胆石症中医辨证分型与B超图像的相关性分析

Correlation Analysis of Cholelithiasis in Chinese Medicine Dialectical and B Ultrasound Image

目的观察胆石症中医辨证分型与B超图像的相关性分析,并总结临床影像学经验。方法 本研究从2013年6月至2014年6月来我院就诊的经中医辨证分型确诊的胆石症患者中随机抽取50例为研究对象,其中肝气郁结型患者设为气郁型组,肝胆湿热型患者设为湿热型组,热毒炽盛型患者设为热毒型组。三组患者均行B超影像学检查,分析胆石症中医辨证分型与B超图像的相关性。结果气郁型组(共18例),B超检查结果为单纯胆囊结石11例,无明显梗阻或感染的单纯胆囊结石所占比例明显高于其他部位结石(P<0.05);湿热型组(共16例),B超检查结果胆总管结石8例,存有或合并有梗阻或感染胆总管结石患者所占比例明显高于其他部位结石(P<0.05);热毒型组(共16例),B超检查结果为合并胆囊、胆总管、肝内胆管结石9例,胆总管下段存有明显梗阻,胆囊内积液或穿孔者所占比例明显高于其他部位结石(P<0.05)。结论临床应用中医辨证分型及B超检查诊断胆石症均具有较高的检出率和准确性,中医辨证与B型超声像图特征在临床上诊断胆石症具有很高的相关性,中医辨证与B型超声像图特征相结合,能够可更为全面、准确地反映胆石症特点,对胆石症的诊断、治疗及预后均提供了有效的参考依据。

Objective To observe and analyze the correlation between TCM syndromes and cholelithiasis B ultrasound image, and summarize the clinical imaging. Methods Selected 50 cases of cholelithiasis patients in our hospital diagnosed by syndrome differentiation of TCM,the patients with liver qi stagnation type were set as qi stagnation type groups,hepatobiliary damp heat type were set as damp heat group,noxious heat type of patients were set as the heat toxin type group. Three groups of patients went for B ultrasound imaging and correlation analyzed of cholelithiasis in the Chinese medicine dialectical and B ultrasound image. Results Qi stagnation type group（ 18cases）,the results of ultrasonic examination was a simple gallbladder stone in 11 cases,no obvious obstruction or infection of simple gallbladder stones proportion was higher than other parts of calculus（ P 〈0.05）; damp heat type group（ 16 cases）,the results of ultrasonic examination of 8 patients with common duct stones,being or with obstruction or infection patients with choledocholithiasis proportion was higher than other parts of calculus（P0.05）; heat toxin type group（16 cases）,the results of ultrasonic examination for complicated with gallbladder,common bile duct and intrahepatic bile duct stone in 9 cases,bile duct obstruction or perforation of the obvious,the gallbladder effusion the proportion was higher than other parts of calculus（ P 〈0.05）. Conclusion TCM with type B ultrasonography features in the clinical diagnosis of cholelithiasis with very high correlation,can be more comprehensive and accurate reflection of cholelithiasis characteristics,diagnosis,treatment and prognosis of gallstone disease provides effective reference.