2型糖尿病中医证型与股动脉血管回声跟踪技术检测指标的相关性分析

目的：探讨糖尿病中医证型与股动脉血管回声跟踪技术检测指标之间的关系，为临床早期防治糖尿病下肢动脉病变提供依据。 方法：纳入147例2型糖尿病患者，均接受基本信息和中医临床信息的采集以及股总动脉血管回声跟踪技术检测。所有病例都进行中医辨证分型，观察各中医证型与股总动脉压力-应变弹性系数（pressure-strain elastic modulus, Ep）、硬化参数β、动脉顺应性（arterial compliance, AC）、脉搏波传导速度β（pulse wave velocity β, PWVβ）和管径增大指数（augmentation index, AI）之间的关系。 结果：阴阳两虚证的Ep明显高于气阴两虚证，硬化参数β明显大于气阴两虚、阴虚热盛和湿热困脾3种证型，AC明显小于阴虚热盛证，PWVβ明显大于阴虚热盛和气阴两虚证，AI明显大于阴虚热盛证。气阴两虚证的硬化参数β明显大于湿热困脾证。兼血瘀证患者的Ep明显大于无血瘀证者，AC明显小于无血瘀证者。 结论：血管回声跟踪技术检测可获知下肢动脉弹性的减退。本研究显示阴阳两虚、湿热困脾兼血瘀证的糖尿病患者下肢动脉硬化较严重。血管回声跟踪技术检测指标中的硬化参数β、AC和PWVβ可能成为早期糖尿病下肢动脉硬化的客观评估指标。

Correlative analysis of the parameters of eTRACKING detection of femoral artery and the syndrome types of traditional Chinese medicine in type 2 diabetic patients

Objective： To explore the correlation between the parameters of eTRACKING detection of femoral artery and the syndrome types of traditional Chinese medicine （TCM） in type 2 diabetic patients so as to provide clinical evidence for early prevention and treatment of diabetic lower extremity arterial disease.
Methods： A total of 147 cases of type 2 diabetic patients were included. Basic data and TCM clinical information were collected, and eTRACKING detection of common femoral arteries was performed. Differentiation of symptoms and signs for classification of TCM syndromes was performed in all patients. The correlations between TCM syndrome and pressure-strain elastic modulus （Ep）, stiffness parameter β, arterial compliance （AC）, pulse wave velocity β （PWVβ）, and augmentation index （AI） in common femoral arteries were observed.
Results： In the patients with deficiency of both yin and yang, the Ep value was higher than that in the patients with deficiency of both qi and yin, the stiffness parameter β was higher than that in the other three syndrome types （deficiency of both qi and yin, excessive heat due to yin deficiency, accumulation of damp-beat in spleen）, the AC value was lower than that in the patients with excessive heat due to yin deficiency, the PWVβ value was higher than that in the patients with excessive heat due to yin deficiency and deficiency of both qi and yin, and the AI value was higher than that in the patients with excessive heat due to yin deficiency. The stiffness parameter β in the patients with deficiency of both qi and yin was higher than that in the patients with accumulation of damp-heat in spleen. In the patients with blood stasis, the Ep value was higher and the AC value was lower than that in the patients without blood stasis.
Conclusion： The decrease of elasticity in lower extremities can be detected by eTRACKING. This study reveals that type 2 diabetic patients with deficiency of both yin and yang, accumulation of damp-heat in spleen and blood stasis have more severe lower extremity arteriosclerosis. In eTRACKING parameters, stiffness parameter β, AC and PWVβ may become the objective indexes in evaluating early diabetic lower extremity arteriosclerosis