脑小血管病的MRI影像诊断与中医证型的相关性研究

发布时间：2018-02-26 19:13

本文关键词： 脑小血管病中医证型磁共振腔隙性脑梗脑白质疏松　出处：《成都中医药大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的通过对脑小血管病患者的统计调查,探讨脑小血管病患者的MRI影像诊断与脑小血管病患者的中医证型之间的相关性,为中医辨证论治的微观化增加新的内容。方法纳入2013年10月至2014年1月来我院行头颅核磁共振符合脑小血管病的患者452例,收集患者中医四诊资料,来探讨脑小血管病的MRI表现与中医证型的相关性,使用SPSS17.0.统计软件进行各种统计分析。结果在纳入的452名患者的影像学表现统计方面,腔隙性脑梗死患者452人,脑白质疏松患者167人,脑微出血4人。其中单纯表现为隙性脑梗死的患者为384人,隙性脑梗死合并脑白质疏松164人,隙性脑梗死合并脑微出血1人,三种表现都有的有3人。在中医证型统计方面,肝阳暴亢,风火上扰证84人,占18.58%；痰热腑实,风痰上扰证27人,占5.97%；风痰瘀血,痹阻经络证181人,占40.04%；气虚血瘀证95人,占21.02%；阴虚风动证65人,占14.58%。在影像学表现与中医证型的相关性方面,452名患者均有隙性脑梗死的表现,肝阳暴亢,风火上扰证合并有脑白质疏松的比例要小于其它4个证型。在腔隙性脑梗死的数量上,肝阳暴亢型腔隙性脑梗死的数量相对风痰阻络证、气虚血瘀证、阴虚风动证较少；在隙性脑梗死病灶的位置方面,后循环供血的部位阴虚风动证在脑干的梗死比例要高于痰热腑实证、肝阳暴亢风证、风痰阻络证；在前循环供血的部位,气虚血瘀和阴虚风动证在基底节梗死病灶的比例要高于痰热腑实证、肝阳暴亢风证、风痰阻络证。在性别和年龄方面,痰热腑实证以男性多见；腔隙性脑梗死和脑白质疏松的影像等级与年龄均有有明显的正相关性。结论脑小血管病的MRI影像表现与中医证型存在相关性.①452名患者均有腔隙性脑梗死的表现,但肝阳暴亢,风火上扰证合并有脑白质疏松的比例要小于其它4个证型。②肝阳暴亢型腔隙性脑梗死的数量相对风痰阻络证、气虚血瘀证、阴虚风动证较少。③后循环供血的部位阴虚风动证在脑干的梗死比例要高于痰热腑实证、肝阳暴亢风证、风痰阻络证；在前循环供血的部位,气虚血瘀和阴虚风动证在基底节梗死病灶的比例要高于痰热腑实证、肝阳暴亢风证、风痰阻络证。④年龄与腔隙性脑梗死和脑白质疏松的影像等级均有有明显的正相关性。
[Abstract]:Objective to investigate the correlation between MRI imaging diagnosis and TCM syndromes in patients with small cerebral vascular disease (CBVD), so as to add new contents to the microcosm of TCM syndrome differentiation and treatment. Methods from October 2013 to January 2014, 452 patients with cerebral microangiopathy underwent cranial magnetic resonance imaging in our hospital were included. The data of four diagnoses of Chinese medicine were collected to explore the correlation between the MRI manifestations of cerebral microangiopathy and the type of TCM syndromes. Using SPSS 17.0. statistical software to carry out various statistical analysis. Results 452 patients with lacunar cerebral infarction, 167 patients with leukoaraiosis and 4 patients with cerebral microhemorrhage were included in the study, including 384 patients with lacunar infarction, 452 patients with lacunar cerebral infarction, 167 patients with leukoaraiosis and 4 patients with cerebral microhemorrhage. 164 patients with lacunar cerebral infarction complicated with leukoaraiosis, 1 with lacunar cerebral infarction with cerebral microhemorrhage, 3 with all three manifestations. In the statistics of TCM syndromes, there are 84 patients with hyperactivity of liver-yang, 84 with wind and fire disturbance, and 18.58 with phlegm and heat. There were 27 cases of wind and phlegm disturbance (5.97g); 181 cases of wind phlegm and blood stasis, which obstructed meridian and collaterals, accounting for 40.04%; 95 cases (21.02%) of qi deficiency and blood stasis syndrome; 65 cases (14.58%) of Yin deficiency wind movement syndrome. All the 452 patients showed lacunar cerebral infarction in terms of the correlation between imaging manifestation and TCM syndrome type. In the number of lacunar cerebral infarction, the number of lacunar cerebral infarction was relative to wind phlegm blocking collaterals syndrome, qi deficiency and blood stasis syndrome, in terms of the number of lacunar cerebral infarction. In the location of the focus of the lacunar cerebral infarction, the proportion of the infarct in the brain stem of the blood supply of the posterior circulation is higher than that of the phlegm and heat in the brain stem, the syndrome of hyperactivity of the liver and yang, the syndrome of wind-phlegm blocking the collaterals, and the position of the blood supply in the anterior circulation. The proportion of Qi deficiency and blood stasis syndrome and Yin deficiency wind movement syndrome in basal ganglia infarction focus was higher than that in phlegm heat Fu syndrome, liver yang violent hyperactivity wind syndrome, wind phlegm blocking collaterals syndrome. In terms of gender and age, phlegm heat Fu syndrome was more common in men. The image grade of lacunar infarction and leukoaraiosis was positively correlated with age. Conclusion the MRI imaging findings of small cerebral vascular disease are correlated with TCM syndromes. 1452 patients have lacunar cerebral infarction, but the liver yang is hyperactive. The proportion of brain leukoaraiosis associated with wind and fire disturbance syndrome was smaller than that of other 4 syndrome types .2 the number of lacunar cerebral infarction with hyperactivity of liver yang was relative to wind phlegm blocking collaterals syndrome, Qi deficiency and blood stasis syndrome. The proportion of infarct in brain stem of Yin deficiency wind movement syndrome was higher than that of phlegm and heat in the brain stem, the syndrome of hyperactivity of liver-yang and hyperactivity of wind, wind and phlegm blocking collaterals, and the part of blood supply before circulation, the proportion of infarction in brain stem of Yin deficiency and wind movement syndrome was higher than that of phlegm and heat. The proportion of Qi deficiency and blood stasis syndrome and Yin deficiency wind movement syndrome in basal ganglia infarction focus was higher than that in phlegm heat and Fu organs syndrome. There was a significant positive correlation between the age of 4 years of liver yang violent hyperactivity and wind phlegm blocking collaterals syndrome and the image grade of lacunar cerebral infarction and leukoaraiosis.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3;R445.2

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