缺血性中风中医证候与颈动脉彩超的相关性研究
|
摘要
目的:探讨颈动脉彩超所示颈动脉粥样硬化病变情况与缺血性中风中医证型的相关性。方法:入选缺血性中风病例308例,采集患者双侧颈动脉的超声检查结果,具体指标为内膜-中层膜厚度、颈动脉狭窄程度、颈动脉斑块积分以及颈动脉斑块分型;按照中医辨证的统一标准进行辨证,建立相应的数据库,分析中医证候与颈动脉超声检查之间的相关性。结果:患者颈动脉平均内-中膜厚度与中医证型的差异无统计学意义;颈动脉狭窄程度:阴虚风动证风火上扰证患者颈动脉狭窄程度为在1级者较多;风痰阻络证、气虚血瘀证患者颈动脉狭窄程度为在2级者较多;痰热腑实证患者颈动脉狭窄程度为在4级者较多,差异具有统计学意义。Crouse积分分析显示:风痰阻络证斑块积分>痰热腑实证>气虚血瘀证>阴虚风动证>风火上扰证,P <0.001,差异具有统计学意义;颈动脉斑块分型统计分析显示不同中医证型患者斑块性质差异无统计学意义。结论:缺血性中风病患者颈动脉狭窄程度与中医证型存在一定的相关性,风痰阻络、气虚血瘀证常见颈动脉狭窄2级;风火上扰证、阴虚风动证常见颈动脉狭窄程度为1级;痰热腑实证较多出现颈动脉狭窄程度4级。颈动脉斑块积分与中医证型存在一定的相关性,风痰阻络证斑块积分最重,其次为痰热腑实证、气虚血瘀证,阴虚风动证,斑块积分程度最轻的证型为风火上扰。
Objective: To investigate the correlation between carotid atherosclerotic lesions and TCM syndromes of ischemic stroke.Methods: 308 cases of ischemic stroke were selected, the ultrasound examination results of patients with bilateral carotid were collected,specific indicators included lining-middle membrane thickness, the degree of carotid stenosis, carotid artery plaque and carotid plaques points; According to the unified standard of TCM syndrome differentiation, a corresponding database was established to analyze the correlation between TCM syndromes and carotid ultrasound examination. Results: There was no statistically significant difference between the mean endometrial thickness and TCM syndromes. The degree of carotid stenosis: the degree of carotid stenosis was higher than that of grade 1 in patients with wind-fire syndrome of Yin deficiency; Patients with wind-phlegm syndrome and qi deficiency and blood stasis syndrome had more carotid stenosis than those with grade 2. The degree of carotid artery stenosis was higher than that of the 4 th grade, and the difference was statistically significant. According to Crouse integral analysis, sputum obstruction syndrome plaque score>phlegm and zang-fu positive score > deficiency of qi and blood stasis syndrome score > deficiency of Yin deficiency of wind-fire disturbance syndrome score, P<0.001, the difference was statistically significant. Statistical analysis of carotid artery plaque classification showed that there was no significant difference in plaque properties among patients with different TCM syndromes. Conclusion: The degree of carotid artery stenosis in ischemic stroke patients was correlated with the syndrome types of traditional Chinese medicine. The common carotid artery stenosis was grade 1 in wind-fire disturbance syndrome and Yin deficiency syndrome. Phlegm and zang-fu was mostly manifested in grade4 carotid stenosis. There was some correlation between TCM syndrome type and carotid artery plaque integral, among which wind phlegm obstruction collaterals card plaque integral was the most significant, and it was followed by relieving phlegm heat empirical qi deficiency,blood stasis, Yin pneumatic, plaque integral level model for the wind fire of the justification was of the lightest.
Objective: To investigate the correlation between carotid atherosclerotic lesions and TCM syndromes of ischemic stroke.Methods: 308 cases of ischemic stroke were selected, the ultrasound examination results of patients with bilateral carotid were collected,specific indicators included lining-middle membrane thickness, the degree of carotid stenosis, carotid artery plaque and carotid plaques points; According to the unified standard of TCM syndrome differentiation, a corresponding database was established to analyze the correlation between TCM syndromes and carotid ultrasound examination. Results: There was no statistically significant difference between the mean endometrial thickness and TCM syndromes. The degree of carotid stenosis: the degree of carotid stenosis was higher than that of grade 1 in patients with wind-fire syndrome of Yin deficiency; Patients with wind-phlegm syndrome and qi deficiency and blood stasis syndrome had more carotid stenosis than those with grade 2. The degree of carotid artery stenosis was higher than that of the 4 th grade, and the difference was statistically significant. According to Crouse integral analysis, sputum obstruction syndrome plaque score>phlegm and zang-fu positive score > deficiency of qi and blood stasis syndrome score > deficiency of Yin deficiency of wind-fire disturbance syndrome score, P<0.001, the difference was statistically significant. Statistical analysis of carotid artery plaque classification showed that there was no significant difference in plaque properties among patients with different TCM syndromes. Conclusion: The degree of carotid artery stenosis in ischemic stroke patients was correlated with the syndrome types of traditional Chinese medicine. The common carotid artery stenosis was grade 1 in wind-fire disturbance syndrome and Yin deficiency syndrome. Phlegm and zang-fu was mostly manifested in grade4 carotid stenosis. There was some correlation between TCM syndrome type and carotid artery plaque integral, among which wind phlegm obstruction collaterals card plaque integral was the most significant, and it was followed by relieving phlegm heat empirical qi deficiency,blood stasis, Yin pneumatic, plaque integral level model for the wind fire of the justification was of the lightest.
引文
[1]董玉秀,刘春杰.脑梗死患者颈动脉粥样硬化的超声诊断及价值[J].中国超声诊断杂志,2005(03):208-210.
[2]刘月英.颈动脉粥样硬化及高敏C反应蛋白与急性脑梗塞的关系[D].沈阳:中国医科大学,2009.
[3]胡庆鹰,崔炜,吴格日勒,等.彩色多普勒超声检查颈动脉内膜-中层厚度的研究进展[J].中国当代医药,2009(15):40-42.
[4]杜文婷,杜文娇,徐辉,等.颈动脉粥样硬化患者不同中医证型间颈动脉超声的比较[J].中华中医药学刊,2015(03):694-696.
[5]《中医病证诊断疗效标准》选登(1)[J].中级医刊,1995(04):56-57.
[6]高颖,马斌,刘强,等.缺血性中风证候要素诊断量表编制及方法学探讨[J].中医杂志,2011(24):2097-2101.
[7]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7):559.
[8]Elatrozy TS,Nicolaides AN,Tegos TJ,et al.The objective characterization of ulteasonic carotid plaque features[J].Eur J Vase Endovasc Surg, 1998,16(3):223-230.
[9]JR Crouse,GH Harpold, FR Kahl.et al.Evaluation of a scoring system for extracranial carotid atherosclerasis extent with B-mode ulteasound[J].Strock,1986(17):270-275.
[10]贾晶.颈动脉粥样硬化与冠心病中医证型关系的临床研究[D].武汉:湖北中医学院,2007.
[11]瞿雪芹,刘浩,王晓峰.维吾尔族与汉族早发冠心病患者中医证型与血脂及纤维蛋白原相关性研究[J].中国中西医结合杂志,2012(04):35-39.
[12]宋登海.中风治验探析[J].吉林中医药,2007,27(3):3-5.
[2]刘月英.颈动脉粥样硬化及高敏C反应蛋白与急性脑梗塞的关系[D].沈阳:中国医科大学,2009.
[3]胡庆鹰,崔炜,吴格日勒,等.彩色多普勒超声检查颈动脉内膜-中层厚度的研究进展[J].中国当代医药,2009(15):40-42.
[4]杜文婷,杜文娇,徐辉,等.颈动脉粥样硬化患者不同中医证型间颈动脉超声的比较[J].中华中医药学刊,2015(03):694-696.
[5]《中医病证诊断疗效标准》选登(1)[J].中级医刊,1995(04):56-57.
[6]高颖,马斌,刘强,等.缺血性中风证候要素诊断量表编制及方法学探讨[J].中医杂志,2011(24):2097-2101.
[7]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7):559.
[8]Elatrozy TS,Nicolaides AN,Tegos TJ,et al.The objective characterization of ulteasonic carotid plaque features[J].Eur J Vase Endovasc Surg, 1998,16(3):223-230.
[9]JR Crouse,GH Harpold, FR Kahl.et al.Evaluation of a scoring system for extracranial carotid atherosclerasis extent with B-mode ulteasound[J].Strock,1986(17):270-275.
[10]贾晶.颈动脉粥样硬化与冠心病中医证型关系的临床研究[D].武汉:湖北中医学院,2007.
[11]瞿雪芹,刘浩,王晓峰.维吾尔族与汉族早发冠心病患者中医证型与血脂及纤维蛋白原相关性研究[J].中国中西医结合杂志,2012(04):35-39.
[12]宋登海.中风治验探析[J].吉林中医药,2007,27(3):3-5.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |