糖尿病视网膜病变中医证型与眼底分级的关系探讨  

Relationship investigation of TCM syndrome type and fundus grading in DR

作　　者：徐艳[1] 杨小生[1] 顾光霞[1] 

机构地区：[1]洛阳市疾病预防控制中心,河南洛阳471000

出　　处：《中医临床研究》2014年第4期9-12,共4页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨糖尿病视网膜病变(DR)中医证型与眼底分级的对应关系,为DR的中医辨证论治提供客观依据。方法:对275例DR患者行眼底血管荧光素造影(FFA),同期进行中医辨证分型,采用简单对应分析(Correspondence analysis)探讨二者之间的关系。结果:①FFA显示轻、中、重度非增殖性视网膜病变(NPDR)分别是71例、65例和64例。中医辨证为阴虚内热证型69例、气阴两虚型61例、瘀血阻滞型67例、阴阳两虚型78例。②不同中医证型的DR分级构成不同,差异有统计学意义,x2=105.992,P=0.000。③对应分析显示:阴虚内热型的点集合投影几乎重叠于轻度NPDR的点集合投影;气阴两虚型的点集合与中、重度NPDR的点集合靠近,阴阳两虚型的点集合与增殖性视网膜病变(PDR)的点集合最近,瘀血阻滞型的点集合没有显示与DR某一分级的紧密关系。结论:随着DR程度由轻、中、重度NPDR→PDR的演变,中医证型也呈现由阴虚→气虚→阳虚的证候变化,而瘀血阻滞的病理改变贯穿于DR的全过程。Objective：To investigate the relationship between TCM syndrome type and fundus grading in diabetic retinopathy （DR）, provide an objective basis for TCM differentiation treatment of DR. Methods： 275 patients with DR was performed fundus fluorescein angiography （FFA）, concurrent TCM differentiation typing, using correspondence analysis to explore the relationship between the two. Results： ①FFA display mild, moderate and severe non proliferative diabetic retinopathy （NPDR） were 71 cases, 65 cases and 64 cases. TCM differentiation typing for Yinxu Neire type 69 cases, Qiyin Liangxu type 61 cases, Yuxue Zuzhi type 67 cases, Yinyang Liangxu type 78 cases. ②Different syndrome types DR classification were different, there was statistically significant difference, x2=105.992, P=0.000.③Correspondence analysis showed：Point set projections of Yinxu Neire type almost overlap in that of mild NPDR. Point set projections of Qiyin Liangxu type closest with that of moderate and severe NPDR. Point set projections of Yinyang Liangxu type closest with that of PDR. Point set projections of Yuxue Zuzhi type does not show a close relationship with DR grading. Conclusion：With DR extent by the mild, moderate and severe NPDR→PDR evolution, TCM types also presents Yinxu→Qixu→Yangxu changes, pathological changes of Yuxue Zuzhi throughout the whole process of DR.

关 键 词：糖尿病视网膜病变 中医证型 眼底分级 对应分析 

分 类 号：R587.1[医药卫生—内分泌]