彩色多普勒超声评价不同证型子宫肌瘤血流特征研究

Research on the Blood Flow Features of Hysteromyoma with Different TCM Syndrome Types Using Color Doppler Ultrasound Imaging

目的:探讨不同证型子宫肌瘤血流彩色多普勒超声声像图特征及其相关性,为中医证候诊断客观指标提供前期工作基础。方法:根据诊断和辨证标准纳入不同证型子宫肌瘤患者120例,采用彩色多普勒超声检测子宫肌瘤局部血流情况,采用统计学软件对不同证型子宫肌瘤血流特征及其相关性进行分析。结果:气滞血瘀、痰湿瘀结、瘀热交阻和气虚血瘀4证子宫肌瘤内部血流特征有区别,其中"周边环绕"以气虚血瘀证所占比例较大,"内部点状"则以气滞血瘀证、痰湿瘀结证所占比例较大,"内部杂乱"以瘀热交阻证所占比例较大。4种常见证型间血流特征构成比差异有统计学意义(P<0.05)。气滞血瘀证与瘀热交阻证、气虚血瘀证,痰湿瘀结证与瘀热交阻证,瘀热交阻证与气虚血瘀证的血流特征构成比差异均有统计学意义(P<0.05);气滞血瘀证与痰湿瘀结证、痰湿瘀结与气虚血瘀证差异无统计学意义(P>0.05)。不同中医证候动、静脉频谱和动脉收缩期峰值流速、舒张末期流速、阻力指数以及静脉流速有不同程度差异,但不同证候间差异均无统计学意义(P>0.05)。结论:子宫肌瘤不同中医证候在其内部及周边血流方面具有不同程度的特征。

Objective： To explore the characteristics and correlation of blood flow of hysteromyoma with different TCM syndrome types using color doppler ultrasound imaging, and to provide basis of early stage work for the objective index of TCM syndrome diagnosis. Methods： The 120 patients with hysteromyoma according to the diagnosis and the standard of syndrome differentiation of TCM syndromes were collected, local blood flow in hysteromyoma patients were detected by color doppler ultrasound, the blood flow characteristics and its correlation between common TCM syndromes of hysteromyoma were analyzed using statistical software. Results： Internal flow characteristics of hysteromyoma of qi stagnation and blood stasis, phlegm blood stasis, stagnation of blood stasis and heat, qi deficiency and blood stasis are different. Qi deficiency and blood stasis were accounted for a larger proportion of ＂surrounding＂. Qi stagnation and blood stasis, phlegm blood stasis were accounted for a larger proportion of ＂interior point＂. Blood stasis and heat was accounted for a larger proportion of stagnation of ＂internal clutter＂. There were significant differences in blood flow characteristics between the four types of Tra- ditional Chinese Medicine syndrome （P〈0.05）. There were significant differences in blood flow characteristics between qi stagnation and blood stasis, stagnation of blood stasis and heat and qi deficiency and blood stasis （P〈 0.05）. There were significant differences in blood flow characteristics between phlegm blood stasis and stagnation of blood stasis and heat （P〈0.05）. There were significant differences in blood flow characteristics between stagnation of blood stasis and heat and qi deficiency and blood stasis. There were no significant difference in blood flow characteristics between qi stagnation and blood stasis and phlegm blood stasis （P〉0.05）. There were no significant difference in blood flow characteristics between phlegm blood stasis and qi deficiency and blood stasis （P〉0.05）. In different TCM syndromes, the spectrum of arterial and venous spectrum, peak systolic velocity, end diastolic velocity, resistance index and venous flow velocity were different in different degrees, while there was no significant difference among the different syndromes （P〉0.05）. Conclusion： Different TCM syndromes of hysteromyoma have different characteristics in their intemal and peripheral blood flow.