血管内皮功能与糖尿病肢体动脉闭塞症中医辨证关系的研究

doi:10.3736/jcim20070604

Abstract

：Objective: To investigate the relationship between syndrome differentiation of traditional Chinese medicine (TCM) and characteristic changes of vascular endothelial function in patients with diabetic arterial occlusion (DAO) of lower extremities.Methods: Forty patients with DAO were selected as trial group. Twenty patients among them were attributed to blood stasis syndrome (group A₁), and the others were attributed to syndrome of pathogenic dampness-heat attacking the lower limb (group A₂) according to syndrome differentiation type of TCM. Patients with diabetes (group B), arteriosclerosis obliterans (group C) and healthy people (group D) were observed as the control groups, respectively. There were 20 cases in each group. Endothelium-dependent dilation (EDD) and endothelium-independent dilation (EID) were measured by high resolution ultrasound in the 100 subjects and the changes of vascular tension factors were also studied. Results: The results showed that EDD in group A was reduced significantly as compared with that in the groups B, C and D. The levels of vascular contractile factors such as endothelin-1 (ET-1) and thromboxane B2 (TXB2) in group A were higher than those in the groups B, C and D, while the levels of vascular dilatory factors such as nitric oxide (NO) and 6-keto-prostaglandin F1α (6-Keto-PGF_1α) were declined significantly as compared with those in the groups B and D. Linear correlation analysis showed that EDD was correlated positively with the levels of NO and 6-Keto-PGF_1α, while the levels of ET-1 and TXB₂ had negative correlation with EDD. EDD and EID in group A₂ were declined significantly as compared with those in group A₁.Conclusion: Our findings indicate that endothelial dysfunction may play an important role in the pathogenesis of DAO and may be associated with syndrome differentiation of TCM.

Key words: diabetic angiopathies, blood vessels, endothelium, syndrome differentiation, ultrasonography

CLC Number:

R587.25

Lian-qing Sun, Yan Yang, Wei Zheng. Relationship between syndrome differentiation of traditional Chinese medicine and vascular endothelial function in patients with diabetic arterial occlusion of lower extremities. Journal of Chinese Integrative Medicine, 2007, 5(6): 621-624.

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URL: http://www.jcimjournal.com/EN/10.3736/jcim20070604

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[1]	中国中西医结合学会周围血管疾病专业委员会. 糖尿病肢体动脉闭塞症诊断及疗效标准(草案)[J]. 中国中西医结合外科杂志, 2003,9(6):150-151
	China Society of Integrated Traditional Chinese and Western Medicine , Committee of Peripheral Vascular Disease. Programme of criteria for diagnosis and therapeutic effects of diabetic arterial occlusion of lower extremities[J]. Zhongguo Zhong Xi Yi Jie He Wai Ke Za Zhi, 2003,9(6):150-151
[2]	钱荣立 . 关于糖尿病的新诊断标准与分型[J]. 中国糖尿病杂志, 2000,8(1):5-6
	Qian RL . New criteria of diagnosis and typing of diabetes mellitus[J]. Zhongguo Tang Niao Bing Za Zhi, 2000,8(1):5-6
[3]	陈柏楠, 侯玉芬, 周涛 . 周围血管疾病中西医诊疗学[M]. 北京: 中国中医药出版社,1999,(): 270
	Chen BN, Hou YF , Zhou T.Peripheral vascular disease with Chinese and Western medicine[M].Beijing: China press of Traditional Chinese Medicine, 1999,(): 270
[4]	Celermajer DS, Sorensen KE, Gooch VM , et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis[J]. Lancet, 1992,340(8828):1111-1115

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Group	n	Age (year)	SBP (mmHg)	DBP (mmHg)	TC (mmol/L)	TG (mmol/L)	FBG (mmol/L)
A₁	20	66.80±9.96	148.31±12.72**	95.12±6.49**	5.31±0.92*	1.44±0.53	8.86±3.26^**△△
A₂	20	67.05±8.34	154.14±9.63**	96.73±7.21**	5.58±1.23*	1.53±0.67	8.67±4.32^**△△
B	20	65.10±9.47	143.53±11.41**	91.38±8.63**	5.29±0.87*	1.37±0.71	11.63±3.79^**△△
C	20	65.32±8.77	151.67±10.88**	93.27±5.84**	5.41±1.02*	1.42±0.63	5.05±1.26
D	20	64.10±8.96	122.04±11.37	74.89±5.28	4.72±0.76	1.36±0.56	4.67±0.76

Group	Diameter (mm)	EDD (%)	EID (%)
A₁	4.04±0.39	6.22±1.27**^{△ △▲▲}	12.85±1.19
A₂	4.02±0.41	4.02±2.35**^{△△▲▲ □□}	9.07±6.36**^{△ △ ▲▲ □□}
B	3.95±0.42	9.01±1.12*	14.56±2.34
C	3.99±0.40	8.42±1.73**	14.94±1.95
D	4.01±0.35	10.58±2.92	15.17±2.71

Group	NO (μmol/L)	TXB2 (ng/L)	k-Keto-PGF1α (ng/L)	ET-1 (ng/L)
A₁	63.54±9.45**^▲	97.54±10.93** ^▲▲	63.21±5.76** ^▲▲	74.10±11.49**^▲
A₂	57.17±8.45**^{△△▲▲□□}	106.19±14.46* * ^{△▲▲□□}	59.52±7.72* *^▲▲	88.27±14.79** ^{△▲▲ □□}
B	69.98±6.16*^△	88.26±9.28** ^△△	70.04±6.27**^△	66.25±10.01**^△△
C	62.91±10.63* *	95.66±11.79**	64.33±8.14**	77.86±14.31* *
D	74.91±6.69	76.71±9.11	77.24±6.27	53.93±8.34

Relationship between syndrome differentiation of traditional Chinese medicine and vascular endothelial function in patients with diabetic arterial occlusion of lower extremities

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