2型糖尿病气阴两虚兼血瘀证治疗前后舌色与空腹血糖等变化的相关性研究
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摘要
目的：通过对60例2型糖尿病气阴两虚兼血瘀证患者治疗前后舌色及空腹血糖、血脂、糖化血红蛋白变化的研究,试图探索舌色变化与这些客观指标变化之间的相关性,并进一步探索将舌色的改变、客观指标的变化、患者自觉症状的改善共同作为综合疗效评价的可行性。
方法：制定统一的临床观察表,按照望、闻、问、切四诊方法,将2型糖尿病气阴两虚兼血瘀证患者作为研究对象,观察其舌色特征,并分为治疗组和对照组两组进行研究。治疗组用西医降糖降脂和中药益气固本汤进行治疗,对照组用西医降糖降脂治疗。治疗8周后,观察两组患者舌色以及空腹血糖、血脂、糖化血红蛋白变化,并对舌色变化和这些客观指标变化的相关性进行分析。
结果：①治疗组治疗前后舌色变化明显,淡红舌例数明显增多,淡白舌、紫暗舌、红舌的例数逐渐减少,舌色变化比较差异明显,有统计学意义(P<0.05)。②对照组治疗前后患者也有淡红舌例数逐渐增多,淡白舌、紫暗舌、红舌的例数逐渐减少的趋势,但舌色变化比较差异不明显,无统计学意义(P>0.05)。③治疗组和对照组治疗前后空腹血糖、血脂、糖化血红蛋白下降幅度差异明显,有统计学意义(P<0.05)。
结论：①通过舌色的变化,可以反映中西医结合治疗对于患者全身状况的改善有显著作用。②在治疗的过程中,舌色趋于好转的同时,客观指标明显下降。说明舌色改变与客观指标变化之间存在一定的相关性,舌色变化在一定程度上能够反映客观指标的变化趋势。③中西医结合治疗对于改善患者的空腹血糖、血脂、糖化血红蛋白要优于单纯西医治疗组。
Objective:To study fasting blood glucose, blood fat, glycated hemoglobin and tongue of type 2 diabetes with deficiency of both vital energy and yin and blood stasis before and after the treatment. Trying to explore tongue with these changes the correlation between the objective index changes, and to further explore the objective index of the change of the tongue, and change the self-conscious symptom improvement together with a comprehensive effect of feasibility evaluation.
Methods:Formulate unified clinical observation, according to the inspection, auscultation and ask, cut the four diagnostic methods, qi and Yin deficiency syndrome belong and blood stasis syndrome diabetes as the research object, the tongue characteristics, and divided into the treatment group and control group were studied. With western medicine treatment group and sugar-down lipid-lowering therapy yiqi consoliated cost control, with soup of western cholesterol-lowering hypoglycemic therapy eight weeks after treatment, patients were observed, fasting blood glucose, blood glycosylated hemoglobin objective indexes and the tongue of the color changes, and the objective index of the changes of the color with tongue changes were analyzed.
Results:①Before and after the treatment group (treated, pink color changes obviously tongue tongue increased obviously, pale white fiberobronchoscopically tongue, dark purple red tongue, the average tongue, tongue gradually decreased significantly change the comparative differences (P< 0.05) before and after the treatment group.②Patients have pink tongue increase gradually, pale white fiberobronchoscopically tongue, dark purple red tongue, the number of tongue gradually decreased, but the tongue no change is difference (P> 0.05).③efore and after the treatment group and control group treated fasting blood glucose, blood fat, glycated hemoglobin decline significantly, a statistically significant (P< 0.05).
Conclusions:①The tongue can reflect the changes of combining traditional Chinese and western medicine treatment for patients with significant improvements.②In the process, treatment tends to improve the tongue, objective index decreased obviously. That color change and objective lingual index variation exists, the tongue reflect the objective index of the trend to a certain extent.③For improving combining traditional Chinese and western medicine treatment of patients with fasting blood glucose, blood fat, glycated hemoglobin than pure western treatment group.
方法：制定统一的临床观察表,按照望、闻、问、切四诊方法,将2型糖尿病气阴两虚兼血瘀证患者作为研究对象,观察其舌色特征,并分为治疗组和对照组两组进行研究。治疗组用西医降糖降脂和中药益气固本汤进行治疗,对照组用西医降糖降脂治疗。治疗8周后,观察两组患者舌色以及空腹血糖、血脂、糖化血红蛋白变化,并对舌色变化和这些客观指标变化的相关性进行分析。
结果：①治疗组治疗前后舌色变化明显,淡红舌例数明显增多,淡白舌、紫暗舌、红舌的例数逐渐减少,舌色变化比较差异明显,有统计学意义(P<0.05)。②对照组治疗前后患者也有淡红舌例数逐渐增多,淡白舌、紫暗舌、红舌的例数逐渐减少的趋势,但舌色变化比较差异不明显,无统计学意义(P>0.05)。③治疗组和对照组治疗前后空腹血糖、血脂、糖化血红蛋白下降幅度差异明显,有统计学意义(P<0.05)。
结论：①通过舌色的变化,可以反映中西医结合治疗对于患者全身状况的改善有显著作用。②在治疗的过程中,舌色趋于好转的同时,客观指标明显下降。说明舌色改变与客观指标变化之间存在一定的相关性,舌色变化在一定程度上能够反映客观指标的变化趋势。③中西医结合治疗对于改善患者的空腹血糖、血脂、糖化血红蛋白要优于单纯西医治疗组。
Objective:To study fasting blood glucose, blood fat, glycated hemoglobin and tongue of type 2 diabetes with deficiency of both vital energy and yin and blood stasis before and after the treatment. Trying to explore tongue with these changes the correlation between the objective index changes, and to further explore the objective index of the change of the tongue, and change the self-conscious symptom improvement together with a comprehensive effect of feasibility evaluation.
Methods:Formulate unified clinical observation, according to the inspection, auscultation and ask, cut the four diagnostic methods, qi and Yin deficiency syndrome belong and blood stasis syndrome diabetes as the research object, the tongue characteristics, and divided into the treatment group and control group were studied. With western medicine treatment group and sugar-down lipid-lowering therapy yiqi consoliated cost control, with soup of western cholesterol-lowering hypoglycemic therapy eight weeks after treatment, patients were observed, fasting blood glucose, blood glycosylated hemoglobin objective indexes and the tongue of the color changes, and the objective index of the changes of the color with tongue changes were analyzed.
Results:①Before and after the treatment group (treated, pink color changes obviously tongue tongue increased obviously, pale white fiberobronchoscopically tongue, dark purple red tongue, the average tongue, tongue gradually decreased significantly change the comparative differences (P< 0.05) before and after the treatment group.②Patients have pink tongue increase gradually, pale white fiberobronchoscopically tongue, dark purple red tongue, the number of tongue gradually decreased, but the tongue no change is difference (P> 0.05).③efore and after the treatment group and control group treated fasting blood glucose, blood fat, glycated hemoglobin decline significantly, a statistically significant (P< 0.05).
Conclusions:①The tongue can reflect the changes of combining traditional Chinese and western medicine treatment for patients with significant improvements.②In the process, treatment tends to improve the tongue, objective index decreased obviously. That color change and objective lingual index variation exists, the tongue reflect the objective index of the trend to a certain extent.③For improving combining traditional Chinese and western medicine treatment of patients with fasting blood glucose, blood fat, glycated hemoglobin than pure western treatment group.
引文
[1]凌利民,郭凤霞.糖尿病足的诊治新进展[J].2005,3(2)：60
[2]冯波,李栩,黄亦文等.上海市浦东新区社区人群糖尿病状况和相关因素分析[J].中华糖尿病杂志.2004,12(3)：187
[3]金其林,宋晓敏,伍佩英等.社区人群糖尿病及代谢综合征的流行病学调查[J].实用诊断与治疗杂志.2005,19(5)：342
[4]阎立芹,孙玉娥,刘晓辉.大连市金州区糖尿病的流行病学调查分析[J].辽宁医学杂志.2004,18(3)：168
[5]卉松涛,金迎,齐今吾等.沈阳地区NIDDM和糖耐量减低流行病学调查研究[J].中国医科大学学报.1997,26(1)：38
[6]袁申元,朱良湘,胡虹莺等.北京地区20682人群糖尿病筛查及1566人OGTT的研究[J].中华内分泌代谢杂志.1997,13(2)：69
[7]潘长玉,陆菊明,田慧等.首都钢铁公司成年人糖尿病患病率的调查[J].中华医学杂志.1995,75(7)：409
[8]潘孝仁,李光伟,刚勇等.糖耐量低减的特征及其与冠心病发生的关联[J].中华内分泌代谢杂志.1989,5(1)：20
[9]衡先培.实用糖尿病中西医治疗[M].人民军医出版社.2006,7：218
[10]冯文才,黄晓峰,陈楚华.辨证治疗2型糖尿病300例临床观察[J].河北中医.2002,24(5)：336
[11]徐金元.辩证分型论治糖尿病108例[J].陕西中医.1997,18(2)：49
[12]沈远东.陈跃来.芪麦汤治疗非胰岛素依赖型糖尿病43例的临床观察[J].甘肃中医.1999,12(5)：23
[13]周妙英.复元活血汤加味治疗2型糖尿病血瘀证38例[J].吉林中医药.1999,(2)：13
[14]季聚良,石歆.平胃散加味治疗湿阻脾胃之消渴病20例[J].河南中医药学刊.1999,14(4)：55-56
[15]王钢柱,董真元,张世联等.从肝论治非胰岛素依赖型糖尿病245例临床分析[J].河北中医.1997,(2)：19
[16]李锐强.益气滋肾生津汤治疗消渴病68例[J].中医研究.1999,12(5)： 51
[17]韩爱莲,刘建新,樊锐.从痰瘀论治2型糖尿病61例疗效观察[J].中医药研究.2000,16(4)：9
[18]朱秀锋.针灸治疗糖尿病246例临床观察[J].中国针灸.1991(1)：5
[19]郭宝荣等.糖尿病贴膏治疗糖尿病临床研究小结[J].山东中医学院学报.1995,19(6)：388
[20]李瑞玉,吴丽萍.中医证型与糖尿病伴耳聋SOD和MDA关系探讨[J].辽宁中医杂志.1999,26(12)：537
[21]徐洁.糖尿病中医辨证与血浆内皮素、心钠素及泌乳素的关系分析[J].中国中医药科技.2001,8(3)：153
[22]梁永春等.降糖中药片对气阴两虚型糖尿病患者RBC-SOD、MDA、INS、ACHE的影响[J].中医杂志.1994(7)：414
[23]潘明政等.中药仙贞片对气阴两虚肾虚血瘀型糖尿病患者红细胞膜Na+-K+-ATP酶等的影响[J].中国中西医结合杂志.1997(1)：3
[24]苏丽,赵希森,杨文炎等.2型糖尿病舌脉规律临床研究[J].中华实用中西医杂志.2001,1(9)：2009
[25]陈泽霖.200例糖尿病患者舌象检查分析[J].浙江中医杂志.1985,30(3)： 137
[26]赵琨.张素清教授诊治糖尿病经验拾零[J].新中医.2001,33(5)：14
[27]杨亚平,申全宏等.300例糖尿病的舌象研究[J].中国中医药信息.1992(10)：50
[28]郝爱真,刘毅等.老年糖尿病患者舌下络脉的对照研究[J].山西医药杂志.1991,31(9)：915
[29]郑筱萸.中药新药临床研究指导原则(试行)[M].中国医药科技出版社.2002,4：236
[30]张发荣.中西医结合糖尿病治疗学[M].中国中医药出版社.1998,3
[31]吴深涛.脾不散精与糖耐量低减[J].中国医药学报.2004,8(19)：463
[32]张乃民.中国舌诊大全[J].学苑出版社.1995,5(2)：1545
[33]赵林,赵军绩.参葛降脂宁治疗冠心病高脂血症疗效观察[J].湖北中医杂志.1999(9)：395
[34]张愍,曾昭龙等.高脂血症患者之友[M].人民军医出版社.1996,4
[35]Fischer LJ, Hamburger SA. Inhibition of alloxan action in isolated pancreatic islets by superoxide disrnutase, catalase and metal chelator[J]. Diabetes.1980 (29):2.13
[36]Spiteller G Lipid peroxidation in aging and age dependent diseases[J].Exp Gerontol.2001,36(9):1425
[37]Baynes JW. Role of oxidative stress in development of Complication in diabetes[J]. Diabetes.1991,11(40):405
[38]Ruiz C. Lipid peroxidation antioxidant enzyme, activities in patients with type I diabetes mellitus[J]. Scand J Clin Lab Invest.1999,59(2):99
[39]张廷模.临床中药学[M].中国中药科技出版社.2004：291
[40]彭锐.中国中药杂志[J].中国中药科技出版社.1991,16(6)：372
[41]田代华.实用中药辞典[M].人民卫生出版社.2002,9：1349
[2]冯波,李栩,黄亦文等.上海市浦东新区社区人群糖尿病状况和相关因素分析[J].中华糖尿病杂志.2004,12(3)：187
[3]金其林,宋晓敏,伍佩英等.社区人群糖尿病及代谢综合征的流行病学调查[J].实用诊断与治疗杂志.2005,19(5)：342
[4]阎立芹,孙玉娥,刘晓辉.大连市金州区糖尿病的流行病学调查分析[J].辽宁医学杂志.2004,18(3)：168
[5]卉松涛,金迎,齐今吾等.沈阳地区NIDDM和糖耐量减低流行病学调查研究[J].中国医科大学学报.1997,26(1)：38
[6]袁申元,朱良湘,胡虹莺等.北京地区20682人群糖尿病筛查及1566人OGTT的研究[J].中华内分泌代谢杂志.1997,13(2)：69
[7]潘长玉,陆菊明,田慧等.首都钢铁公司成年人糖尿病患病率的调查[J].中华医学杂志.1995,75(7)：409
[8]潘孝仁,李光伟,刚勇等.糖耐量低减的特征及其与冠心病发生的关联[J].中华内分泌代谢杂志.1989,5(1)：20
[9]衡先培.实用糖尿病中西医治疗[M].人民军医出版社.2006,7：218
[10]冯文才,黄晓峰,陈楚华.辨证治疗2型糖尿病300例临床观察[J].河北中医.2002,24(5)：336
[11]徐金元.辩证分型论治糖尿病108例[J].陕西中医.1997,18(2)：49
[12]沈远东.陈跃来.芪麦汤治疗非胰岛素依赖型糖尿病43例的临床观察[J].甘肃中医.1999,12(5)：23
[13]周妙英.复元活血汤加味治疗2型糖尿病血瘀证38例[J].吉林中医药.1999,(2)：13
[14]季聚良,石歆.平胃散加味治疗湿阻脾胃之消渴病20例[J].河南中医药学刊.1999,14(4)：55-56
[15]王钢柱,董真元,张世联等.从肝论治非胰岛素依赖型糖尿病245例临床分析[J].河北中医.1997,(2)：19
[16]李锐强.益气滋肾生津汤治疗消渴病68例[J].中医研究.1999,12(5)： 51
[17]韩爱莲,刘建新,樊锐.从痰瘀论治2型糖尿病61例疗效观察[J].中医药研究.2000,16(4)：9
[18]朱秀锋.针灸治疗糖尿病246例临床观察[J].中国针灸.1991(1)：5
[19]郭宝荣等.糖尿病贴膏治疗糖尿病临床研究小结[J].山东中医学院学报.1995,19(6)：388
[20]李瑞玉,吴丽萍.中医证型与糖尿病伴耳聋SOD和MDA关系探讨[J].辽宁中医杂志.1999,26(12)：537
[21]徐洁.糖尿病中医辨证与血浆内皮素、心钠素及泌乳素的关系分析[J].中国中医药科技.2001,8(3)：153
[22]梁永春等.降糖中药片对气阴两虚型糖尿病患者RBC-SOD、MDA、INS、ACHE的影响[J].中医杂志.1994(7)：414
[23]潘明政等.中药仙贞片对气阴两虚肾虚血瘀型糖尿病患者红细胞膜Na+-K+-ATP酶等的影响[J].中国中西医结合杂志.1997(1)：3
[24]苏丽,赵希森,杨文炎等.2型糖尿病舌脉规律临床研究[J].中华实用中西医杂志.2001,1(9)：2009
[25]陈泽霖.200例糖尿病患者舌象检查分析[J].浙江中医杂志.1985,30(3)： 137
[26]赵琨.张素清教授诊治糖尿病经验拾零[J].新中医.2001,33(5)：14
[27]杨亚平,申全宏等.300例糖尿病的舌象研究[J].中国中医药信息.1992(10)：50
[28]郝爱真,刘毅等.老年糖尿病患者舌下络脉的对照研究[J].山西医药杂志.1991,31(9)：915
[29]郑筱萸.中药新药临床研究指导原则(试行)[M].中国医药科技出版社.2002,4：236
[30]张发荣.中西医结合糖尿病治疗学[M].中国中医药出版社.1998,3
[31]吴深涛.脾不散精与糖耐量低减[J].中国医药学报.2004,8(19)：463
[32]张乃民.中国舌诊大全[J].学苑出版社.1995,5(2)：1545
[33]赵林,赵军绩.参葛降脂宁治疗冠心病高脂血症疗效观察[J].湖北中医杂志.1999(9)：395
[34]张愍,曾昭龙等.高脂血症患者之友[M].人民军医出版社.1996,4
[35]Fischer LJ, Hamburger SA. Inhibition of alloxan action in isolated pancreatic islets by superoxide disrnutase, catalase and metal chelator[J]. Diabetes.1980 (29):2.13
[36]Spiteller G Lipid peroxidation in aging and age dependent diseases[J].Exp Gerontol.2001,36(9):1425
[37]Baynes JW. Role of oxidative stress in development of Complication in diabetes[J]. Diabetes.1991,11(40):405
[38]Ruiz C. Lipid peroxidation antioxidant enzyme, activities in patients with type I diabetes mellitus[J]. Scand J Clin Lab Invest.1999,59(2):99
[39]张廷模.临床中药学[M].中国中药科技出版社.2004：291
[40]彭锐.中国中药杂志[J].中国中药科技出版社.1991,16(6)：372
[41]田代华.实用中药辞典[M].人民卫生出版社.2002,9：1349