糖尿病足辨证分型与病理学相关性研究

目的]探讨糖尿病足中医辨证分型与截肢标本病理组织学之间的关系。方法]对32例截肢的糖尿病足患者按中医辨证分为气血两虚瘀阻证、脉络血瘀证、脉络瘀热证、脉络热毒证和气阴两虚瘀阻证,分别对截肢肢体进行病理形态学观察、分析。结果]在32例截肢标本中,中动脉的病理学改变明显,各证型间病变具有显著性差异;微小动脉、神经和肌肉病理学改变各证型间差异不显著。其中脉络热毒证和气阴两虚瘀阻证以动脉粥样硬化和炎性改变为主,气血两虚瘀阻证和脉络瘀热证则以中膜钙化、平滑肌细胞萎缩、变性、坏死及胶原纤维增多及内膜粥样斑块形成为主。结论]糖尿病足中医辨证分型与病理形态学变化及病变特点具有较高的相关性。

Research on Correlation Between Differentiation of the Syndromes of Diabetic Foot and Pathology

Objective] To research the correlation between differentiation of the syndromes of diabetic foot and pathology.Methods] Patients witn diabetic foot were divided into stagant deficiency of both qi and blood type,blood stssis in collaterals type,stagnant heat in collaterals type,heat toxin in collateralstype and stagnant deficiency of both qi and yin type according to syndrome differentiation in TCM.Pathologic picture was observed on amputated limbs.Results] In 32 cases of amputated limbs,the main pathologic changes was the artery with statistical significance in all type.But the pathologic changes of arteriole,nerve and mules was no statistical significance.The main pathologic changes of amputated artery were manifested as a chronic inflammation in its peripheral vessels or in full thicknees in the former.The statistical significance and stagnant heat in collaterals type were mainly as calcification of middle membrance,decrease of smooth muscle,obvious increase of collagenous fiber.Conclusion] Syndrome differentiation has certain correlation with pathologic changes of diabetic foot.