2型糖尿病中医证型与临床生化指标相关性分析
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摘要
目的:分析2型糖尿病患者中医证型与相关临床生化指标的关系。方法:对广州市中医院内分泌科住院的113例2型糖尿病患者的相关资料进行回顾分析和整理,记录一般情况(性别、年龄、病程)及中医证型、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、C-反应蛋白(CRP)、血尿酸(UA),并比较分析各证型与临床生化指标的相关性。结果:2型糖尿病患者中医证型分布依次为:湿热困脾证>阴虚内热证>气阴两虚证>阴阳两虚证。各证型的HbA1c比较,阴阳两虚证的HbA1c明显高于其他证型,差异有统计学意义(P<0.01);与其他中医证型比较,阴阳两虚证TC、TG高于其他中医证型,差异有统计学意义(P<0.05);湿热困脾证、阴虚内热证CRP高于其他证型,差异有统计学意义(P<0.05);与其他中医证型比较,阴阳两虚证UA高于其他证型,差异有统计学意义(P<0.05)。结论:2型糖尿病辨证分型以湿热困脾证为主,TC、TG、HbA1c、CRP、UA指标在一定程度上可以反映2型糖尿病中医证型的变化。
Objective:To analyze the relationship between TCM syndromes and related clinical biochemical indexes in patients with type 2 diabetes. Methods:Retrospective analysis and collation of 113 cases of type2 diabetes patients hospitalized in the department of endocrinology,Guangzhou Hospital of Traditional Chinese Medicine,recorded general conditions(gender,age,course of disease),TCM syndrome,glycosylated hemoglobin(HbA1 c),total cholesterol(TC),triacylglycerol(TG),C-reactive protein(CRP),blood uric acid(UA),and the correlation between each syndrome and clinical biochemical indexes were compared. Results:The distribution of TCM syndromes in patients with type 2 diabetes from high to low was as follows:dampness-heat encumbering spleen syndrome,yin deficiency and internal heat syndrome,qi and yin deficiency syndrome,yin and yang deficiency syndrome. Compared with other syndrome types,HbA1 c in yin and yang deficiency syndrome was signifi cantly higher than that in other syndromes,and the difference was statistically significant(P< 0.01). Compared with other TCM syndrome types,TC and TG in yin and yang deficiency syndrome were higher than those in other TCM syndromes,the difference was statistically significant(P< 0.05). The CRP in dampness-heat encumbering spleen syndrome and yin deficiency and internal heat syndrome was higher than those in other syndromes,and the difference was statistically significant(P< 0.05).Compared with other TCM syndromes,UA in yin and yang deficiency syndrome was higher than that in other TCM syndromes,and the difference was statistically significant(P< 0.05). Conclusions:TCM syndrome differentiation of type 2 diabetes patients is mainly characterize d by dampness-heat encumbering spleen syndrome. The levels of TC,TG,HbA1 c,CRP and UA can reflect the changes of TCM syndromes in patients with type 2 diabetes to some extent.
Objective:To analyze the relationship between TCM syndromes and related clinical biochemical indexes in patients with type 2 diabetes. Methods:Retrospective analysis and collation of 113 cases of type2 diabetes patients hospitalized in the department of endocrinology,Guangzhou Hospital of Traditional Chinese Medicine,recorded general conditions(gender,age,course of disease),TCM syndrome,glycosylated hemoglobin(HbA1 c),total cholesterol(TC),triacylglycerol(TG),C-reactive protein(CRP),blood uric acid(UA),and the correlation between each syndrome and clinical biochemical indexes were compared. Results:The distribution of TCM syndromes in patients with type 2 diabetes from high to low was as follows:dampness-heat encumbering spleen syndrome,yin deficiency and internal heat syndrome,qi and yin deficiency syndrome,yin and yang deficiency syndrome. Compared with other syndrome types,HbA1 c in yin and yang deficiency syndrome was signifi cantly higher than that in other syndromes,and the difference was statistically significant(P< 0.01). Compared with other TCM syndrome types,TC and TG in yin and yang deficiency syndrome were higher than those in other TCM syndromes,the difference was statistically significant(P< 0.05). The CRP in dampness-heat encumbering spleen syndrome and yin deficiency and internal heat syndrome was higher than those in other syndromes,and the difference was statistically significant(P< 0.05).Compared with other TCM syndromes,UA in yin and yang deficiency syndrome was higher than that in other TCM syndromes,and the difference was statistically significant(P< 0.05). Conclusions:TCM syndrome differentiation of type 2 diabetes patients is mainly characterize d by dampness-heat encumbering spleen syndrome. The levels of TC,TG,HbA1 c,CRP and UA can reflect the changes of TCM syndromes in patients with type 2 diabetes to some extent.
引文
[1]钱虹,陆锐明.糖尿病的研究现状及进展[J].医学综述,2015,21(13):2418-2420.
[2]唐湘.阿托伐他汀改善糖尿病血糖代谢的机制[J].中医临床研究,2010,2(17):27-28.
[3]邬丹,刘宏,李申恒.尿酸与2型糖尿病代谢紊乱及危险因素分析[J].南方医科大学学报,2011,31(3):544-547.
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[10]尹德海,梁晓春,朴元林,等. 2型糖尿病患者中医证型分析及其与糖尿病慢性并发症关系的探讨[J].中国中西医结合杂志,2009,29(6):506-510.
[11]孙海鹏. 2型糖尿病中医证型与胰岛素抵抗和胰岛素β细胞功能相关性研究[J].河北中医药学报,2011,26(4):14-15.
[12]许宋超,王纯庠,陆件. 2型糖尿病患者中医证型与血糖波动的相关性分析[J].中国现代医药杂志,2015,17(8):37-40.
[13]李文明,于超,余雪梅,等.糖尿病患者血糖控制与血脂的关系[J].中国生化药物杂志,2015,35(2):126-129.
[14]柳红芳,王皓,胡照娟. 2型糖尿病中医体质与肥胖、血脂、血凝指标的相关性分析[J].北京中医药大学学报,2011,34(10):702-706.
[15]陈璐,孙伯欣.糖化血红蛋白与血脂检测在2型糖尿病检测中的临床评价[J].中国老年学杂志,2013,33(19):4856-4857.
[16]戴鹏,戴友平,刘福明.血管炎性因子与冠心病关系的临床研究[J].长春中医药大学学报,2011,27(2):272-273.
[17] GOLDFINE A B,LEE J,SHOELSON S E. Inflammationand insulin resistance[J]. The Journal of Clinical Inves-tigation:the Official Journal of the American Society forClinical Investigation,2006,116(7):1793-1801.
[18]李慧,邹大进. 2型糖尿病及肥胖与慢性炎症因子[J].第二军医大学学报,2003,24(11):1244-1246.
[19]赵英娟,贺学魁. 2型糖尿病病人中医证型与临床指标的相关性分析[J].中西医结合心脑血管病杂志,2016,14(8):809-811.
[20]郑峰,曲丹,徐浩,等.冠心病稳定期患者中医辨证与超敏C反应蛋白相关性研究[J].中国中西医结合杂志,2009,29(6):485-488.
[21]朱辟疆,周逊,赵华,等.慢性肾功能衰竭微炎症状态与中医证型关系研究[J].现代中西医结合杂志,2008,17(5):652-654.
[22]周先锋,阮晓楠,于思雨,等.血清C反应蛋白与糖尿病发病风险的关系[J].中华糖尿病杂志,2017,9(2):106-111.
[23]马长青,玉山江,王先敏,等. 2型糖尿病合并高尿酸血症的中医证型与HCY和CRP的相关性研究[J].医学研究杂志,2010,39(2):31-34.
[24]吴凯,陈晓平,高音,等.血清尿酸对2型糖尿病预测价值的分析[J].中华流行病学杂志,2011,32(11):1153-1157.
[25]李中南,张进军,赵华,等.糖尿病患者高尿酸血症的发生及对相关疾病的影响[J].中国临床保健杂志,2010,13(6):574-576.
[2]唐湘.阿托伐他汀改善糖尿病血糖代谢的机制[J].中医临床研究,2010,2(17):27-28.
[3]邬丹,刘宏,李申恒.尿酸与2型糖尿病代谢紊乱及危险因素分析[J].南方医科大学学报,2011,31(3):544-547.
[4] RONNEMAA T,LEHTO S,LAAKSO M,et al. Serum uricacid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus[J]. 1998,29(3):635-639.
[5]陈燕,陆帅,邢寅,等. 1626例糖尿病患者血尿酸水平及相关危险因素分析[J].齐齐哈尔医学院学报,2007,28(9):1028-1030.
[6]陆付耳.对2型糖尿病发病环节的再认识及中医治疗的对策探讨[J].实用医院临床杂志,2014,11(1):43-45.
[7]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国医学前沿杂志(电子版),2015,7(3):26-89.
[8]中华中医药学会.中医内科常见病诊疗指南[J].中医药导报,2008,14(8):51.
[9]仝小林,毕桂芝,甄仲,等. 2518例肥胖2型糖尿病中医证型分类研究[J].世界中西医结合杂志,2008,3(1):26-28.
[10]尹德海,梁晓春,朴元林,等. 2型糖尿病患者中医证型分析及其与糖尿病慢性并发症关系的探讨[J].中国中西医结合杂志,2009,29(6):506-510.
[11]孙海鹏. 2型糖尿病中医证型与胰岛素抵抗和胰岛素β细胞功能相关性研究[J].河北中医药学报,2011,26(4):14-15.
[12]许宋超,王纯庠,陆件. 2型糖尿病患者中医证型与血糖波动的相关性分析[J].中国现代医药杂志,2015,17(8):37-40.
[13]李文明,于超,余雪梅,等.糖尿病患者血糖控制与血脂的关系[J].中国生化药物杂志,2015,35(2):126-129.
[14]柳红芳,王皓,胡照娟. 2型糖尿病中医体质与肥胖、血脂、血凝指标的相关性分析[J].北京中医药大学学报,2011,34(10):702-706.
[15]陈璐,孙伯欣.糖化血红蛋白与血脂检测在2型糖尿病检测中的临床评价[J].中国老年学杂志,2013,33(19):4856-4857.
[16]戴鹏,戴友平,刘福明.血管炎性因子与冠心病关系的临床研究[J].长春中医药大学学报,2011,27(2):272-273.
[17] GOLDFINE A B,LEE J,SHOELSON S E. Inflammationand insulin resistance[J]. The Journal of Clinical Inves-tigation:the Official Journal of the American Society forClinical Investigation,2006,116(7):1793-1801.
[18]李慧,邹大进. 2型糖尿病及肥胖与慢性炎症因子[J].第二军医大学学报,2003,24(11):1244-1246.
[19]赵英娟,贺学魁. 2型糖尿病病人中医证型与临床指标的相关性分析[J].中西医结合心脑血管病杂志,2016,14(8):809-811.
[20]郑峰,曲丹,徐浩,等.冠心病稳定期患者中医辨证与超敏C反应蛋白相关性研究[J].中国中西医结合杂志,2009,29(6):485-488.
[21]朱辟疆,周逊,赵华,等.慢性肾功能衰竭微炎症状态与中医证型关系研究[J].现代中西医结合杂志,2008,17(5):652-654.
[22]周先锋,阮晓楠,于思雨,等.血清C反应蛋白与糖尿病发病风险的关系[J].中华糖尿病杂志,2017,9(2):106-111.
[23]马长青,玉山江,王先敏,等. 2型糖尿病合并高尿酸血症的中医证型与HCY和CRP的相关性研究[J].医学研究杂志,2010,39(2):31-34.
[24]吴凯,陈晓平,高音,等.血清尿酸对2型糖尿病预测价值的分析[J].中华流行病学杂志,2011,32(11):1153-1157.
[25]李中南,张进军,赵华,等.糖尿病患者高尿酸血症的发生及对相关疾病的影响[J].中国临床保健杂志,2010,13(6):574-576.
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