补充和活化血液循环法治疗椎基底动脉导水管后循环分水岭梗塞:两例患者的病例报告。

L I He, S U Wenquan, L I Shanshan, J I Hanrui, Cheng Jiangyan, Cui Fangyuan, Tang Lu, Zhou Li, Gao Ying, Dong Xinglu
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摘要

椎基底动脉粥样硬化症(VBD)是一种罕见的后循环血管变异性疾病,是许多急性脑血管疾病的重要危险因素。对 VBD 的认识不足常常导致误诊。本文报告了两例最初被诊断为后循环分水岭梗死的 VBD 病例。由于没有常见的脑卒中病因,包括低灌注、血液系统疾病、颈动脉和主动脉夹层以及嗜酸性粒细胞升高,这两名患者的症状符合 VBD 的诊断标准。两名患者的症状均符合中医 "气虚血瘀 "证型。因此,他们接受了补气活血法的综合治疗。2 名患者的临床表现明显好转,随访 1 年未发现分水岭梗死复发。详细的病史和实验室检查能够提高 VBD 诊断的准确性。以辨证为基础的中医治疗可能是治疗 VBD 的可行方法。
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Supplementingand activating blood circulation method to treat vertebrobasilar dolichoectasia with posterior circulatory watershed infarction: a case report of two patients.

Vertebrobasilar dolichoectasia (VBD), a rare posterior circulation vascular variant disease, is an important risk factor for many acute cerebrovascular diseases. An insufficient understanding of VBD often leads to misdiagnose. Two cases of VBD that were initially diagnosed as posterior circulation watershed infarction are reported here. Absence of common causes of stroke including hypoperfusion, blood system diseases, carotid and aortic dissection, and eosinophil elevation, the symptoms of the 2 patients met the diagnostic criteria of VBD. Both patients displayed symptoms that were in line with the Traditional Chinese Medicine (TCM) syndrome pattern of "deficiency and blood stasis". Accordingly, they were comprehensively treated with Supplementingand activating blood circulation method. The clinical manifestations of the 2 patients were remarkably improved and no recurrence of watershed infarction was found in a 1-year follow-up. A detailed medical history and laboratory examination are capable of improving diagnostic accuracy of VBD. TCM treatment based on syndrome identification might be a promising candidate for VBD management.

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