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目的通过彩色多普勒(CDFI)部分指标的量化来初步探讨制定对糖尿病肾病(DN)中医证候诊断量表。方法选择合适的DN患者489例。首先采用二维图像观察DN肾脏的大小及实质回声;再用CDFI观察肾血流灌注程度;然后用脉冲波多普勒(PW)观察肾动脉(RA)、段间动脉(SRA)及叶间动脉(IRA)血流频谱,测量收缩期峰值血流速度(VS)、舒张期末血流速度(VD)、平均血流速度(VM)、搏动指数(PI)、阻力指数(RI)值。选取肾脏的大小、实质回声、血流灌注的程度及RI值的范围为量化指标,并赋予相应的分值。结果分数在4~12之间,阴虚燥热证可能性高;分数在12~20之间,气阴两虚证可能性高;分数在20~28之间,阴阳两虚证可能性高;分数在28~32之间,阳衰瘀阻证可能性高。结论CDFI部分指标的量化可以用来作为对DN中医证候诊断量表的一部分,为DN中医证候的客观化研究提供新的思路。
Objective To discuss the establishment of TCM syndrome diagnosis scale of diabetic nephropathy (DN) through the quantification of some indicators of color Doppler (CDFI). Methods 489 patients with DN were selected. First of all, the size and the real echo of the kidneys of DN were observed by two-dimensional images. Then the degree of renal perfusion was observed by CDFI. Then the renal artery (RA), inter-segmental arteries (SRA) (IR), peak systolic velocity (VS), end diastolic velocity (VD), mean flow velocity (VM), pulsatility index (PI) and resistance index (RI) were measured. Select the size of the kidney, the real echo, the degree of perfusion and RI range of quantitative indicators, and give the appropriate score. The results score between 4 to 12, yin deficiency heat syndrome is highly likely; score 12 to 20, the possibility of Qi and Yin Deficiency; high scores of 20 to 28, the possibility of Yin and Yang deficiency; Score between 28 and 32, the possibility of Yang stasis syndrome high probability. Conclusion The quantification of some indicators of CDFI can be used as a part of the diagnostic scale for TCM syndromes of DN and provide new ideas for the objective study of TCM syndromes of DN.