摘要
目的:观察2型糖尿病肾病(diabetes nephropathy,DN)肾脏二维声像图表现与中医证型的相关性,为制定中西医结合诊治方案提供科学依据。方法:选择DN患者489例,正常对照组50例。采用二维超声观察肾脏的大小及实质的回声。结果:①随着疾病证候的转变,彩色多普勒观察到的肾脏体积存在不同的表现:阴虚燥热证,部分患者肾脏体积可增大,部分体积正常,与正常组比较,差异无统计学意义(P>0.05);气阴两虚患者肾脏体积基本正常,与正常组比较,差异无统计学意义(P>0.05);阴阳两虚证、阳衰瘀阻证,肾脏体积逐渐缩小,与正常组比较,差异有统计学意义(P<0.05,P<0.01);与阴虚燥热证、气阴两虚证组比较,差异有统计学意义(P<0.05,P<0.01);②不同证候超声观察到的肾实质回声也存在不同表现,与中医证候之间亦存在相关性:经Ridit分析,R阳衰瘀阻>R阴阳两虚>R气阴两虚>R阴虚燥热,各组间比较差异有统计学意义(P<0.05);中医各证型与肾实质改变的分级亦存在相关性,经Kappa检验,阴虚燥热证与Ⅰ级对比:K=0.696,一致性高度;气阴两虚证与Ⅱ级对比:K=0.594,一致性中度;阴阳两虚证与Ⅲ级对比:K=0.751,一致性高度;阳衰瘀阻证与Ⅳ级对比:K=0.932,一致性极强。结论:DN的二维超声表现与中医证候分布有一定的相关性,可作为其诊断分型的客观指标之一。
Objective：2D sonographic changes were observed in type 2 diabetic nephropathy （DN） of the kidney with TCM-re- lated,to provide a scientific basis for the development of diagnosis and treatment of Integrative Medicine program. Methods：Se- lect the DN patients with 489 cases, 50 cases of normal control group. The size and real echo of the kidney were observed by two-dimensional ultrasound. Resuits With the shift of disease syndromes, different syndromes had different performance of the observed color Doppler kidney volume：Yin hot license, some patients with kidney volume can be increased, normal part of the volume,compared with the normal group, the difference was not significant （P〈0.05）. Basically normal Qiyinliangxu pa- tients with kidney volume compared with normal group,the difference was not significant （P〉0.05）. Yin and Yang deficiency, yang decline stasis, kidney volume gradually reduced, with the normal group difference significant or very significant （P〈0.05, P〈0.01）, permit Yin hot the Qi Deficiency group, a significant or very s ignificant（P〈0.05, P〈0.01）; TCM syndromes, different syndromes ultrasound observation to renal parenchymal echo different performance, and there was also a correlation between TCM syndrome： analysis by Ridit, R Yang decline stasis〉R yin and yang〉 R Qiyinliangxu〉R Yin hot, among the three groups was significantly different （P〈0. 05） ; TCM syndromes of renal parenchyma changes and the DN of different clas- sification stage （ Ⅰ -Ⅱ-Ⅲ-Ⅳ grade） also showed a correlation. By the Kappa test; Yin hot certificate level I compared：Kappa= 0. 696, consistency height; the Qi Deficiency grade Ⅱ contrast：Kappa= 0. 594 ,consistency moderate; yin and yang deficiency of both the contrast level . Kappa = 0.751, consistent height the Yang decline stasis gradeⅣ contrast： Kappa = 0. 932, consis- tency strong. Conclnsion：DN dimensional ultrasound changes has some correlation with the distribution of syndrome,and could be one of the objective indicators of diagnostic classification.
出处
《中国中西医结合影像学杂志》
2014年第1期7-9,共3页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
湖北省卫生厅科研计划课题(鄂卫发[2008]Z-Y16号)
关键词
糖尿病肾病
超声检查
医学
中国传统
Diabetic nephropathies
Ultrasonography
Medicine, Chinese traditional
