急性丘脑梗死病人中医证型演变规律及其与颈动脉硬化的相关性研究

Correlation between TCM Syndrome Evolution and Carotid Arteriosclerosis in Patients with Acute Thalamic Infarction

目的从辅助检查角度分析急性丘脑梗死病人的中医证型分布,并探讨其与颈动脉硬化程度及性质的相关性。方法对103例病人(病例组)进行颈动脉彩超检查,同时进行中医辨证分型,分析中医证型与颈动脉硬化程度及性质之间的相关性。同时选取同期于本院体检中心相应年龄段非脑血管病体检者50例为对照组。结果急性丘脑梗死病人内膜增厚及斑块检出率、不稳定斑块出现率、中重度狭窄发生率明显高于对照组。瘀证内膜增厚及斑块检出率最高,其次为痰证、风证及火证。病例组中不稳定斑块出现率以风证、火证出现率最高,其次为瘀证、痰证,且风证、火证不稳定斑块出现率较痰证、瘀证比较差异有统计学意义(P<0.05)。结论丘脑梗死急性期病人颈动脉血管内-中膜厚度(IMT)增厚、斑块形成与痰证和瘀证明显相关;风证、火证、痰证、瘀证等实证为急性丘脑梗死发病的关键因素,痰瘀互结是急性丘脑梗死的基本病理因素,风火相煽为疾病的始动因素(诱因),气虚及阴虚证与疾病的复发有关。

Objective To analyze the traditional Chinese medicine(TCM)syndrome types of patients with acute thalamus infarction(ATI)from the perspective of auxiliary examination,and to understand its correlation with the degree and nature of carotid arteriosclerosis.Methods Carotid artery ultrasound examination was performed in 103 patients,and TCM syndrome differentiation was performed at the same time.The correlation between TCM syndrome types and the degree and nature of carotid arteriosclerosis was analyzed.Results The endometrial thickening and plaque detection rate,the occurrence rate of unstable plaques,and moderate to severe stenosis in patients with ATI were significantly higher than those in the control group.The endometrial thickening and plaque detection rate of stasis syndrome were the highest,followed by sputum syndrome,wind syndrome and fire syndrome.The incidence of unstable plaques was the highest in wind syndrome and fire syndrome,followed by stasis syndrome and phlegm syndrome.There was statistical difference in the incidence of unstable plaques between wind syndrome,fire syndrome,and sputum syndrome and stasis syndrome.Conclusion The intimal thickening of the carotid IMT and plaque formation in patients with thalamic infarction are related to sputum syndrome and stasis syndrome.Wind,fire,sputum syndrome,and stasis syndrome are key factors in the pathogenesis of ATI.Phlegm and blood stasis are the basic pathological factors of ATI.Wind and fire are the initiating factors of the disease.Qi deficiency and yin deficiency syndrome are related to the recurrence of the disease.