| ObjectiveBy using infrared thermal imager to observe the infrared thermal imaging characteristics of apoplexy patients with anterior circulation artery stenosis,measure the temperature difference between the left and right sides of the subject’s forehead,compare and summarize the differences in the distribution and manifestations of infrared thermography between such patients and normal people and the apoplexy patients without anterior circulation artery stenosis,to determine whether the stenosis of the large intracranial and external arteries will cause heat distribution changes in the forehead areas.In addition,to compare whether the systemic infrared thermograms of patients with different TCM syndroms have different characteristics of heat metabolism,and compare the temperature difference between the left and right sides of the spleen and stomach meridians of apoplexy patients with that of normal people,to conclude whether the temperature distribution on the trunk of apoplexy patients is different from that of normal people.Therefore,it provides a certain reference value for the application of infrared thermal imaging technology in the screening of stroke and arterial stenosis diseases,and provides a new idea for the clinical syndrome differentiation analysis and treatment of traditional Chinese medicine.MethodsBy collecting infrared thermal imaging of 67 apoplexy patients(including 50 patients complicated with anterior circulation artery stenosis and 17 patients wihout anterior circulation artery stenosis)and 70 normal controls.To study the characteristics of frontal temperature distribution in patients with stroke complicated with anterior circulation artery stenosis and the frontal heat metabolism reflected by the heat map which is different in apoplexy patients without anterior circulation artery stenosis and normal people.At the same time,observe the thermal distribution characteristics of the infrared heat map corresponding to different TCM syndromes in the stroke group,and calculate the temperature differences between the apoplexy patients and the normal group.Carotid ultrasound and TCD were used to screen for anterior circulation artery stenosis,and the degree of arterial stenosis in the included patients with anterior circulation artery stenosis was greater than 50%.Laboratory examinations,general information and four diagnoses of traditional Chinese medicine of all patients were collected,and infrared thermal imaging examination was performed on all subjects.Five infrared thermal images of subjects were collected,including the front body image,the back body image,the left side body image,the right side body image and the close-up image of head and face.Results1.The frontal temperature distribution of apoplexy patients complicated with anterior circulation artery stenosis was different from that of normal group and the apoplexy patients without anterior circulation artery stenosis:Compared with the normal group,the temperature difference between the left and right frontal parts of the stroke group compilcated with anterior circulation artery group was significantly higher(P=0.000).There was no statistically significant difference in the temperature difference between the left and right side of the forehead in the stroke group without anterior circulation artery stenosis compared with the normal group(P=0.233>0.05).2.The frontal temperature distribution characteristics of apoplexy patients complicated with anterior circulation artery stenosis were not affected by the location of the stenosis vessels:There was no statistically significant difference in the temperature difference between the left and right sides of the forehead in the three groups:patients with extracranial internal carotid artery stenosis,patients with intracranial internal carotid artery stenosis or patients with anterior/middle cerebral artery stenosis,and patients with intracranial and extracranial artery stenosis(P=0.836>0.05).3.The face and frontal heat metabolism of apoplexy patients combined with anterior circulation artery stenosis was different from that of the normal group and the apoplexy patients without anterior circulation artery stenosis:In apoplexy patients combined with anterior circulation artery stenosis,the temperature of the inner canthus was asymmetrical.There was obvious asymmetry and uneven color distribution in the forehead.Either flaky red high temperature area or flaky green low temperature area can be seen.Diffuse and asymmetrical abnormal light red or red high temperature area can be seen on both cheeks.In the normal control group,the bilateral lateral inner canthus showed a red high temperature area,and the frontal infrared thermograph showed a relatively uniform and symmetrical light red temperature area,and the cheek color distribution was relatively smooth and symmetrical.Compared with the normal group,the bilateral distribution of frontal heat map in the stroke group without anterior circulation artery stenosis was relatively uniform.4.The frequency of TCM syndrome elements in the enrolled 67 stroke patients was from more to less as follows:Phlegm and dampness syndrome,blood stasis syndrome,qi deficiency syndrome,internal fire syndrome,yin deficiency syndrome and internal wind syndrome.Among the syndromes,the combination of two syndromes was the most,accounting for 55 cases,followed by a single syndrome,accounting for 8 cases,and the combination of three syndromes accounted for 4 cases.The top three syndromes are phlegm-dampness and blood-stasis syndrome,qi-deficiency and blood-stasis syndrome and phlegm-fire syndrome.5.Infrared thermography of the whole body.of patients with different syndromes show differences:In the syndrome with internal wind syndrome,the red hot area concentrated on the head and face can be seen.Patients with phlegm-dampness syndrome often show scattered and uneven,spotty thermal images,and diffuse distribution of irregular areas are mostly green low temperature zone.If phlegm-dampness is combined with heat syndrome or heat of phlegm-dampness,it can be seen that the irregular area of dispersion distribution is light red warm area or red hot area.For those with blood stasis syndrome,spot or flake temperature increase or decrease in non-physiological heat storage area is more common.6.No matter the apoplexy patients complicated with anterior circulation artery stenosis or not,there was no statistical difference in temperature between spleen and stomach meridians(P=0.117,P=0.061).The difference in temperature of spleen and stomach meridians between the left and right sides of apoplexy patients was statistically significant compared with that of the healthy control group(P=0.000).And there was a difference in the temperature between the right and left sides of the stomach meridians between patients with phlegm syndrome and those with other syndromes(P=0.048<0.05).7.The change of heat distribution in the infrared heat map can reflect the evolution of TCM syndromes to some extent.Conclusions1.The frontal temperature distribution of stroke patients with anterior circulation artery stenosis was different from that of normal people.The temperature asymmetry of inner canthus can be seen in most infrared heat maps.The forehead shows obvious asymmetry and uneven color distribution.2.Compared with the normal people,the temperature difference of spleen and stomach meridians between the left and right sides of apoplexy patients was increased.3.The most common TCM syndromes of apoplexy patients included were the combination of phlegm and dampness and blood stasis,followed by the combination of qi deficiency and blood stasis,phlegm dampness and internal fire.The hot red area concentrated on the head and face can be seen in TCM syndrome with internal wind syndrome.In the patients with phlegm and dampness syndrome,scattered,non-uniform and spotty thermal images can be seen,and the diffuse and distributed irregular areaswere mostly at low-temperature.If phlegm and dampness is combined with heat syndrome,it can be seen that the irregular areas of dispersion distribution were light red warm areas or red hot areas.For those with blood stasis syndrome,spot or flake temperature increase or decrease in non-physiological heat storage area was more common.4.The change of heat distribution in the infrared heat map can reflect the evolution of TCM syndromes to some extent. |
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