彩色多普勒超声在颈动脉粥样硬化中医辨证分型临床应用价值

Clinical Value of Color Doppler Ultrasonography in TCM Syndrome Differentiation of Carotid Atherosclerosis

目的：通过对各中医证型颈动脉粥样硬化（carotid athero sclerosis,CAS）患者的颈动脉超声图像的分析研究,探讨超声检查在颈动脉粥样硬化中医辨证分型中的临床应用价值。方法：回顾性分析2013年10月—2014年12月确诊为CAS患者385例,应用彩色多普勒超声观察患者双侧颈动脉,包括颈动脉内-中膜厚度、斑块发生部位、斑块性质、管腔狭窄程度,综合分析其声像图特点与中医证候要素的相关性。结果：颈动脉粥样硬化各证型间,颈动脉内-中膜增厚以痰浊内盛型最明显;软斑痰浊内盛型、瘀血内阻型以软斑最多见,脾肾不足型、阴虚火旺型、血虚失荣型以硬斑最多见;颈动脉粥样硬化斑块分布部位以颈动脉膨大部（42%）及颈总动脉（38.5%）为主;血管狭窄程度与痰浊内盛、瘀血内阻密切相关。结论：颈动脉超声检测指标可作为CAS中医辨证的客观化指标,提高中医辨证分型的客观化和规范化,并且为指导临床用药提供客观依据。

Objective：Based on the TCM Syndromes of carotid atherosclerosis（carotid athero,sclerosis,CAS）analysis of carotid artery ultrasound images of patients and investigate the clinical value of ultrasonography in the diagnosis of carotid atherosclerosis in TCM.Methods：A retrospective analysis of October 2013—December 2014 in our hospital of traditional Chinese medicine and Western medicine combined with cardiovascular wards and 385 cases were diagnosed as CAS patients were observed by color Doppler ultrasound in patients with bilateral carotid artery,including carotid intima-media thickness,plaque area,plaque,degree of stenosis,a comprehensive analysis of the correlation between ultrasonographic features and traditional Chinese medicine the elements of syndrome.Results：The syndromes of carotid atherosclerosis,carotid artery intima-media thickness in turbid phlegm type is most obvious;soft plaque turbid phlegm type,the most common type of blood stasis with soft plaque,spleen and kidney deficiency,over yin fire,blood loss to the most common type wing hard plaque;carotid atherosclerotic plaque score the cloth part in carotid artery enlargement（42%）and common carotid artery（38.5%）;the degree of vascular stenosis and turbid phlegm,stasis resistance are closely related.Conclusion：Carotid ultrasonography can be used as an objective index of TCM syndrome differentiation in CAS,and it can improve the objectivity and standardization of TCM syndrome differentiation,and provide an objective basis for guiding the clinical use of drugs.