摘要
目的:探讨不同中医证型眩晕经颅多普勒超声检查特征与脑动脉血流的变化关系。方法:选取2020年12月至2021年12月我院收治的182例眩晕患者作为研究对象,根据中医辨证分型将该182例眩晕患者分为肝阳上亢组(n=49)、痰湿中阻组(n=23)、瘀血阻窍组(n=18)、气血亏虚组(n=79)及肾精不足组(n=13),并另选体检健康者50例作为对照组,均予多普勒超声检查,观察不同中医证候类型患者多普勒超声检查特征与脑动脉血流变化的关系。结果:(1)各中医证候类型患者与对照组左右椎动脉、基底动脉及大脑中动脉血流情况对比,差异均有统计学意义(P<0.05)。(2)与瘀血阻窍组相比,肝阳上亢组患者左右椎动脉、左右大脑中动脉Vs、Vm水平较高,而Vd、PI值较低,基底动脉Vs、Vd、Vm水平较高,而PI值较低(均P<0.05),痰湿中阻组患者左右椎动脉、基底动脉Vs、Vm、Vd水平较高,而PI值较低,左右大脑中动脉Vs、Vm水平较高,而Vd、PI值较低(均P<0.05),气血亏虚组患者左右椎动脉、基底动脉、左右大脑中动脉Vs、Vm、Vd水平较高,而PI值较低(均P<0.05),肾精不足组患者左右椎动脉Vs、Vd水平较高,而PI值较低,基底动脉Vs、Vm、PI值均较低,而Vd水平较高,左右大脑中动脉Vs、Vm较高,而Vd水平及PI值较低(均P<0.05)。(3)与肝阳上亢组相比,痰湿中阻组、气血亏虚组、肾精不足组患者左右椎动脉、基底动脉Vs、Vm、PI值均较低,而Vd值均较高(均P<0.05),痰湿中阻组患者左右大脑中动脉Vm、PI值均较低,而Vd值较高(均P<0.05),气血亏虚组及肾精不足组大脑中动脉Vs、Vm、PI值均较低,而Vd水平较高(均P<0.05)。(4)与痰湿中阻组相比,气血亏虚组患者左右椎动脉、基底动脉Vs、Vm、Vd、PI值均较低,大脑中动脉Vs、Vm、PI值均较低,而Vd水平较高(均P<0.05),肾精不足组患者左右椎动脉、左右大脑中动脉Vs、Vm、Vd水平较低,而PI值较高,基底动脉Vs、Vm、Vd、PI值均较低(均P<0.05)。(5)与气血亏虚组相比,肾精不足组患者基底动脉Vs、PI值较高,而Vm、Vd水平较低(P<0.05),肾精不足组大脑中动脉Vs、Vm、PI值较高,而Vd水平较低(P<0.05)。(6)瘀血阻窍组、气血亏虚组及肾精不足组脑动脉血流流速以异常缓慢为主,肝阳上亢组及痰湿中阻组脑动脉血流流速以异常增快为主。结论:不同证候类型眩晕患者多存在不同程度脑动脉血流动力学异常,经颅多普勒超声对眩晕中医辨证分型有一定的参考价值。
Objective:To explore the relationship between the characteristics of transcranial Doppler ultrasonography and changes of cerebral arterial blood flow in vertigo of different TCM syndromes.Methods:182 patients with vertigo who were treated in the hospital from December 2020 to December 2021 were selected as the research subjects,and they were divided into a liver-Yang hyperactivity group(n=49),a phlegm-dampness retention group(n=23),a blood stasis blocking orifice group(n=18),a Qi and blood deficiency group(n=79),and a kidney-essence deficiency group(n=13)according to TCM syndrome differentiation.Another 50 healthy subjects with physical examination were enrolled as a controlled group.Doppler ultrasonography was performed on all subjects,and the relationship between the characteristics of Doppler ultrasonography and the changes of cerebral arterial blood flow in patients with different TCM syndromes was observed.Results:(1)The blood flow status of the left and right vertebral arteries,basilar artery and middle cerebral artery in patients with various TCM syndromes were significantly different from those in the controlled group(P<0.05).(2)Compared with the blood stasis blocking orifice group,the levels of Vs and Vm of left and right vertebral arteries and left and right middle cerebral arteries in the liver-Yang hyperactivity group were higher while the Vd and PI were lower,and the levels of Vs,Vd and Vm of basilar artery were higher while the PI was lower(all P<0.05),the left and right vertebral arteries and basilar artery Vs,Vm and Vd were higher in the phlegm-dampness retention group while the PI was lower,and the left and right middle cerebral arteries Vs and Vm were higher while Vd and PI were lower(all P<0.05),the left and right vertebral arteries,basilar artery and left and right middle cerebral arteries had higher levels of Vs,Vm and Vd and lower PI in the Qi and blood deficiency group(all P<0.05),and the left and right vertebral arteries Vs and Vd were higher while the PI was lower,the basilar artery Vs,Vm,and PI were lower while the Vd was higher and the left and right middle cerebral arteries Vs and Vm were higher while Vd and PI were lower in the kidney-essence deficiency group(all P<0.05).(3)Compared with the liver-Yang hyperactivity group,the left and right vertebral arteries and basilar artery Vs,Vm and PI were all lower in the phlegm-dampness retention group,Qi and blood deficiency group and the kidney-essence deficiency group while the Vd was higher(all P<0.05),the Vm and PI of the left and right middle cerebral arteries were lower while the Vd was higher in the phlegm-dampness retention group(all P<0.05),the middle cerebral artery Vm and PI were lower while Vd was higher in Qi and blood deficiency group and the kidney-essence deficiency group(all P<0.05).(4)Compared with the phlegm-dampness retention group,the left and right vertebral arteries and basilar artery Vs,Vm,Vd and PI in the Qi and blood deficiency group were all lower,the middle cerebral artery Vs,Vm,and PI were lower while the Vd was lower(all P<0.05),the Vs,Vm and Vd of left and right vertebral arteries and left and right middle cerebral arteries were lower in kidney-essence deficiency group while the PI was higher,and the Vs,Vm,Vd and PI of basilar artery were lower(all P<0.05).(5)Compared with the Qi and blood deficiency group,the Vs and PI of the basilar artery in the kidney-essence deficiency group were higher while the Vm and Vd were lower(P<0.05),the Vs,Vm and PI of middle cerebral artery were higher while Vd level was lower(P<0.05).(6)The cerebral artery blood flow velocity in the blood stasis blocking orifice group,the Qi and blood deficiency group and the kidney-essence deficiency group was mainly abnormally slow,while the cerebral artery blood flow velocity in the liver-Yang hyperactivity group and the phlegm-damp retention group was mainly abnormally fast.Conclusion:Patients with vertigo of different syndromes have different degrees of abnormal cerebral artery hemodynamics.Transcranial Doppler ultrasound has a certain reference value for TCM syndrome differentiation of vertigo.
作者
袁建兴
丁颖颖
YUAN Jianxing;Ding Yingying(Rugao Hospital of Traditional Chinese Medicine,Rugao Jiangsu 226500,China)
出处
《四川中医》
2022年第11期72-76,共5页
Journal of Sichuan of Traditional Chinese Medicine
关键词
眩晕
中医证候类型
经颅多普勒超声
脑动脉血流
Vertigo
TCM syndromes
Transcranial Doppler ultrasound
Cerebral arterial blood flow
