摘要
目的:研究脑梗死急性期病灶部位与中医证候之间的关系。方法:前瞻性分析89例急性脑梗死患者的临床资料和辅助检查结果,借助弥散加权核磁共振(Diffusion Weighted Imaging,DWI)和临床神经系统局灶体征,判断本次责任病灶。梗死灶首先按脑循环系统划分为:前循环供血区和后循环供血区,前循环供血区又分成:皮层、皮层下白质和基底节区,后循环供血区包括脑干、丘脑和小脑。在发病的30天内以虚实为纲对患者进行中医辨证,分为:以实为主、以虚为主、虚实并重3大证候类型。结果:发生在皮层的梗死,中医辨证以实为主的证候最多见(58.8%),以虚为主的证候仅占17.6%;发生在基底节区的梗死,则更多见以虚为主的证候(85.7%),且无1例表现为以实为主的证候;发生在皮层下白质的梗死,以实为主的证候(42.9%)和以虚为主的证候(35.7%)相差不多;而后循环梗死以实为主的证候最多,占46.7%,以虚为主的证候只占20.0%。结论:此研究结果提示急性脑梗死的责任病变部位与中医虚实证候之间存在相关性,单发的皮层和脑干梗死多见以实为主的证候,单发的基底节区梗死多见以虚为主的证候。
Objectives：To explore the correlation between infarction site and Chinese medicine syndromes in acute cerebral infarction （ACI）. Methods：Eighty-nine selected ACI patients were prospectively studied to identify acute infarction site by diffusion weighted imaging （DWI） plus neurological deficit sign. The location of infarction was classified according to the cerebral circulation system, i.e. the anterior infarction, including those occurring in cortex, white matter or basal ganglia, and the posterior infarction including those in brain stem, thalamus or cerebella. The TCM syndrome differentiation was performed within 30 days after attack to classify as predominant excess syndrome, predominant deficiency syndrome, and syndrome with same degree of excess ＆ deficiency. Results： Most cortical infarction incidences were of excess syndrome （58.8%）, while only 17.6% was found as deficient. The result was reversed in basal ganglia infarction with 85.7% of deficiency syndrome yet zero excess syndrome. In white matter infarction 42.9% was of excess syndrome compared with a 35.7% deficiency syndrome. Posterior circulation infarction had more excess syndrome （45.7%） than deficiency syndrome （20. 0% ）. Conclusions：The correlation between site of infarction and Chinese medicine syndromes in ACI is that single cortical or brainstem infarction are mostly seen in predominant excess syndrome, single basal ganglia infarction are in predominant deficiency syndrome.
出处
《世界中医药》
CAS
2008年第5期265-267,共3页
World Chinese Medicine
关键词
脑梗死
中医辨证
临床研究
治疗方法
Cerebral infarction/Syndrome Differentiation of Chinese Medicine
