2型糖尿病合并阻塞性睡眠呼吸暂停综合征痰湿证的表征研究

发布时间：2018-12-31 09:31

【摘要】：目的:旨在观察2型糖尿病合并阻塞性睡眠呼吸暂停综合征痰湿证患者的人口生物学指标、代谢相关指标、凝血功能指标、呼吸障碍指标、糖尿病并发症及合并症等方面的特征,初步归纳2型糖尿病合并阻塞性睡眠呼吸暂停综合征痰湿证患者的表征特点,以期为2型糖尿病合并阻塞性睡眠呼吸暂停综合征痰湿证的中医辨证论治提供参考。方法:选自2015年9月至2017年1月厦门大学附属第一医院内分泌糖尿病科住院及门诊的2型糖尿病合并阻塞性睡眠呼吸暂停综合症患者197例。根据证素辨证诊断标准,将其分为痰湿证组(98例)与非痰湿证组(99例)。分别记录人口生物学指标、代谢相关指标、凝血功能指标、呼吸障碍指标、糖尿病并发症及合并症等。收集资料后进行整理分析,并分别比较痰湿证组与非痰湿证组相关指标的差异。采用SPSS 20.0统计软件进行分析、检验。计量资料服从正态分布者以均数±标准差(x±S)表示,采用两独立样本t检验,不服从正态分布者以中位数(25%-75%)M(25%-75%)表示,采用Mann-Whitney检验。计数资料用率(%)表示,采用x2检验。以P0.05为时认为差异有统计学意义。结果:1.人口生物学指标:与非痰湿证组相比,痰湿证组的体重、身体质量指数、腰围、臀围、颈围较大(P0.05)。2.痰湿证组合并轻度OSAS有29例(29.59%)、中度OSAS有30例(30.61%)、重度OSAS有39例(39.80%);非痰湿证组合并轻度OSAS有54例(54.55%)、中度OSAS有23例(23.23%)、重度OSAS有22例(22.22%),两组间OSAS严重程度构成比有统计学差异(P0.05)。3.实验室检查指标:与非痰湿证组相比,痰湿证组的高密度脂蛋白胆固醇较低、血浆纤维蛋白原较高(P0.05)。4.合并症情况:与非痰湿证组相比,痰湿证组的动脉斑块患病率较高(65.31%vs50.51%,P=0.035)、冠心病患病率较高(21.43%vs10.1%,P=0.029)、脑卒中患病率较高(10.2%vs3.0%,P=0.043)。5.呼吸障碍相关指标:与非痰湿证组相比,痰湿证组的呼吸暂停指数、ESS评分较高(P0.05)。结论:1.在T2DM合并OSAS痰湿证患者中,中重度OSAS患者占70.41%。2.在T2DM合并OSAS痰湿证患者中,痰湿证表征表现在BMI、颈围、HDL-C、FIB、AHI、ESS评分以及合并动脉斑块、冠心病、脑卒中的患病率上,与非痰湿证T2DM合并OSAS患者相比具有可比性。3.T2DM合并OSAS痰湿证患者合并心脑血管疾病的风险可能比非痰湿证的风险更高,在中医药治疗T2DM合并OSAS应注重祛湿化痰。
[Abstract]:Objective: to observe the biological index, metabolism index, coagulation function index, respiratory disorder index of type 2 diabetes mellitus complicated with obstructive sleep apnea syndrome with phlegm dampness syndrome. The characteristics of type 2 diabetes mellitus with obstructive sleep apnea syndrome and phlegm dampness syndrome were summarized. In order to provide reference for type 2 diabetes mellitus with obstructive sleep apnea syndrome phlegm dampness syndrome differentiation of TCM treatment. Methods: 197 patients with type 2 diabetes complicated with obstructive sleep apnea syndrome were selected from September 2015 to January 2017 in Department of Endocrine Diabetes, first affiliated Hospital of Xiamen University. According to the diagnostic criteria of syndrome element differentiation, it was divided into phlegm dampness syndrome group (98 cases) and non phlegm dampness syndrome group (99 cases). The indexes of population biology, metabolism, coagulation function, respiratory disorders, diabetic complications and complications were recorded. The data were collected and analyzed, and the differences between phlegm dampness syndrome group and non-phlegm dampness syndrome group were compared. SPSS 20.0 statistical software was used to analyze and test. The measured data were expressed as mean 卤standard deviation (x 卤S) in normal distribution, t test in two independent samples, and Mann-Whitney test in median (25-75%) M (25-75%) in those who did not accept normal distribution. The count data rate (%) was expressed by x 2 test. The difference was statistically significant in terms of P05. Results: 1. Demographic indicators: compared with the non-phlegm dampness syndrome group, the phlegm dampness syndrome group's body weight, body mass index, waist circumference, hip circumference, neck circumference was larger (P0.05). There were 29 cases (29.59%) with mild OSAS, 30 cases (30.61%) with moderate OSAS and 39 cases (39.80%) with severe OSAS. There were 54 cases (54.55%) with mild OSAS, 23 cases (23.23%) with moderate OSAS and 22 cases (22.22%) with severe OSAS. Laboratory indicators: compared with the non-phlegm dampness syndrome group, the phlegm dampness syndrome group had lower HDL cholesterol and higher plasma fibrinogen (P0.05). Complications: compared with the non-phlegm dampness syndrome group, the prevalence of arterial plaque in phlegm dampness syndrome group was higher (65.31 vs 50.51P = 0.035), and the prevalence rate of coronary heart disease was higher (21.43 vs 10.1% P0.029). The incidence of stroke was higher (10.2% vs 3.0% P 0.043). Respiratory disorders related indicators: compared with the non-phlegm dampness syndrome group, phlegm dampness syndrome group apnea index, ESS score was higher (P0.05). Conclusion: 1. In T2DM patients with OSAS phlegm dampness syndrome, moderate and severe OSAS patients accounted for 70.41cm. 2. In T2DM patients with OSAS phlegm dampness syndrome, the characteristics of phlegm dampness syndrome were BMI, neck circumference, HDL-C,FIB,AHI,ESS score and the prevalence of artery plaque, coronary heart disease and stroke. Compared with non-phlegm dampness syndrome T2DM combined with OSAS patients, 3.T2DM combined with OSAS phlegm dampness syndrome patients with cardio-cerebrovascular disease risk may be higher than non-phlegm dampness syndrome risk, in Chinese medicine treatment of T2DM with OSAS should pay attention to remove dampness phlegm.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259;R276.1

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