糖尿病足辨证分型与病理学相关性研究初探

目的]探讨糖尿病足中医辨证分型与截肢标本病理形态学之间的关系。方法]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。结果]13例患者以脉络热毒证、脉络瘀热证、气血两虚瘀阻证3型为多。前者截肢动脉以血管周围及全层均呈慢性炎性改变为主；脉络瘀热证截肢动脉以中膜钙化、平滑肌萎缩变性、坏死及胶原纤维增多显著，炎性改变较前者明显减轻；气血两虚瘀阻证以中膜钙化、平滑肌减少、胶原纤维增生明显。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一定的相关性。

Exploration of correlation of syndrome differentiation with pathology in diabetic foot

To explore the correlation of syndrome differentiation in TCM with pathologic change of amputated sample in diabetic foot.Patients with 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 collaterals type and stagnant deficiency of both qi and yin type according to syndrome differentiation in TCM.Pathologic picture was observed on amputated limbs.thirteen cases were mainly of stagnant heat in collaterals type,heat toxin in collaterals type and stagnant deficiency of both qi and yin type.The main pathologic changes of amputated artery were manifested as a chronic inflammation in its peripheral vessels or in full thickness in the former.The stagnant heat in collaterals type were mainly as calaification of middle membrane,atrophy,degeration and necriosis of smooth muscle,obvious increase of collagenous fiber.The inflammatory changes were alleviated more obviously than the former.The stagnant deficiency of both qi and yin type were mainly as calcification of middle membrane,decrease of smooth muscle,obvious increase of collagenous fiber.Conclusion]Syndrome differentiation has certain correlation with pathologic changes of diabetic foot.