急性胰腺炎中医辨证分型与多层螺旋CT灌注相关性研究  

Correlation study on acute pancreatitis between its Chinese differentiation types and multispial CT perfusion data

作　　者：邵娟[1] 卜平[1] 征锦[1] 孔桂美[1] 

机构地区：[1]扬州大学医学院中西医结合临床实验室,江苏扬州225001

出　　处：《中国中西医结合消化杂志》2008年第1期14-17,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：江苏省自然科学基金资助项目(BG2006606)

摘　　要：[目的]通过对急性胰腺炎(AP)CT灌注血流参数的变化与中医证型相关性的研究,试图找出特异的指标,将其引入中医对AP的辨证,以使辨证更为客观。[方法]运用中医理论将49例AP患者分为肝郁气滞、胃肠实热、湿热蕴结3种证型组,同期运用16排螺旋CT进行灌注扫描。应用perfusion 3软件包进行数据处理,计算各型的血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管通透性(PS)等灌注参数,对不同证型的AP患者的灌注数据与正常胰腺(对照)组进行方差分析检验。[结果]3个不同证型的AP组BF、BV平均值较对照组显著降低(P<0.01),而PS高于对照组(P<0.05);胃肠实热型的BF、BV平均值较肝郁气滞及湿热蕴结型显著降低。[结论]不同中医证型的AP,其CT灌注血流参数不尽相同,胃肠实热型AP病情较其他证型重,血流参数BV、BF明显低于肝郁气滞型和湿热蕴结型。血流参数的变化是中医证型变化的主要因素之一,是判断AP中医证型的一个参考指标,同时也可作为判断病情轻重程度的客观指标之一。[Objective]Through a correlation study between the CT perfusion data of acute pancreatitis（AP） and their differentiation types of syndrome in Chinese medicine, to find specific indexes which could be introduced to strengthen the Chinese differentiation of syndromes and signs for the disease, so that the process of the traditional differentiation could be more objective and dependable. [Methods]Fourty nine patients with AP were devided into three types according to the theory of Chinese medicine, they were： （1）the type of stagnation of QI clue to depression of liver; （2）the stomach intestine sthenic fever type; （3）the humid heat heaping type. And CT perfusion on the pancreases of the patients of AP with 16 rows CT were performed, the perfusion data of the relevant groups including blood flow （BE）, blood volume（BV） and capillary permeability（PS） with the perfusion package 3 were collected. The analysis of variance test were used to deal with the perfusion data within the three groups and between the above mentioned individual group and the normal group. [Results] The mean values of BF, BV reduced significally in the groups of AP compared with the normal group（P〈0. 01）, only PS went higher than that of the normal group（ P〈0. 05）. The BV,BF were significantly lower in group B than in group A and C. [Conclusion ]The CT perfusion data deffer between the three groups, indicating the condition is obviously more severe in group B than in the other two groups. The change of blood perfusion is among the main factors that leads to the changes of the differentiation type in Chinese medicine, the perfusion CT data can act as sensitive index in the diagnostic process of differentiation in AP, and predict the severity of AP.

关 键 词：急性胰腺炎 中医证型 螺旋CT 

分 类 号：R576[医药卫生—消化系统]