Clinical Research Of T2DM With Macroangiopathy TCM Syndrome Differentiation And ABI

Objective:To discuss the relationship between differentiation of symptoms and signs for classification of syndrome of traditional Chinese medicine, ABI and clinical symptoms in patients with T2DM. To evaluate the significance of different ABI values in the assessment of diabetic macroangiopathy.Method:Select 120 patients with T2DM who attend the incretion section, in-patient department of our hospital from March,2009 to November,2009. The patients are in line with WHO diagnostic criteria for diabetes,1999 . Among them,90 cases met the diagnostic criteria of diabetic macroangiopathy:patients with Typeâ…¡diabetes were diagnosed suffering from coronary artery disease (angina,myocardial infarction), ischemic cerebrovascular disease, membrum inferius arterial vasculopathy, exclusion of diabetic microangiopathy such as retinopathy, renal lesions, etc.. The other 30 patients with type 2 diabetes kept as the control group were excluded from macroangiopathy and microangiopathy. Carry out traditional Chinese medicine differentiation of symptoms and signs for classification of syndrome. According to the " guidelines to the clinical research of New Chinese medicine in the treatment of Diabetes ", the patients were divided into extreme heat with yin asthenia group,deficiency of both vital energy and yin section,deficiency of both yin and yang group. Inquire the patient history detailed,carry through physical examination, and complete the score list of clinical symptom. Determine the ABI by ES-1000SPM Doppler flow inaging detector. Employ the colored Doppler ultrasonic diagnostic apparatus made in the US-- Agilenl and Logic7 to check the blood vessels of both lower extremities, and the frequency of the transducer is 5.0-10.0MHz.Observation content:â‘ The dependablity of ABI and clinical symptom in patients with T2DM;â‘¡The coincidence of diffreent ABI values and color Doppler ultrasound in the diagnosis of diabetic macroangiopathy, macrovascular compliance rate;â‘¢The correlation of traditional Chinese medicine differentiation of symptoms and signs for classification of syndrome and ABI in patients with T2DM. The observed results were statistically analyzed with SPSS13.0.Result:â‘ The ABI and clinical symptom in patients with T2DM: There are differences in ABI between the severe symptom group, the asymptomatic group, the mild symptom group and the moderate symptom group (P<0.01, P<0.01, P<0.05); differences in ABI between the asymptomatic group and the moderate symptom group (P<0.05). With the aggravation of clinical symptoms, ABI showed a gradual decrease in features. There are 18 patients with diabetic macroangiopathy in the asymptomatic group.â‘¡The diagnose accordance rate of diffreent ABI values and color Doppler ultrasound:The maximum diagnose accordance rate is 85.8% in assessing the diabetic macroangiopathy and color Doppler ultrasound when setting ABI<0.95 as a standard. The corresponding diagnose accordance rate of ABI<0.8, ABI<0.85 and ABI<0.9 is 48.2%,60.0%,78.8%.â‘¢The traditional Chinese medicine differentiation of symptoms and signs for classification of syndrome and ABI in patients with T2DM: The lowest ABI occurrs in the deficiency of both yin and yang group in traditional Chinese medicine differentiation of symptoms and signs for classification of syndrome. From the extreme heat with yin asthenia group to deficiency of both vital energy and yin group, and to the asthenia of both yin and yang group, the ABI presents a tendency of gradually decrease. We can find that there are statistically differences between the deficiency of both yin and yang group and the extreme heat with yin asthenia group by Comparing the ABI of each group(P<0.001).Conclusion:1. ABI was negatively correlated with the clinical symptoms, and there are significant diffferences in different clinical symptom groups.2. ABI shows a high screening rate in determing macroangiopathy, and a high diagnose accordance rate with lower extremit color Doppler ultrasound when ABI<0.95, and is worth to be generalized as a non-invasive, convenient and reliable screening method.3. From extreme heat with yin asthenia Group to deficiency of both vital energy and yin Group,and asthenia of both yin and yang group,the gradually decrease of ABI is concord with the progression of disease, and the lowest ABI occurs in the deficiency of both yin and yang group.