缺血性中风急性期头颅CT与中医辨证分型的相关性研究

【作者】 赵旭颖；

【导师】 唐启盛；

【作者基本信息】 北京中医药大学 ， 中医学， 2009， 硕士

【摘要】 影像诊断技术的发展,不但极大地提高了中风病的诊断准确率,而且对治疗方案的确定,临床疗效的判定以及病人预后的评价均有很大价值。头颅CT是脑血管病变的影像学依据,可以直观地显示脑梗死的范围、部位等,帮助临床判断组织缺血后是否可逆、血管状况,以及血液动力学改变。证候是人体对于机体在内外环境变化时所发生的生理病理改变的一种反映状态,头颅CT可客观地表现出中风病的病变性质和严重程度,因此,针对同一中风病人,二者之间一定存在着关联,但它们之间的关系尚不明了。而借助神经影像学手段揭示中医证候特征与脑血管病变的关系,是建立中风病病证结合的临床评价标准的重要基础。本研究在建立临床数据采集规范基础上,选取符合纳入标准的急性期缺血性中风患者150例,采集头颅CT、理化检查及辨证分型等资料。用描述统计、卡方检验的统计方法探索缺血性中风急性期的头颅CT与辨证分型的相关性。研究表明,缺血性中风好发于基底节、内囊区及大脑中动脉供血区,梗塞多发多于单发,多累及双侧,风痰瘀阻型和气虚血瘀型是最多发的两种证型。痰湿蒙神在缺血性中风的证型中,对神经功能影响最大。研究还表明,气虚血瘀型及风痰瘀血型两大常见证型中梗塞部位集中于内囊、基底节区及大脑中动脉供血区;痰热腑实、痰湿蒙神、阴虚风动型责任病灶分布较均匀;风痰火亢型及风火上扰型多分布于内囊、基底节区及大脑前动脉供血区。而病灶的数目及累计单双侧与辨证分型无明显相关性。本研究初步探索了缺血性中风急性期头颅CT与辨证分型的关系,为使用中医证候量表判断缺血性中风病病人病情提供了影像学依据;为缺血性中风病证结合之影像学与证候结合的研究提供了思路。更多还原

【Abstract】 Applying modern imaging diagnosis methods not only improves the veracity of stroke diagnosis,but also is helpful for choosing therapy scheme and evaluating curative effect and prognosis.Brain CT are image evidences of stroke.Symptoms and signs are feedback of organism under exceptional condition. Brain CT can clearly evaluate the progress of ischemic stroke.Although they both contain one patient information of condition classification and prognosis, the relationship between them is unknown.The modern imaging diagnosis methods are basilic foundation of digging the relativity between CTM symptom and pathology disorder.All the cases of this research based on standard collection methods and in virtue of image tools,150 cases are selected according the accepting standard and information collected at the first time is used to explore the characters of Ischemic Stroke and the correlation of the duty focus postion and the seven symptoms and signs.Methods of correlation and multiple linear regression are applied.The results indicate that ischemic stroke often occurred in the basal ganglia, internal capsule and middle cerebral artery area.Infarct duty focus are prone to multi-bilateral involvement.The wind resistance phlegm and blood stasis and qi deficiency and blood stasis are two common syndromes in all seven. The results also indicate that the Qi-deficiency and blood stasis and the wind resistance phlegm and blood stasis syndromes infarct occur mostly on internal capsule,basal ganglia and middle cerebral artery.Other syndromes infarct are even distribution.The number of infarct focus and distributed in single or bilateral of brain have no significant correlation with the syndromes.更多还原