| Objectives: Clinical observations and analysis was carried out on 446 cases of diabetic patients by syndrome differentiation of traditional Chinese medicine (TCM) combined with color Doppler ultrasound diagnosis to explore the relevance between color Doppler ultrasound and syndrome differentiation of TCM in arterial disease in lower limbs of diabetic patients.Methods: According to syndrome differentiation of TCM, 446 cases of arterial disease in lower limbs of diabetic patients were divided into 143 cases of deficiency both in yin and blood, skin dystrophy (group A), among them, 81 were male and 62 were female, with an average age of 68±12; 118 cases of Qi deficiency and blood stasis, skin vessels and networks obstruction (group B), among them, 76 were male and 42 were female, with an average age of 69±11; 96 cases of Yin deficiency and blood stasis, toxin accumulation caused skin pruritus (group C), among them, 61 were male and 35 were female, with an average age of 70±10; 89 cases of damp-heat and blood stasis, skin tendon-bone toxin and corrosion (Group D), among them, 57 were male and 32 were female, with an average age of 69±11. American Acuson, aspen color Doppler ultrasound diagnosis device and 5 to 10 MHz high-frequency linear array probe with variable frequency were employed. Color Doppler Ultrasonography was performed on patients in the 4 groups. Patients took supine position, prone or sitting position. First, 2D ultrasound imaging was used to transversely measure the arterial diameter, and then color Doppler ultrasound was used to show the filling of blood. Pulsed Doppler sampling volume will be placed in the center part of vessel measurement point, the angle between the velocity and blood flow was less than 60°to obtain pulsed Doppler spectrum, and related hemodynamic parameters was measured. The imaging situation of 2D and color Doppler spectrum of the artery of lower limbs was observed. 3 repeats of measurement were conducted and the average was used for each data. SPSS12.0 statistical software was employed, measurement data was expressed asχ±s and adopted t-test.χ2 test was adopted for count data.Results: Intima of the artery in the lower limbs in group A had enhanced echoes, thickness, was rough with local plaques, 99.1% of the spectrum showed normal three-phase wave spectrum of the artery of lower limbs. The arterial lesion of lower limbs in Group B compared with group A: inside diameter reduced from the superficial femoral artery, there was significant difference in the reduction of inside diameter of the popliteal artery (P<0.01). The number of blood vessels, whose Doppler had a single peak, increased with significant difference (P<0.01). There was no significant difference in blood flow velocity between the two groups. In Group C compared with A, B group, the reduction of the inside diameter become obvious from the femoral artery (P<0.01), and the number of blood vessels showed Doppler with a single peak increased and the blood flow velocity decreased from the femoral artery with significant difference (P<0.01). 83 (8.6%) blood vessels were blocked and color blood flow imaging had no signal, and no spectrum was obtained. Intima of the artery of lower limbs of Group D was rough, and there were rarely normal endometrial surface. Compared with Group A and B, there was significant difference in the reduction of inside diameter of artery of lower limbs (P<0.01). Compared with group C, the reduction in the inside diameter of femoral artery was significant (P<0.01). And compared with A, B, C group, the blood vessel that the Doppler showed a single peak increased with significant difference (P<0.01). Compared with Group C, there was no significant difference in blood flow velocity between the two groups(P>0.05).Conclusions: Through observation on the syndromes divided by differentiation of syndrome of TCM, Color Doppler Ultrasonography revealed progressive aggravation of lesion in the following order of deficiency in both Yin and blood, skin dystrophy; Qi deficiency and blood stasis, skin vessels and networks obstruction; Yin deficiency and blood stasis, toxin accumulation caused skin pruritus; hot and humid Stasis, damp-heat and blood stasis, skin tendon-bone toxin and corrosion. The pathological changes in group A and B are mainly endometrial thickness, roughness and small plaque formation; pathological changes in group C and D are mainly blockage and the dynamic changes of flexibility of blood vessels, blood flow spectrum, blood flow velocity, etc. Syndrome differentiation of diabetic lower-extremity arterial disease has certain correlation with color Doppler ultrasound. |
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