本文選題：乳腺增生病 + 中醫(yī)辨證分型��； 參考：《濟(jì)南大學(xué)》2017年碩士論文

【摘要】：目的通過(guò)分析乳腺增生病中醫(yī)辨證分型和磁共振成像(MRI)在臨床上的應(yīng)用,并基于乳腺增生病癥的影像資料表現(xiàn)與中醫(yī)辨證歸類之間關(guān)系,本文對(duì)各證型的MRI成像進(jìn)行了分析。并且對(duì)各證型影像掃描的指標(biāo)進(jìn)行了探究,對(duì)比中醫(yī)不同證型與不同的MRI影像學(xué)表現(xiàn)之間的關(guān)系分布情況,為今后中醫(yī)在乳腺增生病的辨證治療提供科學(xué)依據(jù)。方法挑選196名在2014年2月至2016年6月期間在醫(yī)院就診的乳腺增生患者,其中年齡在24至54歲范圍內(nèi)不等�；诨颊咛峁┑囊话阈畔�(如年齡、哺乳史、月經(jīng)史等),由專業(yè)的中醫(yī)師對(duì)所挑選的患者進(jìn)行初步診斷并辨別分類。并對(duì)所有患者采用乳腺專用線圈(線圈同時(shí)并行采集通道數(shù)為8道)進(jìn)行常規(guī)MRI成像,動(dòng)態(tài)增強(qiáng)成像(DCE-MR)、擴(kuò)散加權(quán)成像(DWI)掃描,成像序列完整,圖像清晰。掃描視野(FOV):根據(jù)乳腺大小而選擇300×300到350×350mm。通過(guò)SS-EPI成像,DWI掃描的平面影像只出現(xiàn)橫向切面上,并在X、Y、Z軸上施加擴(kuò)散敏感梯度脈沖(DSGP)。其中選取敏感系數(shù)800秒每平方毫米和一個(gè)空白參照,選用馬根維顯(德國(guó)先靈藥業(yè)公司)為造影劑,注射流速為3毫升每秒,試劑用量(濃度為0.5毫摩爾每毫升)為0.1摩爾每千克。并采用SPSS17.0統(tǒng)計(jì)軟件對(duì)得到的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,計(jì)量資料采用%來(lái)表示,并選用卡方檢驗(yàn),并且P0.05,表明該計(jì)算有統(tǒng)計(jì)學(xué)意義。結(jié)果根據(jù)MRI成像顯示:圖像中局部有致密陰影部位,強(qiáng)化呈條索狀的患者中以沖任失調(diào)居多(占總樣的50%);其次依次為肝郁氣滯型、痰瘀互結(jié)型,分別占總樣的33.33%和16.67%;圖像中患者的雙乳呈少量腺體型,腺體為斑片狀且強(qiáng)化呈片狀的患者中以沖任失調(diào)者居多(占總樣50%),其次依次為痰瘀互結(jié)型、肝郁氣滯型,分別占總樣的35.29%和14.71%;在雙側(cè)乳房呈團(tuán)片狀多發(fā)類結(jié)節(jié)樣、點(diǎn)狀強(qiáng)化的患者中以以肝郁氣滯型、痰瘀互結(jié)型居多,而沖任失調(diào)型較少。三種證型之間的對(duì)比(P0.05)。TIC曲線對(duì)于分析三種癥狀類型的分布具有重要意義。根據(jù)TIC曲線顯示:I型曲線主要為肝郁氣滯型;Ⅱ型和Ⅲ型曲線均以痰瘀互結(jié)型居多;其中只有一位沖任失調(diào)型患者的TIC曲線隸屬于Ⅳ型。結(jié)論乳腺增生不同證型患者的MRI影像各不相同,有著明顯特征。借助MRI影像資料可以為中醫(yī)對(duì)于乳腺增生辨證施治提供科學(xué)支持。
[Abstract]:Objective to analyze the clinical application of traditional Chinese medicine syndrome differentiation and magnetic resonance imaging (MRI) of mammary hyperplasia, and to analyze the MRI imaging of each syndrome type based on the relationship between the imaging data of mammary hyperplasia and TCM syndrome differentiation and classification. And the indexes of imaging scanning of each syndrome type were explored, and the relationship between different syndromes and different MRI manifestations of TCM was compared, which provided the scientific basis for the treatment of hyperplasia of mammary gland in the future. Methods 196 patients with breast hyperplasia from February 2014 to June 2016 were selected. The age ranged from 24 to 54 years. Based on the general information provided by the patient (such as age, history of lactation, menstrual history, etc.), the selected patient is diagnosed and classified by a professional Chinese medicine practitioner. All patients were performed conventional MRI imaging with special coil (8 channels were simultaneously collected by coils), dynamic enhanced imaging (DCE-MRA) and diffusion-weighted imaging (DWI) scan. The imaging sequence was complete and the image was clear. Scan visual field FOV: choose 300 脳 300 to 350 脳 350 mm according to mammary gland size. The plane images scanned by SS-EPI imaging and DWI only appear on the transverse section and apply diffusion sensitive gradient pulse on the axis of XMY _ (YZ). A sensitivity factor of 800 seconds per square millimeter and a blank reference were selected, and Magan Weixian (Germany's Shenling Pharmaceutical Company) was selected as contrast agent. The flow rate of injection was 3 milliliters per second. The dosage of reagent (concentration 0.5 ml / ml) is 0.1 mol / kg. SPSS 17.0 statistical software was used to analyze the obtained data, the measurement data was expressed in%, and chi-square test was used, and P0.05, which showed that the calculation had statistical significance. Results according to MRI imaging, there were dense shadow areas in the local images, and the most of the patients with stripe enhancement were the disorder of flushing and letting (50% of the total), followed by the type of stagnation of liver-qi, the type of phlegm and blood stasis, and the type of phlegm and blood stasis. 33. 33% and 16. 67% of the total samples, respectively. In the image, the double breasts of the patients showed a small amount of gland type, and the majority of the patients whose glands were patchy and enhanced were dysfunctional (accounting for 50% of the total, followed by phlegm and blood stasis type, liver stagnation and qi stagnation type, respectively). Among the patients with bilateral breast, the majority were liver stagnation, phlegm and blood stasis, but the disorder of rush and discharge was less. The proportion of patients with bilateral breast was patchy and multiple nodular, and the patients with punctate enhancement were liver stagnation, phlegm and blood stasis, and phlegm and blood stasis, respectively, which accounted for 35.29% and 14.71% of the total breast samples, respectively. The comparison between the three syndromes is of great significance for the analysis of the distribution of the three symptom types. According to the TIC curve, the TIC curve of type I was mainly the type of stagnation of liver-qi, the type 鈪，

本文編號(hào)：2042322