2型糖尿病合并脂代谢紊乱的中医证候学研究

The TCM symptomatology of type 2 diabetes mellitus with dyslipidemia

目的:探讨2型糖尿病合并脂代谢紊乱的中医证候学特点以及高脂血症各临床分型与不同血脂指标的相关性。方法:将155例2型糖尿病患者按有无血脂异常分为高脂血症组和非高脂血症组,测定TG、LDL-C、HDL-C、TC并判定中医证候,采用Pearson检验研究各证型与血脂各指标的相关性。结果:高脂血症组与非高脂血症组痰湿证、血瘀证差异均有统计学意义(P<0.05)。痰湿证积分、血瘀证积分与TG水平呈显著正相关(r=0.209,P=0.009;r=0.161,P=0.046),与HDL-C水平呈显著负相关(r=-0.208,P=0.009;r=-0.167,P=0.025),阳虚证积分与HDL-C、apoA1水平呈显著正相关(r=0.236,P=0.003;r=0.210,P=0.016)。结论:痰湿证、血瘀证为2型糖尿病合并脂代谢紊乱的主要证候,痰瘀互结为2型糖尿病合并脂代谢紊乱的关键病机。痰湿证、血瘀证与血脂成分存在相关性。

Objective:To investigate the TCM symptomatology characters of the type 2 diabetes mellitus with dyslipidemia and correlation between the TCM clinical types of hyperlipoidemia and the different blood liquid components.Methods:The 155 patients with type 2 diabetes mellitus were divided into the group of hyperlipoidemia and the group of non-hyper lipoidemia according to blood liquid.The levels of TG,LDL-C,HDL-C and TC were detected in two groups respectively.TCM syndromes were determined.The Pearson test method was adopted to analyze the correlation.Results:There was significant differences in the Phlegm-dampness syndrome,Blood stasis syndrome between the two groups (P<0.05).The integration of Phlegm-dampness syndrome,Blood stasis syndrome correlated positively with the level of TG (r=0.209,P=0.009;r=0.161,P=0.046),and correlated negatively with the HDL-C (r=-0.208,P=0.009;r=-0.167,P=0.025).The integration of Yan deficiency syndrome correlated positively with the HDL-C,apoA1 (r=0.236,P=0.003;r=0.210,P=0.016) between the two groups.Conclusion:Phlegm-dampness syndrome and Blood stasis syndrome are the main TCM syndromes of the type 2 diabetes mellitus with dyslipidemia.Phlegm-dampness syndrome and Blood stasis syndrome are correlated to blood liq uid components.