180例2型糖尿病患者中医证候调查及证型研究

Investigation of TCM symptoms and syndrome in 180 patients with T2DM

目的:调查本院内分泌科住院和门诊糖尿病病人,利用数理统计分析得出临床常见糖尿病中医证型特点,并进一步研究常见证型与客观指标(如并发症史、血脂、尿MA/CR等)之间的关系。方法:以调查问卷的形式对180例糖尿病患者进行横断面调查,并应用公因子分析、方差最大化正交旋转与样品聚类相结合的方法进行统计学处理,并由临床专家根据聚类结果判别中医证型。在此基础上,再进一步用方差分析等统计方法对分型结果与一些客观指标(如血糖、血脂、超敏C反应蛋白、尿MA/CR等)进行相关性的研究。结果:对调查表中137个中医症状体征中出现频率大于10%的50个症状体征进行统计分析判别,获得的糖尿病中医证型根据中医诊断学理论可归纳为4个主要复合证型:气阴两虚、瘀热内蕴型77例,肾气亏虚型54例,肝阳上亢夹瘀型39例,湿热夹瘀型10例。进一步对分型结果与一些客观指标进行相关性的研究发现,不同证型与血脂、尿MA/CR等有一定的关联性。结论:气阴两虚、瘀热内蕴型是糖尿病最常见的证型。中医证型与胆固醇(TC)、低密度脂蛋白(LDL)、尿MA/CR等指标具有一定的相关性。

Objective： Taking inpatient and outpatient with diabetes in our hospital as research subjects, to investigate the characteristics of TCM syndrome of diabetes by mathematical statistics, and to study the relationship between common syndromes and objective indexes further, such as history of complication, blood fat, MA/CR. Methods： Cross-sectional study on 180 cases of diabetes was carried by questionnaire. Combining with the suggestion of clinic experts, common factor analysis, varimax procedure and sample cluster were used to determine the TCM syndrome. Then, the dependability of TCM syndromes and objective signs was researched by analysis of variance. Results： Among 137 signs and symptoms, 50 were analyzed which had the frequency of occurrence of more than 10% to determine the TCM syndromes of diabetes. Combining with theory of diagnostics of TCM, 4 main compound syndromes were acquired： 77 cases with deficiency of both qi and yin and stagnated heat stasis, 54 cases with deficiency of kidney qi, 39 cases with excessive rising of liver yang and stagnation, 10cases with humid heat and stagnation. Further study on dependablity of syndromes and objective indexes showed that syndromes correlated with blood fat, MA/CR and so on at some extent. Conclusion： Deficiency of both qi and yin, stagnated heat stasis were the common syndromes of diabetes. TCM syndromes of diabetes correlated to TC, LDL and MA/CR.