2型糖尿病合并骨质疏松中医证型与代谢指标相关性探讨

发布时间：2018-03-16 11:01

本文选题：2型糖尿病　切入点：骨质疏松　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：1目的:通过对2型糖尿病患者的临床指标及中医证候进行回顾性分析,旨在探讨2型糖尿病合并骨质疏松患者的临床特征及中医证候学特点、以及中医证型与临床指标的相关性,为中西医结合防治2型糖尿病并骨质疏松提供一定的依据。2方法:本研究以2015年12月至2016年10月广安门医院内分泌科住院且符合纳入标准及排除标准的156例2型糖尿病患者为研究对象,根据骨密度检测结果将患者分为骨量正常组(T≥-1),骨量减少组(-2.5＜T-1),骨质疏松组(T≤-2.5)。探索三组患者中医证型特点,并分析三组间的一般资料(如性别、年龄、病程、体重指数)、血糖、骨代谢等相关指标,探索它们与2型糖尿病并骨质疏松症的关系及临床指标与中医证型之间的关系。3结果:①共收集到2型糖尿病患者156例,其中合并骨质疏松症有46例,骨量减少有54例,骨量正常有56例,占总数比例分别为29.5%、34.6%、35.9%。在骨质疏松组中,气滞血瘀证明显多于其他证型,在骨量减少组中,气滞血瘀证多于其他证型,而在骨量正常组中,肝肾亏损证所占比例最高,在证型分布上,三组证型差异有统计学意义(P0.05);②骨质疏松组2型糖尿病女性患者所占比例较高;③骨质疏松组年龄高于骨量减少组和骨量正常组(P0.05);④骨质疏松组BMI低于骨量正常组(P＜0.05);骨质疏松组ALP、iPTH、β-CTX、BGP高于骨量正常组(P0.05);骨质疏松组UA低于骨量正常组和骨量减少组(P0.05);骨量减少组的24HMA、24h-uTP高于骨量正常组(P0.05);⑤三组证型BMI、HBA1c、FPG、P、VITD-T、Ca、TG、CHO、HDL、ALP、β-CTX、BGP、UA、24h-uTP差异无统计学意义(P0.05),气滞血瘀证24HMA、iPTH水平高于肝肾亏损证(P0.05);气滞血瘀证全髋BMD小于肝肾亏损证(P0.05)。4结论:①2型糖尿病合并骨质疏松者气滞血瘀证最多,合并骨量减少者气滞血瘀证最多,骨量正常者肝肾亏损证最多。气滞血瘀证全髋BMD较低;②2型糖尿病患者骨量流失与性别及年龄有关,与骨质疏松危险因素报道相一致;③2型糖尿病合并骨质疏松患者BMI较低;④2型糖尿病合并骨质疏松患者ALP、iPTH、β-CTX、BGP较高;⑤2型糖尿病合并骨质疏松患者血UA较低;⑥2型糖尿病合并骨质疏松患者尿蛋白较高。
[Abstract]:1 Objective: retrospective analysis of the clinical indicators and TCM syndromes in patients with type 2 diabetes mellitus, to investigate the clinical characteristics and TCM syndromes in patients with type 2 diabetes complicated with osteoporosis features, and the relationship between TCM syndrome and clinical index, type 2 diabetes and osteoporosis and provide the basis for Chinese and Western.2 methods medicine in the prevention and treatment of this study from December 2015 to October 2016 in Guanganmen hospital in the Department of Endocrinology and in accordance with the inclusion criteria and exclusion criteria, 156 cases of type 2 diabetes patients as the research object, according to the measurement of bone mineral density results were divided into normal bone mass group (T = -1), osteopenia group (-2.5 < T-1), osteoporosis group (T less than -2.5). To explore the TCM syndrome characteristics of three groups of patients, and analyze the general information between the three groups (such as gender, age, duration, body mass index, blood glucose), bone metabolism related indicators, and explore them with type 2 diabetes mellitus The relationship between osteoporosis and clinical indexes and TCM syndrome types of.3 results: We collected 156 cases of patients with type 2 diabetes, of which 46 cases of patients with osteoporosis, osteopenia in 54 cases, normal bone mass in 56 cases, accounting for the proportion of the total number were 29.5%, 34.6%, 35.9%. in osteoporosis group in Qi stagnation and blood stasis were significantly more than the other syndromes, in the osteopenia group, qi stagnation and blood stasis syndrome than other syndromes, and in normal bone mass group, liver and kidney deficiency with the highest proportion in the distribution of syndromes, syndrome of the three groups was statistically significant difference (P0.05); the 2 groups of patients with osteoporosis diabetic women accounted for a higher proportion of osteoporosis; the higher age group osteopenia group and normal group (P0.05); the osteoporosis group BMI was lower than that of normal bone mass group (P < 0.05); osteoporosis group ALP, iPTH, beta -CTX, BGP higher than the normal bone mass group (P0.05); osteoporosis group UA low In normal bone mass group and osteopenia group (P0.05); osteopenia group 24HMA, 24h-uTP higher than the normal bone mass group (P0.05); the three group card type BMI, HBA1c, FPG, P, VITD-T, Ca, TG, CHO, HDL, ALP, BGP, UA, -CTX, 24h-uTP showed no statistically significant difference (P0.05), qi stagnation and blood stasis syndrome 24HMA, iPTH level is higher than that of liver and kidney deficiency syndrome (P0.05); Qi stagnation and blood stasis type total hip BMD less than liver and kidney deficiency syndrome (P0.05).4 conclusion: type 2 diabetes mellitus with osteoporosis complicated with qi stagnation and blood stasis, qi stagnation and blood stasis are the most osteopenia, bone mass in normal liver and kidney deficiency the card up. Qi stagnation and blood stasis type total hip BMD was low; the bone loss in patients with type 2 diabetes and gender and age, consistent with the reported risk factors of osteoporosis; BMI the patients with type 2 diabetes mellitus with osteoporosis is low; the type 2 diabetic patients with osteoporosis in patients with ALP, iPTH, beta -CTX, BGP is higher; the type 2 diabetic patients with bone The blood of the patients with osteoporosis and low UA; type 2 diabetes mellitus with osteoporosis in patients with urinary protein is higher.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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