked
tongue Enlarged tongue Blood patchy
tongue Mirror tongue Etc.
Frequency(N(%)) 201(27.24) 152(20.60) 21(2.85) 18(2.44) 346(46.88)
NIHSS(Mean±S.D) 3.00±3.59 , 3.92±3.59 6.19±6.50 6.56±6.64 3.86±3.93
Statistical significance was calculated by One-way ANOVA for continuous variables, and Scheffe's test was used for Post Hoc.
P<0.05 : Significantly different from Blood patchy tongue.
P<0.05 : Significantly different from Mirror tongue.
Table 4. Frequency of Tongue body and Comparison of NIHSS according to Tongue body
고찰 및 결론
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