缺血性脑卒中类型与中医辨证分型的相关性分析

Correlation analysis between ischemic stroke types and syndrome differentiation of traditional Chinese medicine

目的:探讨MRI在缺血性脑卒中(缺血性脑梗死)类型与中医辨证分型相关性分析中的应用价值。方法:回顾性分析行中西医结合治疗的缺血性脑卒中患者67例,其中风痰阻络证41例,气虚血瘀证26例。所有患者治疗前均行MRI检查(T_(1)WI、T_(2)WI、FLAIR、DWI),分析缺血性脑卒中类型与中医辨证分型的相关性。结果:风痰阻络证41例,其中急性脑梗死4例(9.75%),陈旧性脑梗死5例(12.20%),急性、陈旧性脑梗死并存(混合性脑梗死)32例(78.05%)。单个患者的急性梗死病灶2~18个;最大梗死灶约2.7 cm×1.6 cm,最小者直径约0.2 cm。气虚血瘀证26例,其中混合性脑梗死9例(34.62%),陈旧性脑梗死17例(65.38%);单个患者的急性梗死病灶2~6个;最大梗死灶1.9 cm×1.5 cm,最小直径0.2 cm。两证中,急性梗死病灶数目、大小比较,差异均无统计学意义(均P>0.05);混合性脑梗死的急性梗死复发率差异有统计学意义(P<0.05)。结论:MRI能显示脑梗死的发病部位、大小、范围、数目、急性或陈旧性,为中医辨证分型提供客观依据。

Objective:To explore the application value of MRI in the correlation analysis between ischemic stroke(ischemic cerebral infarction)types and syndrome differentiation of traditional Chinese medicine(TCM).Methods:67 cases of ischemic stroke treated by integrated traditional Chinese and western medicine were retrospectively analyzed,including 41 cases with wind and sputum obstruction evidence and 26 with qi deficiency and blood stasis evidence.All patients underwent MRI examination(T_(1)WI,T_(2)WI,FLAIR,DWI)before treatment to analyze the correlation of ischemic stroke type and TCM syndrome differentiation classification.Results:41 cases of wind sputum obstruction including 4 cases of acute cerebral infarction(9.75%),5 cases of stale cerebral infarction(12.20%),and 32 cases of acute and stale cerebral infarction(hybrid cerebral infarction)(78.05%).In a single case,the number of acute infarction was at least 2 and at most 18,and the maximum infarct focal range was about 2.7 cm×1.6 cm,and the minimum was approximately 0.2 cm.Qi deficiency and blood stasis certificate of 26 cases including 9 cases with hybrid cerebral infarction(34.62%)and 17 cases with stale cerebral infarction(65.38%).In a single case,the number of acute infarction was at least 2 and at most 6,and the maximum infarct local range was about 1.9 cm×1.5 cm,and the minimum was approximately 0.2 cm.In the two types,the number and size differences of acute infarction were insignificant(P>0.05).The acute infarction recurrence rate of hybrid cerebral infarction was statistically different(P<0.05).Conclusions:MRI can clearly reveal the location,size,range,number and acute or stale cerebral infarction,and can provide an objective basis for TCM syndrome differentiation.