宁波姜山社区早期糖尿病肾病中医体质特征与相关危险因素的横断面研究

发布时间：2018-06-07 11:37

本文选题：早期糖尿病肾病 + 中医体质特征　；参考：《浙江中医药大学》2016年硕士论文

【摘要】：目的了解宁波姜山地区早期糖尿病肾病患者的体质分布特点,探讨各种体质对早期糖尿病肾病发生发展的影响,为中医药对该病不同体质患者预防提供依据。方法研究采用王琦教授中医体质九分法对宁波姜山地区400例早期糖尿病肾病患者进行中医体质调查,并运用频数、百分比描述早期糖尿病肾病患者的中医体质类型,计量资料用均数加减标准差进行描述,卡方检验或单因素方差分析来比较相关各组间的差异性,以此了解各中医体质类型对糖尿病肾病相关危险因素的影响。结果本研究中,通过分析入组的早期糖尿病肾病患者在各个中医体质构成比,发现平和质占比最多,8种偏颇体质中,痰湿质占13.6%,血瘀质占9.7%,阴虚质占8.5%,为早期糖尿病肾病的高发体质。在中医体质与不同性别的研究中发现,男性湿热、血瘀较女性多见,而女性气郁、阳虚为多。对不同病程研究发现,病程在5-10年的患者人数最多,占64.3%。随着病程的进展,偏颇体质种类复杂化。本研究发现随着年龄的增长,早期糖尿病肾病患者人数增多,是否吸烟与中医体质构成无显著差异(P0.05),但是否有家族史的中医体质有差异(P0.05)。在空腹血糖的研究中,痰湿质的空腹血糖在各个中医体质中均值最高；在BMI、腰围的研究中,各组间均由显著差异(P0.001,P0.001),其中痰湿体质的腰围明显高于中国肥胖专家提出的“男性85cm,女性80cm”这一安全腰围值,BMI均值为27.58±2.78,接近肥胖标准。痰湿质患者腰围、BMI与平和质、气郁质、湿热质、血瘀质、阳虚质、阴虚质、气虚质均由显著统计学意义(P0.05,P0.01),提示痰湿质多为形体肥胖之人：同时,痰湿质在总胆固醇、低密度脂蛋白、甘油三酯(三项上均值均较高,且经过单因素方差分析与其他多组均由统计学意义(P0.05,P0.01)。中性粒细胞与淋巴细胞比值与中医体质构成有显著统计学意义(P0.005),经方差分析,血瘀质与湿热、阳虚、阴虚、气虚、痰湿、平和体质相比,差异具有显著性(P0.05,P0.01),提示代谢性炎症与中医体质中的血瘀质密切相关。血清胆红素在各中医体质类型构成上无明显统计学差异(P0.05)。本研究中,高血压组痰湿质、血瘀质比例要高于非高血压组。在有否合并心血管病的研究中,发现血瘀质的占比在两组间有显著差异性。而在合并脂肪肝的患者中痰湿、湿热体质显著高于无脂肪肝组。结论1.本研究发现早期糖尿病肾病患者体质仍以平和质为主,8种偏颇体质中,痰湿质、血瘀质、阴虚质为早期糖尿病肾病的高发体质。2.本研究中痰湿体质在血糖、血脂、BMI、腰围、脂肪肝均与其他体质有显著差异,提示痰湿质多为肥胖之人,多伴有脂代谢紊乱,肥胖之人血糖易偏高,可能与现代医学认为的肥胖是产生胰岛素抵抗的重要原因相关。3.血瘀质与心血管病密切相关,且本研究中血瘀质的中性粒细胞与淋巴细胞比值较高,提示血瘀质与炎性因子相关,血瘀质患者需多注意糖尿病微血管并发症的发生。
[Abstract]:Objective to understand the characteristics of the physical distribution of patients with early diabetic nephropathy in Ningbo Jiangshan area, and to explore the effects of various physiques on the occurrence and development of early diabetic nephropathy, and to provide a basis for the prevention of different physique patients with traditional Chinese medicine. Methods the nine points method of TCM constitution was used in the study of 400 cases of early diabetic kidney in the Jiangshan area of Ningbo. The patients were investigated on the physique of traditional Chinese medicine and used the frequency and percentage to describe the type of TCM Constitution of the patients with early diabetic nephropathy. The measurement data were described with the standard deviation of average number and subtraction, chi square test or single factor analysis of variance analysis were used to compare the differences among the related groups in order to solve the risk of diabetic nephropathy. In this study, in this study, by analyzing the constitution ratio of the early diabetic nephropathy in the group of early diabetic nephropathy, it was found that the proportion of flat and mass was the most, 13.6% of the 8 kinds of biased constitution, 9.7% of the blood stasis, 8.5% of blood stasis, the high incidence of Yin deficiency, in the study of the constitution of traditional Chinese medicine and the study of different sexes. Now, the male is hot and hot, and the blood stasis is more common than the female, but the female qi stagnation and yang deficiency are more. In the study of different course of disease, the number of patients in the course of 5-10 years is the most, accounting for 64.3%. with the progress of the disease and the complex physique types. This study found that with the age increasing, the number of early diabetic nephropathy patients increased, whether smoking and Chinese Medicine Constitution were smoking There was no significant difference (P0.05), but there was a difference in the constitution of traditional Chinese medicine (P0.05). In the study of fasting blood glucose, the fasting blood glucose of phlegm wet was the highest in the physical constitution of each Chinese medicine. In the study of BMI, the waist circumference of all groups were significantly different (P0.001, P0.001), and the waist circumference of the phlegm wet constitution was obviously higher than that of Chinese obesity experts. The safety waist circumference of "male 85CM, female 80cm" was 27.58 + 2.78, which was 27.58 + 2.78, close to the standard of obesity. The waist circumference of phlegm damp patients, BMI and flat and mass, qi stagnation, damp heat, blood stasis, Yang deficiency, yin deficiency and Qi deficiency were statistically significant (P0.05, P0.01), suggesting that the phlegm wet quality was mostly body fat person: simultaneously, phlegm wet quality The total cholesterol, low density lipoprotein and triglyceride (the average value of the three items were higher, and the single factor analysis of variance and other groups were statistically significant (P0.05, P0.01). The ratio of neutrophils to lymphocytes and the constitution of Chinese medicine had significant statistical significance (P0.005). The analysis of variance, blood stasis and damp heat, Yang deficiency, yin deficiency, Qi deficiency, the ratio of neutrophils and lymphocytes was statistically significant (P0.005). " Compared with physique, the difference was significant (P0.05, P0.01), indicating that the metabolic inflammation was closely related to the blood stasis in the Chinese medicine constitution. There was no significant difference in the constitution of the TCM Constitution (P0.05). In this study, the proportion of phlegm and blood stasis in the hypertension group was higher than that in the non hypertensive group. In the study of vascular disease, it was found that the proportion of blood stasis was significantly different between the two groups. In the patients with fatty liver, phlegm dampness and humid heat were significantly higher than those in the non fatty liver. Conclusion the 1. studies found that the constitution of the patients with early diabetic nephropathy was still mainly flat and qualitative, and 8 kinds of biased bodies, phlegm, blood stasis and yin deficiency were early diabetes. .2. in this study, the phlegm dampness physique in blood sugar, blood lipid, BMI, waist circumference, fatty liver are all significantly different from other physique, suggesting that the phlegm and fat are mostly obese, most of which are accompanied by lipid metabolism disorder, and the obese people are prone to high blood sugar, which may be related to the important cause of insulin resistance in modern medicine, which is related to.3. blood stasis. It is closely related to cardiovascular disease, and the ratio of blood stasis neutrophils to lymphocyte is higher in this study, suggesting that blood stasis is associated with inflammatory factors. Patients with blood stasis need to pay more attention to the occurrence of diabetic microvascular complications.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259;R277.5

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