2型糖尿病周围神经病变中医证型与危险因素相关性分析

Research on Relativity between Risk Factors and TCM Syndrome Types of Type 2 Diabetes Mellitus Peripherial Neuropathy

目的探讨2型糖尿病周围神经病变(T2DPN)中医证型与危险因素间的关系。方法回顾性分析112例T2DPN病例,收集其年龄、病程、体重指数(BMI)、糖化血红蛋白(HbA1c)、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Cr)、空腹C肽(CP)、餐后2hC肽(P2hCP)等指标。遵循《糖尿病中医防治指南》对入组病例进行辨证分型,并对上述资料进行数据分析。结果气虚血瘀证与痰瘀内阻证相似,与阴虚血瘀证、肝肾亏虚证比较病程差异有统计学意义(P<0.05);气虚血瘀证、肝肾亏虚证、痰瘀内阻证SBP与阴虚血瘀证比较,差异均有统计学意义(P<0.05);HbA1c、TC和LDL-C三者相似,痰瘀内阻证与其他3个证型间差异均有统计学意义(P<0.05);阴虚血瘀证Cr、CP较其他3种证型差异也有统计学意义(P<0.05);痰瘀内阻证、肝肾亏虚证的P2hCP值与其他2种证型比较差异存在统计学意义(P<0.05)。结论按照阴虚血瘀证→气虚血瘀证→肝肾亏虚证→痰瘀内阻证顺序,T2DPN病情有逐步加重的趋势。

Objective To discuss the relativity between risk factors and TCM syndrome types of type 2diabetes mellitus peripherial neuropathy （T2DPN）. Methods One hundred and twelve cases of T2DPNinpatients were retrospective analyzed. The related clinical data such as age, course of disease, HbA1c,SBP, DBP, TC, TG, HDL-C, LDL-C, Cr, CP, P2hCP were collected. TCM syndrome types were classifiedaccording to Guideline for TCM Diabetes Prevention and Treatment. The relationship between risk factorsof T2DPN and TCM syndrome types was summarized by statistical analysis. Results Significant differenceswere found between qi deficiency with blood stasis syndrome and yin deficiency with blood stasissyndrome, and liver-kidney depletion syndrome in aspect of disease course （P 〈0.05）, the similar resultcan be gotten with phlegm and blood stasis obstructing syndrome （P 〈0.05）. Significant differences werefound between yin deficiency with blood stasis syndrome and other types in aspect of SBP （P 〈0.05）.Significant differences were found between phlegm and blood stasis obstructing syndrome and other typesin aspects of HbA1c, TC and LDL （P 〈0.05）. Significant differences were found between yin deficiency withblood stasis syndrome and other types in aspects of Cr and CP （P 〈0.05）. Significant differences werefound among liver-kidney depletion syndrome, phlegm and blood stasis obstructing syndrome and theother two types in aspect of P2hCP （P 〈0.05）. Conclusion There are some trend that the condition ofT2DPN develop more serious down the order of yin deficiency with blood stasis syndrome→qi deficiencywith blood stasis syndrome→liver-kidney depletion syndrome→phlegm and blood stasis obstructingsyndrome.