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目的:研究急性脑梗死中医证型与TCD、颈动脉彩超的相关性,为急性脑梗死中医微观辨证提供客观依据。方法:将入选的108例急性脑梗死患者辨证分为气虚血瘀证、肝阳暴亢证、阴虚风动证、风痰阻络证4组,并设正常对照组20例。对4组不同证型急性脑梗死患者的经颅多普勒(TCD)、颈动脉彩超进行两两比较,然后分别与正常对照组对比,观察急性脑梗死患者各证型与TCD、颈动脉彩超的关系。结果:(1)脑梗死各证型的TCD特点:①气虚血瘀型:颅内及颈部各血管血流速度均最慢,PI、RI值最低;②肝阳暴亢型:颅内及颈部各血管血流速度均最快,PI、RI值最高;③阴虚风动型:颅内及颈部各血管血流速度均增快,PI、RI值增高;④风痰阻络型:颅内及颈部各血管血流速度减慢,PI、RI值增高。(2)脑梗死各证型的颈动脉彩超特点:①气虚血瘀型:颈部动脉粥样斑块面积较大,动脉内径缩小较明显;②肝阳暴亢型:颈部动脉粥样斑块面积较小,动脉内径缩小不明显;③阴虚风动型:颈部动脉粥样斑块面积较小,动脉内径缩小不明显;④风痰阻络型:颈部动脉粥样斑块面积最大,动脉内径缩小最明显。结论:急性脑梗死各证型与TCD、颈动脉彩超的表现有一定的相关性,各项指标在4个证型之间具有较明显的差异,可以作为急性脑梗死中医辨证的客观依据。
Objective: To study the correlation between traditional Chinese medicine syndromes of acute cerebral infarction and TCD and carotid ultrasonography and to provide objective evidences for TCM syndrome differentiation of acute cerebral infarction. Methods: The 108 patients with acute cerebral infarction were divided into four groups according to syndrome differentiation: qi deficiency and blood stasis syndrome, liver yang hyperactivity syndrome, yin deficiency and wind syndrome, and phlegm and blood stasis syndrome, and 20 normal control subjects. Transcranial Doppler (TCD) and carotid ultrasonography were compared among 4 groups of patients with different syndromes of acute cerebral infarction, and then compared with normal control group respectively to observe the syndrome types of TCD, carotid ultrasonography Relationship. Results: (1) TCD characteristics of various syndromes of cerebral infarction: ① Qi deficiency and blood stasis type: the blood flow velocity of each blood vessel in the brain and neck was the slowest, the PI and RI values were the lowest; ② liver hyperactivity type: intracranial and The blood flow velocity in each neck of the neck was the fastest and the PI and RI values were the highest. (3) The yin-deficiency type was faster: the blood flow velocity in the intracranial and cervical vessels were faster and the PI and RI values were higher. : Intracranial and cervical blood vessels blood flow slowed down, PI, RI value increased. (2) The features of carotid ultrasonography in various syndromes of cerebral infarction: ① qi deficiency and blood stasis type: the area of neck atherosclerosis is larger and the arterial diameter narrowed more obviously; ② the type of liver yang hyperactivity: atherosclerotic plaques The size of the artery is small, and the diameter of the arterial artery is not obviously reduced. ③ The yin-deficiency type is characterized by a small area of the atherosclerotic plaque in the neck and an insignificant decrease of the arterial diameter. ④ The type of phlegm obstruction: the area of the atherosclerotic plaque in the neck The largest artery diameter narrowed the most obvious. Conclusion: The syndromes of acute cerebral infarction have a certain correlation with the manifestations of TCD and carotid ultrasonography. There are obvious differences among the four syndromes in each index, which can be used as the objective evidence of syndrome differentiation of traditional Chinese medicine in acute cerebral infarction.