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[肢体淋巴水肿的超声成像与中医证候的关系]

[Relationship between ultrasound imaging and traditional Chinese medicine syndrome in limb lymphedema].

作者信息

Liu Ming, Zhang Yue, Song Fu-chen, Cheng Zhi-xing

机构信息

Department of Peripheral Vascular Surgery, Affiliated Hospital, Shandong University of Traditional Chinese Medicine, Jinan 250011, Shandong Province, China.

出版信息

Zhong Xi Yi Jie He Xue Bao. 2009 May;7(5):418-21. doi: 10.3736/jcim20090504.

Abstract

OBJECTIVE

To study the correlation between traditional Chinese medicine (TCM) syndrome type and the ultrasound imaging changes in patients with limb lymphedema, and to provide evidence for TCM syndrome differentiation.

METHODS

Syndrome typing was done and ultrasonography was performed in 107 patients with limb lymphedema. The thickenings of derma, hypodermis and deep-fascia were measured. The ultrasound echo intensity and the morphology of the hypodermis were classified into five degrees according to the ultrasonogram. The ultrasound indexes in the limb lymphedema patients with different syndromes were compared, and the relationship between TCM syndromes and the ultrasound indexes was analyzed.

RESULTS

There were specific ultrasound image features in different TCM syndromes of limb lymphedema. The thickenings of derma, hypodermis and deep-fascia in the limb lymphedema patients with downward migration of damp-heat or phlegm stagnation and blood stasis were more significant than those in the patients with collateral obstruction due to cold-dampness (P<0.05, P<0.01). The thickenings of derma and hypodermis in the patients with phlegm stagnation and blood stasis were obviously more severe than those in the patients with downward migration of damp-heat (P<0.01). The maximum and minimum ultrasound echo intensities of hypodermis were in phlegm stagnation and blood stasis and downward migration of damp-heat respectively (P<0.05), and there was a significant difference in the hypodermal morphology among the three syndrome types (P<0.05). The most obvious structure disturbance was observed in the patients with phlegm stagnation and blood stasis syndrome.

CONCLUSION

TCM syndrome type of limb lymphedema is related to ultrasound image changes. The imaging data can be regarded as new objective indexes for TCM syndrome differentiation, and it has an important value for diagnosis and treatment of limb lymphedema.

摘要

目的

探讨肢体淋巴水肿患者中医证型与超声影像学改变的相关性,为中医辨证提供依据。

方法

对107例肢体淋巴水肿患者进行辨证分型并进行超声检查,测量皮肤、皮下组织及深筋膜厚度,根据超声图像将皮下组织回声强度及形态分为5度,比较不同证型肢体淋巴水肿患者的超声指标,分析中医证型与超声指标的关系。

结果

肢体淋巴水肿不同中医证型具有特定的超声图像特征。湿热下注或痰湿瘀阻型肢体淋巴水肿患者的皮肤、皮下组织及深筋膜增厚程度较寒湿阻络型患者更显著(P<0.05,P<0.01)。痰湿瘀阻型患者的皮肤及皮下组织增厚程度明显重于湿热下注型患者(P<0.01)。皮下组织超声回声强度最大值和最小值分别出现在痰湿瘀阻型和湿热下注型患者中(P<0.05),三种证型的皮下组织形态存在显著差异(P<0.05)。痰湿瘀阻证患者的结构紊乱最为明显。

结论

肢体淋巴水肿的中医证型与超声图像改变相关。影像学数据可作为中医辨证的新客观指标,对肢体淋巴水肿的诊断和治疗具有重要价值。

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