2型糖尿病合并骨质疏松症患者中医体质的流行病学调查

发布时间：2018-06-20 07:09

本文选题：2型糖尿病 + 骨质疏松症　；参考：《广州中医药大学》2017年硕士论文

【摘要】：目的研究2型糖尿病合并骨质疏松症患者的体质分布,分析其流行病学特征,探讨不同中医体质患者的异同。从而为临床中辨中医体质论治提供有效数据和客观依据,为2型糖尿病合并骨质疏松症预防和治疗的研究提供新的思路和方案。方法选择2015年1月至2016年12月在深圳市宝安中医院门诊、住院部及体检中心就医并确诊为2型糖尿病合并骨质疏松症的患者,应用调查问卷(包括调查人协助填写和被调查人自填)的方法,使用王琦《中医体质分类与判定表》作为标准,按照纳入标准、排除标准收集病例212份,患者同意后进行体质判定,记录患者一般信息及疾病相关信息(年龄、性别、职业、教育、婚姻、饮食、运动、病程、BMD、VAS等),记录数据,运用SPSS 22.0进行数据处理和分析。对深圳市宝安中医院2型糖尿病合并骨质疏松症患者进行中医体质的相关调查。结果本研究共收集T2DM合并OP病例212份,阴虚质54例(26%)、瘀血质38例(18%)、阳虚质32例(15%)、痰湿质28例(13%)、其他体质归为一组共60例(28%);以P0.05,为检验的结果有统计学意义。T2DM合并OP患者中无职业者(44.3%)和体力劳动者(37.7%),脑力劳动者最少(18%),无职业者中较多是阴虚质(28.7%)、阳虚质(22.3%),体力劳动患者中瘀血质(23.8%)和其他体质(36.3%)较多;T2DM合并OP患者中喜清淡饮食患者共(68.4%)较多,喜食高热量患者(31.6%)较少,喜食高热量患者中痰湿质(23.9%)最多;本病中无(48%)或每周1-2次运动习惯(33%)患者较多,每周3次或以上运动患者(18.4%)较少,其中无(31.4%)或每周1-2次运动习惯患者阴虚质较多(22.5%),每周1-2次运动习惯患者中瘀血质(28.2%)较多;不同性别、婚姻状况和受教育程度的T2DM合并OP患者中的中医体质分布的无显著差异(P0.05);所有患者平均年龄为63.68±4.98岁,阴虚质的患者(64.13±5.26)岁普遍较瘀血质患者(61.92±4.97)年龄要大,阳虚质患者(65.94±5.00)较阴虚质患者(64.13±5.26)以外所有体质患者年龄大;患者病程多为5-10年(51%),病程短于5年或长于10年的少(21%,28%),阴虚质和阳虚质患者病程大于10年及以上的比例明显更大(43%,500%),而瘀血质患者大于10年病程的明显更少(13%),痰湿质和其他体质患者大于10年病程的比例相对也偏小(21%,15%);所有患者骨密度为0.64±0.10g/m2,阴虚质患者0.61±0.11g/m2的骨量较瘀血质0.68±0.09g/m2和痰湿质患者0.68±0.11g/m2更低,瘀血质患者0.68±0.09g/m2骨量较阴虚质0.61 ±0.11g/m2、阳虚质0.59±0.10g/m2及其他体质患者0.64±0.09g/m2都要高,阳虚质患者0.59±0.10g/m2骨量较除阴虚质以外所有体质患者更低;所有患者VAS评分为5.03± 1.49,相比起其他任何体质,瘀血质患者6.08±1.38疼痛程度更高。结论1、绝大部分T2DM合并OP患者是偏颇体质,最多是阴虚质,其次依次为瘀血、阳虚、痰湿以及其他体质。2、不同职业、饮食偏好、运动习惯与T2DM合并OP患者不同的体质有关系,大部分患者无工作、饮食清淡、运动少,无工作者多虚弱者,体力劳动者体质多实多瘀,喜高热量饮食患者更多痰湿,运动多的患者更多瘀血质,运动少的患者更多为虚弱者,不同性别、婚姻情况和教育情况与中医体质无明显关系。3、不同中医体质的T2DM合并OP病人年龄、病程、骨量、疼痛有差异,虚弱体质患者年龄更高、病程更长、骨量更低,体质实者年龄更低、病程更短、骨量更高,瘀血质的患者明显更痛。
[Abstract]:Objective to study the physical distribution of patients with type 2 diabetes and osteoporosis, to analyze the epidemiological characteristics and to explore the similarities and differences of patients with different physique of traditional Chinese medicine, so as to provide effective data and objective basis for the clinical treatment of TCM Constitution, and to provide new ideas and plans for the study of pre prevention and treatment of type 2 diabetes with osteoporosis. Methods from January 2015 to December 2016, the patients with type 2 diabetes combined with osteoporosis were hospitalized in the outpatient department of the Baoan traditional Chinese Medicine Hospital of Shenzhen City, the hospitalization department and the medical examination center. The questionnaire (including the investigators assisting in filling out and the self filled) was used, and Wang Qi was used as the standard for the classification and decision table of Chinese medicine. Inclusion criteria, excluding 212 cases of standard collection cases, the patient's consent after the constitution, records of general information and disease related information (age, sex, occupation, education, marriage, diet, exercise, course of disease, BMD, VAS, etc.), record data, use SPSS 22 for data processing and analysis of type 2 diabetes combined with bone in Baoan Hospital of Shenzhen A total of 212 cases of T2DM combined with OP, 54 cases of yin deficiency (26%), 38 cases of blood stasis (18%), 32 cases of Yang deficiency (15%), 28 cases of phlegm dampness (13%), and a group of 60 cases (28%), and the results of P0.05 were statistically significant in.T2DM combined with no occupations in OP patients. 44.3%) and manual labourers (37.7%), the mental labourers were least (18%), and most of the non occupations were Yin deficiency (28.7%), Yang deficiency (22.3%), blood stasis (23.8%) and other physique (36.3%) in physical labor patients. The patients with T2DM combined with OP were more happy with light diet (68.4%), and more calorie patients (31.6%) were happy to eat high calorie patients. Medium phlegm and wet quality (23.9%) was the most; there were no (48%) or 1-2 exercise habits (33%) per week, and 3 or more exercise patients (18.4%) per week (18.4%), of which there was no (31.4%) or 1-2 exercise weekly patients with more yin deficiency (22.5%), and 1-2 times per week of 1-2 exercise habits (28.2%); different sex, marital status and education. There was no significant difference in the physical distribution of Chinese medicine in patients with T2DM combined with OP (P0.05); the average age of all patients was 63.68 + 4.98 years old, and the patients with Yin deficiency (64.13 + 5.26) years were generally older than those of blood stasis (61.92 + 4.97), and the patients with Yang deficiency (65.94 + 5) were older than those of the yin deficiency patients (64.13 + 5.26). The course of disease was 5-10 years (51%), the course of disease was shorter than 5 years or less than 10 years (21%, 28%). The proportion of patients with Yin deficiency and yang deficiency was greater than 10 years and above (43%, 500%), while the patients with blood stasis were significantly less than 10 years (13%), and the proportion of phlegm and other constitution patients was smaller than that of 10 years (21%, 15%); The bone density of the patients was 0.64 + 0.10g/m2, and the bone mass of the patients with Yin deficiency 0.61 + 0.11g/m2 was 0.68 + 0.09g/m2 and 0.68 + 0.11g/m2 in the phlegm dampness. The 0.68 + 0.09g/m2 bone quantity of the blood stasis patients was 0.61 + 0.11g/m2, the 0.59 + 0.10g/m2 of Yang deficiency and the 0.64 + 0.09g/m2 of the other constitution patients were higher, and the patients of Yang deficiency were 0.59 + 0.10g/m2 The bone mass was lower than that of all physical patients except Yin deficiency; the VAS score of all patients was 5.03 + 1.49. Compared with any other constitution, the pain degree of the patients with blood stasis was 6.08 + 1.38. Conclusion 1, most of the T2DM patients with OP were biased constitution, most of which were Yin deficiency, followed by blood stasis, Yang deficiency, phlegm dampness and other physique.2, different positions. Industry, diet preference and exercise habits are related to the different physique of patients with T2DM combined with OP. Most patients have no work, light diet, less exercise, less workers, more physical and more blood stasis, more patients with high calorie diet, more phlegm in the patients with high calorie diet, more blood stasis in the patients with more exercise, and more debilitating and different in the patients with less exercise. There is no obvious relationship between the marital status and education situation and the constitution of Chinese medicine.3. The T2DM of different Chinese medicine constitution combined with the age of the OP patients, the course of the disease, the bone mass and the pain, the age of the debilitating body is higher, the course of the disease is longer, the bone mass is lower, the age of the body is lower, the course is shorter, the bone mass is higher, and the patients with blood stasis are obviously more painful.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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