Table 1.

Traditional Chinese Medicine Syndrome Differentiation Diagnostic Criteria for Apoplexy Scale

TCM syndrome	Item	Acute ischemic stroke–related symptoms and signs	Score
Wind syndrome	Onset	Peaked 48 hours	2
		Peaked 24 hours	4
		Highly varied conditions	6
		Onset reached peak	8
	Limbs	Clenched hands or clenched jaw	3
		Jerking limbs	5
		Hypertonicity of the limbs or stiffness of the neck and nape	7
	Tongue body	Trembling tongue	5
		Deviation and trembling of the tongue	7
	Eyeball	Eyeball moving about or squinting without blinking	3
		Normal	0
	String-like pulse	Yes	3
		No	0
	Dizziness and headache	Dizziness or headache with a pulling sensation	1
		Dizzy head and vision	2
Fire-heat syndrome	Tongue body	Red tongue	5
		Crimson tongue	6
	Tongue fur	Thin yellow fur	2
		Thick yellow fur	3
		Dry fur	4
		Gray-black and dry fur	5
	Stool	Dry feces that were difficult to evacuate	2
		Dry feces that were difficult to evacuate for 3 days	3
		Dry feces that were difficult to evacuate for more than 5 days	4
	Spirit-affect	Vexation and irascibility	2
		Agitation and restlessness	3
		Loss of consciousness and delirious speech	4
	Features of face and eyes/breath/odor	Strident voice and rough breathing or red dry lips	2
		Red face and eyes or hasty breathing and fetid mouth odor	3
	Fever	Yes	3
		No	0
	Pulse condition	Rapid large forceful pulse or string-like rapid pulse or slippery rapid pulse	2
	Mouth sensation	Bitter taste in mouth and dry pharynx	1
		Thirst with affinity for cold things	2
	Scant red urine	Yes	1
		No	0
Phlegm syndrome	Phlegm	Sticky drooling at the mouth	2
		Coughing of phlegm or vomiting of phlegm-drool	4
		Copious sticky phlegm	6
		Snoring with phlegm rale	8
	Tongue fur	Slimy or slippery tongue fur	6
		Thick slimy fur	8
	Tongue body	Enlarged tongue	4
		Enlarged tongue with teeth markings	6
	Spirit-affect	Indifferent expression or taciturn	2
		Dullness of spirit-affect or torpor response or somnolence	3
	Pulse condition	Slippery pulse or soggy pulse	3
	Lethargy	Yes	1
		No	0
	Fat and swollen body	Yes	1
		No	0
Blood stasis syndrome	Tongue body	Stagnated, varicose, and bruising sublingual collateral vessels	4
		Dark purple tongue	5
		Stasis speckle	6
		Stasis macule	8
		Purple tongue	9
	Headache	Pain of fixed location	5
		Pain like the stabbing of a needle or pain like the burst	7
	Limbs	Limb pain in a fixed location	5
		Purple nails	6
	Facial complexion	Dark lower eyelid	2
		Dark purple lips	3
		Dark purple lips and somber facial complexion	5
	Pulse condition	Sunken string-like fine pulse	1
		sunken string-like slow pulse	2
		Rough pulse or bound and intermittent pulse	3
Qi deficiency syndrome	Tongue body	Pale tongue	3
		Enlarged tongue	4
		Enlarged with teeth-marked tongue or limp tongue	5
	Bearing of the body and voice	Lassitude of spirit and lack of strength or shortage of qi and lazy words	1
		Timid low voice or forceless coughing sound	2
		Fatigue and somnolence	3
		Weak snoring	4
	Sweating	Sweating easily brought on by exertion	2
		Resting sweating	3
		Incessant cold sweating	4
	Stool and urine	Sloppy stool or stool that is first hard and then sloppy	1
		Involuntary loss of urine	2
		Urinary and fecal incontinence	4
	Limbs	Swelling of the limbs	2
		Paralysis and flaccidity of the limbs	3
		Limp hands and cold limbs	4
	Palpitations	Exertional palpitations	1
		Palpitations while performing minor activities	2
		Resting palpitations	3
	Facial complexion	Pale complexion	1
		Pale and vacuous puffy complexion	3
	Pulse condition	Sunken fine pulse or slow moderate pulse or vacuous pulse	1
		Bound and intermittent pulse	2
		Faint pulse	3
Yin deficiency with yang -hyperactivity syndrome	Tongue body	Thin tongue	3
		Thin and red tongue	4
		Thin and dry red tongue	7
		Thin and dry red cracked tongue	9
	Tongue fur	Scant fur or peeling fur	5
		Smooth bare red without fur tongue	7
	Spirit-affect	Vexation and irascibility	1
		Vexation and sleeplessness	2
		Agitated and restless	3
	Heat signs	Postmeridian reddening of the cheeks or facial baking heat or heat in the palms and soles	2
	Dizzy head and vision	Yes	2
		No	0
	Night sweating	Yes	2
		No	0
	Tinnitus	Yes	2
		No	0
	Dry	Dry throat and mouth or dry eyes or dry stool and scant urine	2
	Pulse condition	Fine string-like pulse or fine rapid pulse	1

Each syndrome is established when the score is >7 (the sum of the highest scores of the respective diagnostic items).