2型糖尿病痰湿体质患者的中医证候的相关性分析

发布时间：2018-03-23 05:31

本文选题：2型糖尿病　切入点：中医证候　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过收集2型糖尿病痰湿质患者基本情况、中医证候、生存质量等资料,运用统计学方法对痰湿质的2型糖尿病患者在病程、并发症、生化指标、中医证候进行相关性分析,探讨2型糖尿病痰湿质患者发病的倾向性和易伴发疾患。方法:采用临床问卷调查的方式,收集2015年6月至12月在内分泌科住院的2型糖尿病的痰湿质患者的基本情况、生化指标、中医证候、并发症、生存质量等资料,然后运用统计学方法,进行数据分析。结果:1一般情况:2型糖尿病痰湿质患者青年人比例为零,全部患者年龄均处于45-80岁。男女比例分别占50.6%、49.4%。体重过低的患者的比例为零;正常的体重有3例,占3.7%;超重的有41例,比例占50.6%;肥胖的有37例,占45.7%。在病程上,按5年以下、5-10年、10年以上的病程进行分层,患者的比例分别是35.8%、24.7%、39.5%。在饮食偏好上,患者嗜好油腻食物最多,有26例,占21%;有吸烟史者24例,占30%;饮酒史者32例,占40%。生存质量方面,痰湿质患者在心理健康维度和治疗维度评分明显较优。慢性并发症方面,痰湿质组出现糖尿病视网膜病变和高血压的比例分别为85.4%、24%,两者呈正相关。2生化指标:痰湿质的空腹血糖控制在4.4-7.0 mmol/L比例占59.3%。餐后2h血糖维持在10 mmol/L以上的比例占74.1%;总胆固醇控制在4.5 mmol/L以下的比例占74.1%,甘油三酯控制在1.5 mmol/L以上的比例占66.7%;LDL-C、HDL-L小于1 mmol/L的66例,占81.5%;在糖化血红蛋白方面,控制在8~9%和大于9%的分别占33.3%、34.6%。3中医症状和证候:痰湿质组多有易饥多食、形体肥胖、口干喜冷饮、溲赤便秘、舌苔黄腻、脉弦滑等中医症状。3类聚类分析时,覆盖率最高的中医症状分别是形体肥胖、口干喜冷饮、腹部胀大、脉弦滑。与痰湿质相关的有形体肥胖、肢体麻木、脉弦滑三个中医症状。在证候方面,痰湿质患者比较容易出现痰热互结证,而出现肝肾阴虚证、阴阳两虚证的比率最低。痰湿质与痰热互结证呈正相关;肝肾阴虚证与痰湿组呈明显的负相关。而且在证候虚实上,痰湿质患者两者比例相近。结论:1.2型糖尿病痰湿质以中、老年患者多见;以超重和肥胖的患者为主;痰湿质贯穿整个糖尿病全程;患者偏好油腻食物,有嗜烟酒倾向。2.患者餐后血糖较高,甘油三酯水平偏高,糖化血红蛋白控制不理想或很差,病情上不容乐观,较易出现糖尿病视网膜病变和高血压等并发症,需要积极予糖尿病宣教和早期的干预。3.2型糖尿病痰湿质患者最常见的中医症状是形体肥胖、口干喜冷饮、腹部胀大、脉弦滑。临床上,痰湿质患者较易出现痰热互结证。
[Abstract]:Objective: to collect the data of phlegm dampness, TCM syndromes and quality of life in type 2 diabetes mellitus, and to analyze the course, complications and biochemical indexes of type 2 diabetes patients with phlegm dampness by statistical method. The relationship between TCM syndrome and phlegm dampness in type 2 diabetes mellitus was studied. Methods: clinical questionnaire was used to investigate the tendency of phlegm dampness in type 2 diabetes mellitus. To collect the basic information, biochemical indexes, TCM syndromes, complications, quality of life and other data of type 2 diabetes mellitus patients hospitalized in the Endocrinology Department from June to December 2015, and then use statistical methods. Results in the general situation of 1: 1, the proportion of young people with phlegm dampness in type 2 diabetes mellitus was zero, and all the patients were aged 45-80. The ratio of male to female was 50.6% and 49.49.4cm, respectively. The proportion of patients with low body weight was zero; there were 3 cases of normal weight. Accounting for 3.7%; there were 41 cases of overweight, accounting for 50.6%; 37 cases were obese, accounting for 45.70.In the course of disease, according to the course of disease of less than 5 years or 10 years and more than 10 years, the proportion of patients was 35.8and 24.77.The proportion of patients with fatty food was the most in diet preference, there were 26 cases. There were 24 cases (30%) with a history of smoking, 32 cases (40%) with a history of drinking alcohol. In terms of quality of life, the scores of phlegm and dampness were significantly better in mental health dimension and treatment dimension. The rates of diabetic retinopathy and hypertension in phlegm wet substance group were 85.4% and 24%, respectively. 2 positive correlation was found between the two biochemical indexes: the proportion of fasting blood glucose of phlegm wet substance was controlled at 4.4-7.0 mmol/L (59.3%), and the proportion of 2 h postprandial blood glucose remained above 10 mmol/L. The proportion of total cholesterol under 4.5 mmol/L was 74.1%, the proportion of triglyceride was more than 1.5 mmol/L, the proportion of 66.7% LDL-CU HDL-L was less than 1 mmol/L, In saccharified hemoglobin, 33.3% and more than 9% of them had symptoms and syndromes of traditional Chinese medicine: phlegm dampness group was prone to hunger and eating, obesity, dry mouth, cold drink, Deutzia constipation, yellow and greasy tongue coating, In the cluster analysis of TCM symptoms such as pulse-string slippage and other TCM symptoms, the symptoms with the highest coverage were obesity in form, cold drink in dry mouth, flatulence in abdomen and slippery pulse in abdomen. There was body obesity and numbness of limbs associated with phlegm and dampness. In the syndromes, phlegm dampness syndrome is more likely to appear phlegm heat mutual knot syndrome, while liver and kidney yin deficiency syndrome, yin and yang deficiency syndrome has the lowest ratio. Phlegm dampness and phlegm heat mutual junction syndrome are positively correlated; There was a significant negative correlation between liver and kidney yin deficiency syndrome and phlegm dampness group, and the proportion of phlegm and dampness was similar in syndrome deficiency group. Conclusion in type 1.2 diabetes mellitus, phlegm dampness is more common in elderly patients, overweight and obese patients are the main ones. Phlegm and dampness ran through the whole course of diabetes; patients preferred greasy food and tended to be addicted to tobacco and alcohol .2.The patients' postprandial blood sugar was higher, triglyceride level was on the high side, glycosylated hemoglobin control was not ideal or poor, and the condition was not optimistic. Complications such as diabetic retinopathy and hypertension are more likely to occur. The most common symptoms of type 3.2 diabetes patients with phlegm and dampness are obesity, dry mouth and cold drink, abdominal distension, and so on, which need to be actively treated with diabetes education and early intervention. In clinic, phlegm dampness patients are more prone to phlegm heat syndromes.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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