2型糖尿病中医证候间客观指标差异研究

发布时间：2018-01-19 13:35

本文关键词： 2型糖尿病中医证候客观指标　出处：《大连医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过对100例T2DM(Type 2 Diabetes Mellitus,2型糖尿病)患者的中医证候、客观指标等内容收集和统计分析,研究本病中医证候的分布规律,同时探讨本病中医证候与客观指标之间的关联,试图为本病中医证候的客观化及治疗提供可供参考依据。方法:本研究采用流行病学调查的方法,收集2016年1月期间在大连医科大学附属第二医院内分泌科住院治疗的100例调查对象,根据《中药新药临床研究指导原则(试行)》[1]严格归纳糖尿病中医证候,记录GLU(Fasting Blood Glucose,空腹血糖)、Hb A1c(Glycosylated Hemoglobin A1C,糖化血红蛋白)等客观指标水平。应用SPSS 22.0软件录入数据,检查后进行统计学处理,初步总结分析2型糖尿病患者中医证候与客观指标之间的关联。结果:1.2型糖尿病患者各中医证候分布:气阴两虚型(35%)阴阳两虚型(18%)=血瘀气滞型(18%)阴虚热盛型(17%)痰湿(热)内蕴型(12%);2.从性别上看:各证候间P0.05,差别无统计学意义;3.从年龄上:血瘀气滞型、阴阳两虚型与其余三组相比显著偏高(P0.05或0.01),痰湿(热)内蕴型与其余四型相比均显著偏低(P0.05或0.01);4.从病程上:各证候病程按阴虚热盛型痰湿(热)内蕴型气阴两虚型血瘀气滞型阴阳两虚型趋势递增,差别有统计学意义,P0.05或0.01;5.从BMI(Body Mass Index,体重指数)上:痰湿(热)内蕴型与其余各证候比较显著偏高(P0.05或0.01);6.从GLU上:气阴两虚型与阴阳两虚型、血瘀气滞型相比显著偏高(P0.05);7.从Hb A1c上看:气阴两虚型与血瘀气滞型相比显著偏高(P0.05);8.从血脂上看:(1)从TC(Total Cholesterol,总胆固醇)上看,痰湿(热)内蕴型与阴虚热盛型、阴阳两虚型、血瘀气滞型相比明显偏高(P0.05或0.01);阴虚热盛型与痰湿(热)内蕴型、气阴两虚型相比显著偏低(P0.01)。(2)从TG(Triglyceride,甘油三酯)上看,痰湿(热)内蕴型与其余各组比较显著偏高(P0.01)。(3)从HDL-C(High-Density Lipoprotein Cholesterol,高密度脂蛋白)上看,各证候间P0.05,差别无统计学意义。(4)从LDL-C(Low-Density Lipoprotein Cholesterol,低密度脂蛋白)上看,气阴两虚型与阴虚热盛型、阴阳两虚型相比显著偏高(P0.05或0.01);9.从IR(Insulin Resistance,胰岛素抵抗)、C-P(Fasting C-Peptide,空腹C肽)上看,各证候间P0.05,差别无统计学意义。结论:1.2型糖尿病中医证候的分布存在一定规律,临床中以气阴两虚型患者居多;2.2型糖尿病各中医证候间在年龄、病程、BMI、GLU、Hb A1c、TC、TG和LDL-C上存在差异,在性别、HDL-C、IR和C-P上未发现差异;3.TC水平较低可作为阴虚热盛型的参考指标;发病年龄偏低或BMI、TC、尤TG水平一种或多种升高可作为痰湿(热)内蕴型的参考指标;GLU、Hb A1c、LDL-C水平中一种或多种偏高可作为气阴两虚型的参考指标;4.痰湿(热)内蕴型患者BMI、血脂异常尤为明显,提示对本病合并高脂血症患者可在辨证论治基础加化痰降浊药物,疗效可能更佳。
[Abstract]:Objective: to collect and analyze the TCM syndromes and objective indexes of 100 patients with T2DMN Type 2 Diabetes Mellitus2 diabetes mellitus. To study the distribution of TCM syndromes and the relationship between TCM syndromes and objective indexes. Attempts to provide a reference for the objective and treatment of TCM syndromes of this disease. Methods: this study adopts the method of epidemiological investigation. In January 2016, 100 patients who were hospitalized in the Department of Endocrinology in the second affiliated Hospital of Dalian Medical University were collected. According to the guiding principles of Clinical Research on New drugs of traditional Chinese Medicine (trial), [1. The TCM syndrome of diabetes was summarized strictly, and GLU(Fasting Blood glucose was recorded. Objective indexes such as HbA1cCGlycosylated Hemoglobin A1C (glycosylated hemoglobin) were recorded by SPSS 22.0 software. Statistical analysis was performed after examination. The relationship between TCM syndromes and objective indexes in type 2 diabetes mellitus patients was preliminarily summarized and analyzed. Results the distribution of TCM syndromes in type 1.2 diabetes mellitus patients was as follows: Qi-yin deficiency type 35) yin and yang deficiency type 18). Blood stasis and Qi stagnation type 18) Yin deficiency and heat flourishing type Li 17) phlegm dampness (heat) internal type of 12 meters; 2. From the gender point of view, there was no significant difference among the syndromes (P0.05); 3. Age: blood stasis qi stagnation type, yin and yang deficiency type compared with the other three groups significantly higher than P05 or 0.01). Phlegm dampness (heat) accumulation type was significantly lower than the other four types (P0.05 or 0.01). 4. From the course of the disease: the course of each syndrome according to the Yin deficiency heat type phlegm dampness (heat) accumulation type Qi and Yin deficiency type blood stasis type Yin and Yang deficiency type trend increasing, the difference has statistical significance P05 or 0.01; 5. From BMI(Body Mass Index (BMI): phlegm dampness (heat) implied type was significantly higher than other syndromes (P0.05 or 0.01); 6. From GLU: compared with deficiency of Yin and Yin, deficiency of Yin and Yang, stagnation of Blood stasis and Qi, it was significantly higher than that of P0.05; 7. From the point of view of HB A1c, the deficiency of Qi and Yin was significantly higher than that of blood stasis and qi stagnation (P 0.05); From TC(Total Cholesteroll (total cholesterol), phlegm dampness (heat) accumulation type and Yin deficiency heat flourishing type, yin and yang deficiency type. The blood stasis and qi stagnation type was significantly higher than that of blood stasis qi stagnation type (P0.05 or 0.01). Deficiency of Yin heat, phlegm and dampness (heat) accumulation type, deficiency of qi and yin type were significantly lower than that of deficiency of qi and yin (P0.01P0.01P0.01U) from the point of view of TGG Triglyceride (triglyceride). Phlegm dampness (heat) accumulation type was significantly higher than that of other groups (P 0.01). High-Density Lipoprotein Cholesterol. High density lipoprotein (HDL), each syndrome between P0.05. LDL-C(Low-Density Lipoprotein Cholesteroll, low density lipoprotein (LDL). The deficiency of qi and yin was significantly higher than that of deficiency of yin and yang (P0.05 or 0.01). 9.Look at IR(Insulin resilience, insulin resistance, C-Pasting C-Peptide.fasting C-peptide. Conclusion the distribution of TCM syndromes of type 1.2 diabetes mellitus is regular, and the majority of the patients with deficiency of qi and yin are in clinic. 2.2 there were differences in TG and LDL-C between TCM syndromes of type 2 diabetes mellitus in age and course of disease. No difference was found between IR and C-P. 3.The lower TC level can be used as the reference index of Yin deficiency and heat flourishing type; The age of onset was low or BMI-TC, especially the level of TG increased one or more can be used as a reference index of phlegm dampness (heat) intrinsic type; One or more of the LDL-C levels of GLU HbA1cU can be used as a reference index for deficiency of Qi and Yin. 4. The abnormal blood lipid of the patients with phlegm dampness (heat) accumulation type is especially obvious, which suggests that the treatment of hyperlipidemia can be combined with phlegm and turbid medicine on the basis of syndrome differentiation, and the curative effect may be better.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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