脑梗死患者影像学表现与中医证型诊断相关性的研究综述

The Correlation between Imaging Manifestations and Traditional Chinese Medicine Syndrome Diagnosis in Patients with Cerebral Infarction: A Systematic Review of the Literature

摘要: 脑梗死作为全球高致死率及致残率的疾病，其精准诊疗对改善患者预后至关重要。本文系统综述了脑梗死患者影像学表现与中医证型诊断的相关性研究进展，旨在通过整合现代影像技术(如CT、MRI、DSA、超声等)与中医辨证体系，探索中西医结合诊疗的协同效应。研究表明，不同中医证型(如气虚血瘀、风痰阻络、阴虚风动等)与特定影像学特征存在显著关联：气虚证患者脑灌注水平及再灌注概率较低，风痰瘀阻证与多支脑血管病变密切相关，而CT/MRI显示的缺血半暗带、梗死体积及血流动力学参数可为中医证候要素(如内火、血瘀)提供客观影像学依据。尽管影像技术在血管结构评估、血流监测及预后预测中具有重要价值，但中医辨证标准化不足、多模态影像数据融合困难及微观病理与宏观证候的跨尺度关联机制仍是当前研究的瓶颈。未来需通过人工智能驱动的影像组学、动态影像技术及多组学数据整合，推动中西医结合诊疗向精准化与个体化方向发展。

Abstract: Ischemic stroke, as a disease with high global mortality and disability rates, requires precise diagnosis and treatment to improve patient prognosis. This article systematically reviews the research progress on the correlation between imaging manifestations of cerebral infarction and Traditional Chinese Medicine (TCM) syndrome diagnosis, aiming to explore the synergistic effects of integrating modern imaging techniques (e.g., CT, MRI, DSA, ultrasound) with TCM syndrome differentiation systems. Studies indicate that different TCM syndrome types (e.g., Qi deficiency and blood stasis, wind-phlegm obstructing collaterals, Yin deficiency and wind stirring) exhibit significant associations with specific imaging features: patients with Qi deficiency syndrome demonstrate lower cerebral perfusion levels and reduced reperfusion probability, while wind-phlegm-blood stasis syndrome is closely related to multi-vessel cerebrovascular lesions. Imaging parameters such as ischemic penumbra, infarct volume, and hemodynamic characteristics revealed by CT/MRI provide objective evidence for TCM syndrome elements (e.g., internal fire, blood stasis). Despite the critical value of imaging technologies in vascular structure assessment, hemodynamic monitoring, and prognostic prediction, challenges persist in standardizing TCM syndrome differentiation, integrating multimodal imaging data, and bridging cross-scale mechanisms between microscopic pathology and macroscopic syndromes. Future research should leverage artificial intelligence-driven radiomics, dynamic imaging technologies, and multi-omics data integration to advance TCM-Western medicine integrated diagnostics and treatment toward precision and individualized approaches.