摘要
目的探讨热带地区急性缺血性中风中医证型与DWI脑梗死容积间的关系。方法选取2010年8月至2013年12月经三亚市中医院临床及核磁共振扩散成像技术(MRI-DWI)确诊的急性缺血性中风患者134例,其中动脉粥样硬化性血栓性脑梗死56例和腔隙性脑梗死78例,按1993年颁布的《中药新药临床研究指导原则》将其分为肝阳暴亢、风火上扰(2例);风痰瘀血、痹阻脉络(68例);痰热腑实、风痰上扰(13例);气虚血瘀(49例);阴虚风动(2例)。分析其MRI-DWI图像资料,并测量DWI病灶大小信息。肝阳暴亢、风火上扰和阴虚风动证型仅各有2例,代表性较差,不予分析。结果三组患者的DWI脑梗死容积经Kruskal-Wallis秩和检验,差异有统计学意义(H=9.229,P=0.010)。进一步经扩展的t检验法作组间的两两比较,风痰瘀血、痹阻脉络与热痰腑实、风痰上扰证型间DWI脑梗死容积的差异有统计学意义(t=2.182,P=0.031);风痰瘀血、痹阻脉络与气虚血瘀间DWI脑梗死容积的差异也有统计学意义(t=2.551,P=0.011);而热痰腑实、风痰上扰与气虚血瘀中证型间DWI脑梗死容积的差异则无统计学意义(t=0.637,P=0.525)。结论 MRI-DWI在评价热带地区的急性缺血性中风各中医证型的脑梗死容积预后具有一定的临床意义。
Objective To investigate the relationship between TCM syndrome types of acute ischemic stroke in the tropical region and cerebral infarction volume in diffusion weighted imaging （DWI）. Methods A total of 134 patients with acute ischemic stroke diagnosed by clinic and MRI-DWI in Sanya Traditional Chinese Medicine Hospi-tal from August 2010 to December 2013 were enrolled, including 78 cases of atherosclerotic thrombotic cerebral in-farction and 56 cases of lacunar infarction. According to the＂traditional Chinese medicine new medicine clinical re-search guiding principle＂ （promulgated in 1993）, the 134 cases were divided into the hyperactivity of liver Yang, wind fire disturbance （2 cases）, wind phlegm and blood stasis, stagnation vein （68 cases）, phlegm heat accumulation, the wind phlegm （13 cases）, Qi deficiency and blood stasis （49 cases）, Yin pneumatic （2 cases）. The MRI-DWI imag-ing data was analyzed, and the size of lesions in DWI was measured. Hyperactivity of liver Yang, wind and fire dis-turbance and Yinxu Fengdong syndrome type of the 2 cases were excluded because the representative was not good. Results Cerebral infarction volume in DWI of three patient groups by Kruskal-Wallis rank sum test showed statisti-cally significant difference （H=9.229, P=0.010）. Further testing by the expansion of T method between each of the two groups showed that the difference of cerebral infarction volume in DWI was statistically significant between wind phlegm and blood stasis, stagnation and heat phlegm Fu real, the wind phlegm syndrome type （t=2.182, P=0.031）. There was also significant difference of cerebral infarction volume in DWI between wind phlegm blood stasis, stagna-tion of Qi and blood stasis （t=2.551, P=0.011）, but there was no significant difference of cerebral infarction volume in DWI between the heat phlegm Fu real, wind phlegm and Qi deficiency and blood stasis syndrome （t=0.637, P=0.525）. Conclusion MRI-DWI has certain clinical significance in the evaluation o
出处
《海南医学》
CAS
2015年第5期676-678,共3页
Hainan Medical Journal
基金
海南省卫生厅科学基金(编号:琼卫2013资助-082号)
关键词
热带地区
急性缺血性中风
中医证型
DWI
脑梗死容积
Tropical region
Acute ischemic str9ke
TCM syndrome type
Diffusion weighted imaging（DWI）
Cerebral infarction volume
