本文關(guān)鍵詞： 腦小血管病 中醫(yī)證型 磁共振 腔隙性腦梗 腦白質(zhì)疏松　出處：《成都中醫(yī)藥大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過對(duì)腦小血管病患者的統(tǒng)計(jì)調(diào)查,探討腦小血管病患者的MRI影像診斷與腦小血管病患者的中醫(yī)證型之間的相關(guān)性,為中醫(yī)辨證論治的微觀化增加新的內(nèi)容。 方法納入2013年10月至2014年1月來我院行頭顱核磁共振符合腦小血管病的患者452例,收集患者中醫(yī)四診資料,來探討腦小血管病的MRI表現(xiàn)與中醫(yī)證型的相關(guān)性,使用SPSS17.0.統(tǒng)計(jì)軟件進(jìn)行各種統(tǒng)計(jì)分析。 結(jié)果在納入的452名患者的影像學(xué)表現(xiàn)統(tǒng)計(jì)方面,腔隙性腦梗死患者452人,腦白質(zhì)疏松患者167人,腦微出血4人。其中單純表現(xiàn)為隙性腦梗死的患者為384人,隙性腦梗死合并腦白質(zhì)疏松164人,隙性腦梗死合并腦微出血1人,三種表現(xiàn)都有的有3人。在中醫(yī)證型統(tǒng)計(jì)方面,肝陽暴亢,風(fēng)火上擾證84人,占18.58%；痰熱腑實(shí),風(fēng)痰上擾證27人,占5.97%；風(fēng)痰瘀血,痹阻經(jīng)絡(luò)證181人,占40.04%；氣虛血瘀證95人,占21.02%；陰虛風(fēng)動(dòng)證65人,占14.58%。在影像學(xué)表現(xiàn)與中醫(yī)證型的相關(guān)性方面,452名患者均有隙性腦梗死的表現(xiàn),肝陽暴亢,風(fēng)火上擾證合并有腦白質(zhì)疏松的比例要小于其它4個(gè)證型。在腔隙性腦梗死的數(shù)量上,肝陽暴亢型腔隙性腦梗死的數(shù)量相對(duì)風(fēng)痰阻絡(luò)證、氣虛血瘀證、陰虛風(fēng)動(dòng)證較少；在隙性腦梗死病灶的位置方面,后循環(huán)供血的部位陰虛風(fēng)動(dòng)證在腦干的梗死比例要高于痰熱腑實(shí)證、肝陽暴亢風(fēng)證、風(fēng)痰阻絡(luò)證；在前循環(huán)供血的部位,氣虛血瘀和陰虛風(fēng)動(dòng)證在基底節(jié)梗死病灶的比例要高于痰熱腑實(shí)證、肝陽暴亢風(fēng)證、風(fēng)痰阻絡(luò)證。在性別和年齡方面,痰熱腑實(shí)證以男性多見；腔隙性腦梗死和腦白質(zhì)疏松的影像等級(jí)與年齡均有有明顯的正相關(guān)性。 結(jié)論腦小血管病的MRI影像表現(xiàn)與中醫(yī)證型存在相關(guān)性.①452名患者均有腔隙性腦梗死的表現(xiàn),但肝陽暴亢,風(fēng)火上擾證合并有腦白質(zhì)疏松的比例要小于其它4個(gè)證型。②肝陽暴亢型腔隙性腦梗死的數(shù)量相對(duì)風(fēng)痰阻絡(luò)證、氣虛血瘀證、陰虛風(fēng)動(dòng)證較少。③后循環(huán)供血的部位陰虛風(fēng)動(dòng)證在腦干的梗死比例要高于痰熱腑實(shí)證、肝陽暴亢風(fēng)證、風(fēng)痰阻絡(luò)證；在前循環(huán)供血的部位,氣虛血瘀和陰虛風(fēng)動(dòng)證在基底節(jié)梗死病灶的比例要高于痰熱腑實(shí)證、肝陽暴亢風(fēng)證、風(fēng)痰阻絡(luò)證。④年齡與腔隙性腦梗死和腦白質(zhì)疏松的影像等級(jí)均有有明顯的正相關(guān)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.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 張微微;;腦小血管病[J];中華老年心腦血管病雜志;2009年12期

2 張微微;;腦小血管病的新進(jìn)展[J];中華腦血管病雜志(電子版);2008年04期

3 陳可冀;;急性缺血性腦血管病的治療[J];中西醫(yī)結(jié)合雜志;1990年06期

4 林瑯;張微微;趙秀欣;黃勇華;郭文華;;腦小血管病對(duì)卒中后轉(zhuǎn)歸和并發(fā)癥的影響[J];中國卒中雜志;2009年08期

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本文編號(hào)：1539313