中医体质学与基于经颅多普勒血流动力学参数的相关性分析

The Correlation between Constitution of Traditional Chinese Medicine and Hemodynamic Parameters Based on Transcranial Doppler

目的探讨中医体质学与基于经颅多普勒血流动力学参数的相关性。方法选取北京中医药大学东直门医院门诊病人38例,所有病人均进行经颅多普勒血流超声检查和中医体质学量表评定,计算颅内14个血管部位的S1峰时流速(Ys1)和S1峰血流加速度(Ss1),分析不同中医体质与血流动力学参数的关系。结果Ys1.右侧颈内动脉虹吸段(RCS)和痰湿质呈正相关(r=0.461,P<0.01),Ys1.左侧颈内动脉虹吸段(LCS)和痰湿质呈正相关(r=0.469,P<0.01),Ys1.左侧大脑后动脉(LPCA)和湿热质呈负相关(r=-0.367,P<0.05),Ys1.右侧椎动脉(RVA)和阳虚质呈正相关(r=0.332,P<0.05)。Ss1.RCS和痰湿质呈正相关(r=0.383,P<0.05),Ss1.LCS和痰湿质呈正相关(r=0.403,P<0.05),Ss1.右侧颈内动脉终末段(RICA)和湿热质呈正相关(r=0.329,P<0.05),Ss1.左侧大脑后动脉(LPCA)和气虚质呈负相关(r=-0.498,P<0.01),Ss1.LPCA和阳虚质呈负相关(r=-0.433,P<0.05),Ss1.左侧椎动脉(LVA)和阳虚质呈负相关(r=-0.321,P<0.05),Ss1.基底动脉近段(BA80)和阳虚质呈负相关(r=-0.335,P<0.05)。结论颈内动脉虹吸段血流动力学变化与痰湿质关系密切,后循环血流Ss1可作为提示阳气虚衰等体质的敏感指标。Ss1较Ys1可灵敏辨识中医体质,对临床中医体质辨识和早期预防具有重要的预测意义。

Objective To explore the correlation between constitution of traditional Chinese medicine and hemodynamic parameters based on transcranial Doppler.Methods Thirty-eight patients from Dongzhimen Hospital of Beijing University of Chinese medicine were selected.All patients were examined by transcranial Doppler and evaluated by traditional Chinese medicine physical constitution scale.The S1 peak velocity(Ys1)and S1 peak blood flow acceleration(Ss1)of 14 intracranial blood vessels were calculated,and the relationship between different constitution of traditional Chinese medicine and hemodynamic parameters was analyzed.Results Both Ys1.right siphon segment of internal carotid artery(RCS)and Ys1.left siphon segment of internal carotid artery(LCS)showed positive correlation with phlegm-dampness constitution(r=0.461,P<0.01;r=0.469,P<0.01).Ys1.left posterior cerebral artery(LPCA)showed negative correlation with dampness-heat constitution(r=-0.367,P<0.05).Ys1.right vertebral artery(RVA)showed positive correlation with Yang deficiency constitution(r=0.383,P<0.05).Both Ss1.RCS and Ss1.LCS showed positive correlation with phlegm-dampness constitution(r=0.383,P<0.05;r=0.403,P<0.05).Ss1.right terminal segment of internal carotid artery(RICA)showed positive correlation with dampness-heat constitution(r=0.329,P<0.05).Ss1.LPCA showed negative correlation with Qi deficiency constitution(r=-0.498,P<0.01).Ss1.LPCA,Ss1.left vertebral artery(LVA),and Ss1.basilar artery(BA)at depth of 80 mm showed negative correlation with Yang deficiency constitution(r=-0.433,P<0.05;r=-0.321,P<0.05;r=-0.335,P<0.05).Conclusion There were close relationship between hemodynamic changes of internal carotid artery siphon segment and phlegm-dampness constitution.The S1 peak blood flow acceleration of posterior circulation could be used as a sensitive index to indicate deficiency of Yang-Qi.S1 peak blood flow acceleration was more sensitive to identify constitution of traditional Chinese medicine than peak velocity of vessels,which might be an important predictive factor for identifying constitution of traditional Chinese medicine and early prevention.