【摘要】：目的:探討大腦中動(dòng)脈（MCA）供血區(qū)進(jìn)展性缺血性卒中影像類型、腦血管病變特點(diǎn)和中醫(yī)證候要素間的內(nèi)在聯(lián)系，以期為MCA供血區(qū)進(jìn)展性卒中的防治提供依據(jù)。 方法:選取我院腦病科MCA供血區(qū)進(jìn)展性缺血性卒中住院患者128例,收集相關(guān)資料，根據(jù)磁共振DWI序列表現(xiàn)將患者分為區(qū)域梗死、皮質(zhì)下梗死、邊緣帶梗死、彌散小梗死4種類型；根據(jù)缺血性中風(fēng)證候要素診斷量表，，以風(fēng)、火、痰、氣虛、血瘀、陰虛6大要素判定證候，就患者一般資料、梗死類型、證候特點(diǎn)和相應(yīng)MRA表現(xiàn)作出統(tǒng)計(jì)學(xué)分析。 結(jié)果:MCA供血區(qū)進(jìn)展性缺血性卒中多在起病3天神經(jīng)功能缺損達(dá)高峰；大血管病變普遍；影像梗死類型以邊緣帶梗死發(fā)生率最高（53.1%），其血管病變以MCA重度狹窄和多支血管病變?yōu)橹鳎?3.85%）；中風(fēng)證候以風(fēng)、氣虛、血瘀為主；六種證候中唯有氣虛與梗死類型相關(guān)，以邊緣帶梗死為主；也僅有氣虛證與血管病變程度有一定相關(guān)性；包含氣虛血瘀的多證組合（氣虛-血瘀、氣虛－血瘀－痰濕與氣虛－血瘀－陰虛）是MCA供血區(qū)進(jìn)展性卒中主要的證候組合形式。 結(jié)論：MCA供血區(qū)進(jìn)展性卒中以MCA狹窄及多支血管狹窄引起的邊緣帶梗死為主。中醫(yī)證候要素以風(fēng)、氣虛、血瘀多見，其中惟有氣虛與MCA嚴(yán)重狹窄、多支血管狹窄和邊緣帶梗死相關(guān)。包含氣虛血瘀的多證組合是MCA供血區(qū)進(jìn)展性卒中主要的證候組合形式。
[Abstract]:Objective: to explore the image types of progressive ischemic stroke in (MCA) supply area of middle cerebral artery (MCAA), the characteristics of cerebrovascular disease and TCM syndromes in order to provide evidence for the prevention and treatment of progressive stroke in MCA supply area. Methods: 128 patients with progressive ischemic stroke in MCA blood supply area in our department of encephalopathy were selected, and the relevant data were collected. According to the DWI sequence list, the patients were divided into regional infarction, subcortical infarction and marginal zone infarction. 4 types of diffuse small infarction; According to the diagnostic scale of syndromes of ischemic stroke, six factors, wind, fire, phlegm, qi deficiency, blood stasis and yin deficiency, were used to determine the syndromes. The general data, infarction type, syndrome characteristics and corresponding MRA manifestations were analyzed statistically. Results: progressive ischemic stroke in the MCA blood supply area reached the peak on the 3rd day after onset of the disease, and the major vascular lesions were common. The incidence of infarction in the marginal zone was the highest (53.1%), the main vascular lesions were severe stenosis of MCA and multi-vessel disease (73.85%), the syndrome of apoplexy was wind, deficiency of qi and blood stasis. Among the six syndromes, only deficiency of qi was related to the type of infarction, mainly in marginal zone, and there was only a certain correlation between deficiency of qi and degree of vascular lesion. Multiple syndromes including qi deficiency and blood stasis (qi deficiency-blood stasis, qi deficiency-blood stasis-phlegm dampness and qi deficiency-blood stasis-yin deficiency) are the main syndromes of progressive stroke in MCA blood supply area. Conclusion: the main type of progressive stroke in MCA feeding area is the marginal zone infarction caused by MCA stenosis and multiple vessel stenosis. Syndrome elements of TCM are wind, qi deficiency and blood stasis, among which qi deficiency is associated with severe stenosis of MCA, stenosis of multiple vessels and infarction of marginal zone. Multiple syndromes including qi deficiency and blood stasis are the main syndromes of progressive stroke in MCA blood supply area.
【學(xué)位授予單位】：山東中醫(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

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 段文慧;李立志;王承龍;史大卓;高鑄燁;劉劍剛;劉紅旭;胡元會(huì);林謙;魯衛(wèi)星;王宇娟;;急性心肌梗死中醫(yī)證候分布及與心功能相關(guān)性的研究[J];北京中醫(yī)藥;2010年04期

2 汪鐵錚;王少杰;;原發(fā)性高血壓病合并頸動(dòng)脈粥樣硬化中醫(yī)證候?qū)W規(guī)律研究[J];北京中醫(yī)藥;2011年12期

3 劉強(qiáng);高穎;;中風(fēng)病不同階段四診信息的指標(biāo)聚類分析[J];中華中醫(yī)藥雜志;2007年03期

4 封銀曼,陳焱;腦動(dòng)脈硬化癥中醫(yī)病機(jī)釋要[J];光明中醫(yī);2001年03期

5 周慎,楊維華,卜獻(xiàn)春,郭子華,歐陽(yáng)劍虹;腦動(dòng)脈硬化癥中醫(yī)診療方案之文獻(xiàn)及臨床研究總結(jié)[J];湖南中醫(yī)雜志;1995年01期

6 王德云;;無癥狀性腦梗死的臨床分析及影像學(xué)研究[J];罕少疾病雜志;2009年06期

7 張華;高潁;;缺血性中風(fēng)證候演變與神經(jīng)功能缺損的相關(guān)性研究[J];北京中醫(yī)藥大學(xué)學(xué)報(bào);2007年04期

8 ;中風(fēng)病診斷與療效評(píng)定標(biāo)準(zhǔn)（試行）[J];北京中醫(yī)藥大學(xué)學(xué)報(bào);1996年01期

9 馬斌;高穎;;中風(fēng)病發(fā)病第7天和第14天證候要素演變規(guī)律初步研究[J];遼寧中醫(yī)雜志;2006年12期

10 劉俊艷,董玉娟,李娜,任士卿,李育臣,王建茹,劉好文,王冰;進(jìn)展性卒中的相關(guān)因素研究[J];腦與神經(jīng)疾病雜志;2001年03期

本文編號(hào)：2406758