慢性功能性便秘的仿真排粪造影征象与中医证型相关性研究  

Correlation between simulated defecography and TCM patterns of chronic functional constipation

作　　者：李超 张娜 曹春婕 华海琴 李胜鳌 Li Chao;Zhang Na;Cao Chunjie;Hua Haiqin;Li Sheng’ao(Dongfang Hospital, Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院

出　　处：《北京中医药大学学报》2019年第7期607-610,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：首都临床特色应用研究项目(No.Z151100004015191)~~

摘　　要：目的研究仿真排粪造影影像学征象与中医证型的相关性。方法纳入80例慢性功能性便秘患者,中医辨证分为肝郁气滞证、肺脾气虚证、脾肾阳虚证、肝肾阴虚证。仿真排粪造影检查,于PACS系统上测量数据及影像征象,应用对应分析对征象与证型进行分析。结果通过对中医证型和造影征象对应图的解读,不同象限区分了不同中医证型及其相关的排粪造影表现。特异性分析发现,脾肺气虚及脾肾阳虚证型之间相关性较强,而肝肾阴虚及肝郁气滞的辨证分型差异性较大。会阴下降及黏膜内套叠对应辨证分型的差异性不大。耻骨直肠肌综合征更具特异性。肝郁气滞与耻直肌痉挛相关性强;肝肾阴虚与黏膜内脱垂、直肠前突相关性强。脾肺气虚与脾肾阳虚更倾向于出现会阴下降、黏膜内套叠、骶直分离、小肠疝及乙状结肠疝。结论排粪造影征象与中医证型之间存在一定相关性,可以为临床用药辨证论治提供依据,为中医辨证的客观化及可视化发展提供支持。Objective To explore the correlation between simulated defecography and TCM patterns. Methods Patients with chronic constipation(n=80) were diagnosed as the following patterns: liver-qi stagnation, spleen-lung qi deficiency, spleen-kidney yang deficiency and liver-kidney yin deficiency. PACS system was used to examine patients and collect imaging data. Their correlation was analyzed. Results Through the interpretation of corresponding TCM patterns and defecographical findings, different TCM patterns and related defecography manifestations were distinguished in different quadrants. Specificity analysis showed that there was a strong correlation between spleen-lung qi deficiency and spleen-kidney yang deficiency, while there were significant differences between liver-kidney yin deficiency and liver-qi stagnation. There was no significant difference between the symptoms and signs of perineal descent and mucosal intussusception. Puborectalis syndrome was more specific. Liver-qi stagnation was strongly correlated with puborectalis syndrome, while liver-kidney yin deficiency was strongly correlated with mucosal prolapse and rectocele. Spleen-lung qi deficiency and spleen-kidney yang deficiency were more likely to lead to perineal descent, mucosal intussusception, sacrum-rectal separae, small intestinal hernia and sigmoid hernia. Conclusion The study found that there was a certain correlation between defecographic findings and TCM patterns. It may provide the basis for clinical treatment based on pattern diagnosis and may promote the development of dialectical and objective differentiation of traditional Chinese medicine.

关 键 词：功能性便秘 排粪造影 中医证型 相关性 

分 类 号：R256.35[医药卫生—中医内科学]