【摘要】：目的:探討大腦中動脈（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)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

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