代谢综合征对急性脑梗死患者中医证候分布及软脑膜侧支循环建立的影响  

Effects of metabolic syndrome on the distribution of TCM syndrome and the establishment of leptomeningeal collateral circulation in patients with acute cerebral infarction

作　　者：朱宏勋[1] 李京[1] 曹锐[1] ZHU Hong-xun;LI Jing;CAO Rui(Department of Chinese Medicine,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院中医科,北京100020

出　　处：《中华中医药杂志》2020年第11期5831-5834,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市属医院科研培育计划(No.PZ2016028)。

摘　　要：目的:研究代谢综合征(MS)对急性脑梗死患者中医证候分布及软脑膜侧支循环建立的影响。方法:纳入124例急性脑梗死患者,于入组当天及发病第7天进行中医证候评价,并于发病第7天对患者进行TCD及CTA检查,记录患者脑平均血流速度(Vm)、搏动指数(PI)和基于CTA的区域软脑膜评分(rLMC),数据收集后,按是否合并MS分成无MS组和MS组,进行数据分析。结果:与无MS组比较,入组当天MS组患者火热证、气虚证患者人数比例较高,且MS组气虚证评分较高。发病第7天MS组的PI较高,而rLMC评分较低。结论:合并代谢综合征的急性脑梗死患者发病初期各种证候组合中,风、火热、痰、血瘀是主要证候要素,合并代谢综合征的急性脑梗死患者侧支循环建立不良,与火热证、气虚证存在一定的联系。Objective:To study the effects of metabolic syndrome on distribution of TCM syndromes and leptomeningeal collateral circulation establishment in patients with acute cerebral infarction.Methods:A total of 124 patients with acute cerebral infarction were studied.TCM syndromes were evaluated on the day of admission and on the 7 th day of onset.TCD and CTA were performed on the 7 th day of onset.The mean cerebral blood flow velocity(Vm),pulsatility index(PI),regional leptomeningeal scores(rLMC)based on CTA were observed.After data collection,the patients were divided into non-metabolic syndrome group(non-MS group)and metabolic syndrome group(MS group)according to whether they had metabolic syndrome or not,data were analyzed.Results:On the day of admission,the proportion of patients with fire-heat syndrome and qi deficiency syndrome in MS group was higher,and the score of qi deficiency syndrome in MS group was higher.On the 7 th day of onset,the PI of MS group was higher,while the rLMC score was lower.Conclusion:Compared with non-MS group,wind,fire-heat,phlegm and blood stasis are the main syndromes in the early stage of acute cerebral infarction with metabolic syndrome.The collateral circulation of patients with acute cerebral infarction with metabolic syndrome is not well established,which is related to fire-heat syndrome and qi deficiency syndrome.

关 键 词：代谢综合征 脑梗死 中医证候 软脑膜侧支循环 

分 类 号：R277.7[医药卫生—中医学]