电子喉镜结合窄带成像技术对慢喉瘖局部及整体辨证分型关联性研究  

Correlation Study of Electronic Laryngoscopy Combined with Narrow Band Imaging Technology in Local and Overall Syndrome Differentiation of Chronic Laryngitis

作　　者：彭倩琳 肖志贤 周立[3] 田理[3] 梁方琪[3] PENG Qian-lin;XIAO Zhi-xian;ZHOU Li;TIAN Li;LIANG Fang-qi(Chengdu Pidu District Integrated Traditional Chinese and Western Medicine Hospital,Chengdu,610000;Otorhinolaryngology and Head&Neck Surgery Department,Traditional Chinese Medicine Hospital of Meishan,Sichuan,620010;Otorhinolaryngology Department,Hospital of Chengdu University of TCM,Chengdu,610075)

机构地区：[1]成都市郫都区中西医结合医院内科,成都610000 [2]眉山市中医医院耳鼻咽喉头颈外科,四川620010 [3]成都中医药大学附属医院耳鼻喉科,成都610075

出　　处：《中国中西医结合杂志》2024年第10期1215-1220,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：“杏林学者”学科人才科研提升计划项目(No.YYZX2021088)。

摘　　要：目的探讨电子内镜结合窄带成像技术(NBI)对慢喉瘖局部与整体辨证分型之间的关系。方法从成都中医药大学附属眉山医院耳鼻咽喉科门诊纳入120例慢喉瘖患者,根据整体辨证分为肺肾阴虚、肺脾气虚、血瘀痰凝3组。通过电子喉镜观察喉部形态结构,结合窄带成像技术进行上皮内乳头样毛细血管袢(IPCL)分型,最后统计分析不同证型与喉局部体征之间的关系。结果慢喉瘖声带颜色及IPCL分型在不同中医证型的分布上差异有统计学意义(P<0.05)。声带颜色正常、淡红、IPCLⅠ、Ⅱ型患者以肺脾气虚证为主,声带颜色充血、IPCLⅢ型以肺肾阴虚证为主,声带颜色瘀暗、IPCLⅣ、Ⅴ型以血瘀痰凝证为主。不同中医证型在杓间区颜色及形态的分布上差异有统计学意义(P<0.05),肺脾气虚证颜色以泛白,形态以肥厚为主,肺肾阴虚证、血瘀痰凝证慢喉瘖患者杓间区颜色及形态以正常为主。结论对慢喉瘖声带颜色及IPCL的判别有助于辨证分型,慢喉瘖肺脾气虚证患者杓间区多表现为泛白、肥厚,与咽喉反流患者体征一致,提示肺脾气虚证慢喉瘖的发病可能与反流相关。Objective To explore the relationship between electronic endoscopy combined with Narrow Band Imaging(NBI)technology and the local and overall syndrome differentiation of chronic laryngitis.Methods A total of 120 patients with chronic laryngitis were enrolled from the outpatient clinic of the Department of Otorhinolaryngology,Chengdu University of Traditional Chinese Medicine Mianyang Hospital.The patients were divided into three groups based on overall syndrome differentiation:Fei-Shen yin deficiency,Fei-Pi qi deficiency,and blood stasis phlegm coagulation.The morphological structure of the larynx was observed through electronic laryngoscopy,and the Intraepithelial Papillary Capillary Loop(IPCL)typing was performed with NBI technology.Finally,the relationship between different syndrome types and local signs of the larynx was statistically analyzed.Results There were significant differences in the distribution of vocal cord color and IPCL typing among different Chinese medicine(CM)syndrome types(P<0.05).Patients with normal or red color of vocal cord and TypeⅠor TypeⅡIPCL were mainly of the Fei-Pi qi deficiency syndrome,those with congested color of vocal cord and TypeⅢIPCL were mainly of the Fei-Shen yin deficiency syndrome,and those with dark color of vocal cord color and TypeⅣor TypeⅤIPCL were mainly of the phlegm blood stasis syndrome.There were also significant differences in the distribution of color and morphology of the inter-arytenoid area among different CM syndrome types(P<0.05).The Fei-Pi qi deficiency syndrome was mainly characterized by pale color and thickened morphology,while the Fei-Shen yin deficiency syndrome and blood stasis phlegm coagulation syndrome patients mainly showed normal color and morphology in the inter-arytenoid area.Conclusions The differentiation of vocal cord color and IPCL is helpful for syndrome differentiation.Patients with Fei-Pi qi deficiency syndrome of chronic laryngitis often show pale thickened inter-arytenoid area,which is consistent with the signs of patient

关 键 词：慢喉瘖 窄带成像技术 中医证型 整体辨证 局部辨证 

分 类 号：R276.1[医药卫生—中医五官科学]