摘要
目的:研究脑梗塞患者动脉粥样硬化斑块与中医血瘀证的相关性。方法:脑梗塞及其梗塞亚型的诊断采用1995年中华神经病学会《各类脑血管疾病诊断要点》制定的标准,并经影像学证实。中医证候诊断采用《中风病证候诊断标准》。研究对象年龄在40-80岁之间,发病时间在2周以内。采用ACUSON7彩色多普勒超声仪,探头中心频率为7.0MHz。颈动脉超声从实时灰阶图像扫查开始,采用标准横切面、纵切面及连续扫查方法,记录颈内动脉斑块及其大小,以及内中膜厚度。结果:受试者151人中,脑梗塞组117例,椎基底动脉供血不足组34例。脑梗塞组中火热证51.0%,血瘀证48.0%,气虚证32.0%,肝风证27.0%,痰浊证23.0%,阴虚阳亢证66.0%。脑梗塞组血瘀证56例中有颈动脉斑块者44例(78.6%),脑梗塞组无血瘀证61例中有颈动脉斑块者35例(57.4%),两者比较差异有显著性(P<0.05);颈动脉斑块合并颈动脉内中膜增厚病例的证候分布率最高为血瘀证(56.0%和51.0%)。应用二分类变量的多元Logistic回归方法对颈动脉斑块与证候的关系研究提示,颈动脉粥样硬化斑块与血瘀证有正相关性(P<0.05,OR=2.7),与气虚证呈负相关性(P<0.05,OR=0.33)。与其它四种证型没有相关性。结论:血瘀证的发生不仅因为脑梗塞,而与颈动脉粥样硬化斑块的形成有更加密切的关系。本研究对运用活血化瘀疗法防治脑梗塞及动脉硬化粥样硬化斑块具有重要意义。
Objective： To investigate frequency of blood stasis syndrome （BSS） defined by traditional Chinese medicine in cerebral infarction and its correlations with carotid atherosclerotic plaque （CAP）. Methods： All subjects comprised 151 patients aged 40 to 80 years （Mean ± SD age, 65 ± 11 years） with 67.9% for males and 32.1% for females. With the use of ACUSON7 color Doppler ultrasound, carotid atheroselerosis was evaluated by the plaque score, the left plaque score, the fight plaque score, the numbers of the plaque respectively as defined by the sum of all plaque heights in bilateral carotid arteries. On the basis of neurological signs and symptoms, medical history, and brain MRI, we diagnosed stroke and its subtypes as follows： stroke （ n = 117）, and vertebrobasilar insufficiency （VBI） （ n = 34） without the history of the stroke, which were based on Diagnostic Criteria for Cerebral Vaseular Diseases in 2005. Diagnosis for syndromes defined by traditional Chinese medicine were made according to Diagnostic Criteria for Stroke in 1994. One-way ANOVA was used in comparison between groups, and multivariant Eogistic Regression Analysis was conferred in correlations between several variables. Results： 47.0% of all eases with cerebral infarction presented the BSS, with as lower than syndrome of fireheat （51.0%）, as but signifieantly higher than syndrome of Qi defieieney （32.0%）, liver-wind syndrome （27.0%）, phlegm syndrome （23.0%） and syndrome of asthenie yin eausing predominant yang （6.0%）. There is a signifleant difference between groups for 44 （79.0%） eases of 56 patients with cerebral infarction and the BSS have CAP, and only 35 （57.0%） eases of 61 patients with cerebral infarction but without the BSS have CAP（ P 〈0.05）. There is significant correlation between CAP and BSS in patients with cerebral infarction （ P 〈 0.05, OR = 2.7）. Contrarily, CAP has a negative correlation with syndrome of Qi insuttleieney （ P 〈 0.05, OR = 0.33）. Conclusion�
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2007年第3期149-152,共4页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家重点基础研究发展计划(973)资助项目(No.2003CB517104)
关键词
脑梗塞
血瘀证
动脉粥样硬化斑块
中医
cerebral infarction
blood stasis syndrome
carotid atherosderotic plaque（CAP）
