MRCP在梗阻性黄疸中医辨证分型中的应用研究

The application of MRCP in syndrome differentiation of TCM on obstructive jaundice

目的:探讨磁共振胆胰管成像(MRCP)在黄疸中医辨证分型中的应用价值。方法:对72例梗阻性黄疸患者进行MRI及MRCP检查,同时进行中医辨证分型,并与临床诊断、化验结果或手术和病理结果对比分析。结果:72例梗阻性黄疸病例中医辨证阳黄30例,主要以结石、炎症、先天囊肿为主;阴黄42例,主要以肝内、肝外肿瘤为主,并发现肝外胆管扩张程度阴黄高于阳黄。前者以重度和中度黄疸为主,占38/42,且形态以软藤状为主,占38/42;后者以轻度和中度黄疸为主,占28/30,且形态以枯枝状为主,占17/24。结论:MRCP图像清晰,能清楚显示扩张肝内胆管、胆总管、胆囊的形态、部位以及与周围组织结构的关系,对梗阻性黄疸中医辨证分型的诊断具有一定指导价值。

Objective.. To evaluate the magnetic resonance cholangio-pancreaticography（MRCP）in syndrome differentiation of TCM on obstructive jaundice. Methods：Seventy-two patients with obstructive jaundice were performed both MRCP and MRI. All of them had been classified in syndrome differentiation of TCM,and comparing with clinical and surgical and histopathologic results. Results：The images of all the bile ducts and pancreatic duct were showed clearly,30 cases of Yang-Huang, which include stones,inflammatory stenosis and congenital cyst,the majority shape style was soft canes-like,42 of Yin-Huang, which include both intrahepatic and perihepatic tumors, the majority shape style was soft bines-like. It shown close relationship between grades of dilatation and syndrome styles, also shown distinct relationship between shapes and syndrome styles. Conclusion： MRCP can reveal the conformation,location of the common bile duct,gallbladder and the relationship of the texture around them clearly,it is helpful to syndrome differentiation of TCM.