糖尿病性聋中医不同证型血液流变学的改变及辨证论治疗效观察

Effect of syndrome differentiation treatment for diabetic deafness and the change of blood rheology of traditional Chinese medicine syndrome types of diabetic deafness

目的观察糖尿病性聋中医不同证型血液流变学的改变及辨证论治疗效。方法选取153例糖尿病性聋患者为观察组研究对象,根据中医证型不同分为3组,阴虚热盛证组(n=54),气阴两虚证组(n=50)及阴阳两虚证组(n=49),另选取50例糖尿病性聋患者为对照组。观察组分别给予中医辨证治疗,对照组给予西医治疗,比较观察组不同证型血液流变学指标的变化,并评定各组疗临床疗效。结果阴虚热盛证组全血黏度(高切)、全血黏度(低切)、血浆比黏度、红细胞比容和全血还原黏度均低于气阴两虚证组和阴阳两虚证组(均P<0.05)。气阴两虚证组和阴阳两虚证组血液流变学各项指标比较差异无统计学意义(P>0.05)。阴虚热盛证组总有效率61.11%,气阴两虚证组总有效率60.0%,阴阳两虚证组总有效率65.31%,均高于对照组(22.0%,均P<0.05)。阴虚热盛证组、气阴两虚证组和阴阳两虚证组3组总有效率比较差异无统计学意义(均P>0.05)。结论阴虚热盛证患者多为糖尿病早期阶段,血液流变学指标异常变化轻于气阴两虚证组和阴阳两虚证组。中医分型辨证治疗糖尿病性聋患者,症状改善以及听力恢复效果优于西药治疗。

Objective To observe the change of blood rheology of Traditional Chinese Medicine syndrome types of diabetic deafness and the effect of syndrome differentiation treatment for diabetic deafness.Methods 153 cases of patients with diabetic deafness were selected as the research object of the observation group and were divided into three groups according to Traditional Chinese Medicine syndrome types,which were the deficiency of yin and excessive heat syndrome group（n=54）,the deficiency of both qi and yin group（n= 50） and the yin-yang deficiency group（n= 49）.And the other 50 cases of patients with diabetic deafness were selected for the control group.Then the difference group patients given the Chinese medicine diagnosis and treatment and western medicine therapy,the effect of four groups and the change of blood rheology of Traditional Chinese Medicine syndrome types of diabetic deafness were compared.Results The whole blood high shear viscosity,the low shear blood viscosity,the plasma viscosity,the hematocrit and the whole blood restore viscosity in the deficiency of yin and excessive heat syndrome group were lower than those in the deficiency of both qi and yin group and the yin-yang deficiency group,the comparative differences were significant（all P0.05）.The difference between the deficiency of both qi and yin group and the yin-yang deficiency group were not significant（all P0.05）.The total effective rate of the deficiency of yin and excessive heat syndrome group was 61.11%,of the deficiency of both qi and yin group was 60.0%,and of the yin-yang deficiency group was 65.31%,which were higher than that of the control group was 22.0%,the comparative differences were significant（all P0.05）,but the difference among the deficiency of yin and excessive heat syndrome group,the deficiency of both qi and yin group and the yin-yang deficiency group were not significant（all P0.05）.Conclusion The deficiency of yin and excessive heat syndrome is diabetes early stage,which the abnormal changes of hemorheology indices are lighter than those of the deficiency of both qi and yin syndrome and the yin-yang deficiency syndrome.Of the traditional Chinese medicine diagnosis and treatment for diabetic deafness patients,the improvement of symptoms and hearing restored effect are better th an that of western medicine.