【摘要】 目的探讨计算机辅助对冲技术测定运动神经传导速度分布(CVD)在糖尿病周围神经病变(DPN)中的诊断价值,并探讨其与中医证候特征之间的关系。方法纳入148例2型糖尿病患者,采用计算机辅助对冲技术测定CVD,与常规神经传导速度(NCV)检测进行比较;并进行中医证候归类、5级计分法量化评分和相关实验室检查。结果CVD异常率为86.1%,较同步检测的MCV、SCV异常率高(P<0.01);病程、餐后2小时血糖是CVD异常的独立危险因素;CVD各频纤维传导速度与血糖呈负相关。中医证候中阴虚证、血瘀证所占比例>50%;病程长者阳虚比重显著增加(P<0.05);>60岁组阳虚、血瘀证候所占比例较高,阳虚积分显著高于≤60岁组(P<0.01)。阳虚、血瘀、痰湿3种证候积分值越高,CVD异常的危险性越大。结论计算机辅助对冲技术测定CVD的敏感性高于NCV,是一种DPN早期诊断的有效手段;病程、血糖是DPN患者CVD异常的独立危险因素;阳虚、血瘀和痰湿3种证候及其病变程度对CVD检测结果有一定影响。更多还原

【Abstract】 Objective To discuss the evaluation value of conduction velocity distribution (CVD) test with computer-assisted collision technique in diabetic peripheral neuropathy patients and its relationship with TCM syndromes. Methods Totally 148 patients with diabetes Ⅱ were selected to receive CVD test and were compared with NCV test. Furthermore they were classified into TCM syndromes, given score in 5 grades and given the related lab tests. Results The rate of CVD abnormality was 86.1%, which was remarkably higher than MCV or SCV test synchronously (P<0.01). The course and 2hPBG were the independent risk factors for CVD abnormality. There was a negative correlation between blood sugar and motor nerve conduction velocities. The frequency of Yin-deficiency syndrome and blood-stasis syndrome was more than 50%. The proportion of Yang-deficiency arose in the longer-course group (P<0.05). Besides, the proportion of Yang-deficiency syndrome and blood-stasis syndrome were significantly higher in the group aged>60 than in the group aged≤60(P<0.01). The risk of CVD abnormality increased as the scores of Yang-deficiency, blood-stasis and phlegm-damp upgraded. Conclusion CVD test with computer-assisted collision technique is more sensitive than NCV test and can serve as an early and effective index for evaluation of DPN. The course and blood glucose are the independent risk factors for CVD abnormality. Yang-deficiency, blood-stasis and phlegm-damp syndromes have certain effects on the parameters of CVD.更多还原