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目的:探讨彩色B超在2型糖尿病伴冠心病中医辨证分型中的应用价值。方法:选择在本院就诊的100例2型糖尿病伴冠心病患者,采用中医辨证分型分为气虚痰瘀组38例、气阴两虚组29例、阳虚血瘀组33例,同时选择30例健康人为对照组。所有患者采用彩色B超检查左室舒张功能,测定并比较心室舒张早期血流峰值速度(E)、舒张晚期血流峰值速度(A)、E/A及心室等容舒张时间(IVRT)。结果:4组间E、A、E/A、IVRT值变化不全相等,各指标整体比较,差异均有统计学意义(P<0.01)。气阴两虚组、气虚痰瘀组及阳虚血瘀组的E值、E/A值均较对照组下降(P<0.05,P<0.01),3组中气阴两虚组的下降幅度最大,与其余2组比较,差异均有统计学意义(P<0.05,P<0.01)。气阴两虚组、气虚痰瘀组及阳虚血瘀组的A值、IVRT值均较对照组上升和增加(P<0.05,P<0.01),3组中气阴两虚组的上升、增加幅度最大,与其余2组比较,差异均有统计学意义(P<0.05)。结论:采用彩色B超检测2型糖尿病伴冠心病患者的左室舒张功能能为中医辨证分型提供重要的依据。
Objective: To explore the value of color B ultrasound in type 2 diabetes mellitus with syndrome differentiation of coronary heart disease. Methods: One hundred patients with type 2 diabetes mellitus with coronary heart disease who were treated in our hospital were selected and divided into three groups according to TCM syndrome differentiation: 38 cases of qi deficiency and phlegm and blood stasis group, 29 cases of qi and yin deficiency group and 33 cases of yang deficiency and blood stasis group. 30 healthy people as control group. All patients underwent color B ultrasound examination of left ventricular diastolic function, determination and comparison of early ventricular diastolic peak flow velocity (E), late diastolic peak flow velocity (A), E / A and ventricular isovolumic relaxation time (IVRT). Results: The changes of E, A, E / A and IVRT were not equal among the four groups. There was significant difference between the indexes of the four groups (P <0.01). The values of E and E / A in Qi and Yin Deficiency group, Qi deficiency and phlegm and blood stasis group and Yang deficiency and blood stasis group were lower than those in control group (P <0.05, P <0.01) Maximum, compared with the other two groups, the differences were statistically significant (P <0.05, P <0.01). The values of A and IVRT in Qi and Yin Deficiency, Qi Deficiency and Phlegm and Blood Stasis groups were all higher than those in control group (P <0.05, P <0.01) The largest increase, compared with the other two groups, the difference was statistically significant (P <0.05). Conclusion: The detection of left ventricular diastolic function in patients with type 2 diabetes mellitus with coronary heart disease by color B-ultrasound can provide important evidence for TCM syndrome differentiation.