2型糖尿病大血管并发症中医证候演变规律探讨

Development rules of TCM syndrome of type 2 diabetes mellitus with macrovascular complications

目的:探讨2型糖尿病(T2DM)大血管病变患者中医证候演变规律。方法:60例T2DM大血管病变患者按中医证候分为阴虚燥热型、气阴两虚型、阴阳两虚型3型,每型各20例,另设正常对照组20例,统计T2DM大血管并发症主要中医症状及与性别、体重、病程等临床参数的关系。结果:中医症状出现频率由高到低依次为腰酸膝软(70.0%)、肢体困重(65.0%)、口渴引饮(56.7%)、头晕目眩(55.0%)、心悸怔忡(53.3%)、倦怠乏力(53.3%)。T2DM大血管并发症各型患者体重较正常对照组均有上升,其中阴阳两虚型患者体重增加最为明显(P<0.01),病程变化也符合此趋势,但无统计学差异(P>0.05)。结论:糖尿病大血管并发症中医病机错综复杂,虚实夹杂。在正虚方面,从阴虚燥热、气阴两虚发展为阴阳两虚,邪实方面,瘀血贯穿于疾病的始终。

Objective：To explore the development rules of TCM syndrome of type 2 diabetes mellitus with macrovascular complication.Methods：A total of 60 patients with type 2 diabetes mellitus and macrovascular complications were divided into 3 groups：dryness-heat due to Yin deficiency group（20 cases）,deficiency in Qi and Yin group（20 cases） and deficiency in Yin and Yang group（20 cases） according to TCM syndrome,control group was 20 cases.The relationships between main TCM syndromes and gender,weight,course,etc.were observed.Results：In 60 TCM cases,weakness of waist and knees were the most frequent symptom（70.0%）,followed by arthralgia of extremities（65.0%）,thirst with desire of drink（56.7%）,vertigo（55.0%）,palpitation with a distress feeling（53.3%）,fatigue and weakness（53.3%）.The weights of all patients with complication were increased comparing with normal cases,and the change of patients with deficiency in Yin and Yang was most significant（P〈0.01）.The course showed the same change,but without significant difference（P〉0.05）.Conclusions：TCM Pathogenesis of type 2 diabetes mellitus with macrovascular complication is complicated,including both deficiency and excessive syndrome.Concerning deficiency,the syndrome developed from interior heat due to Yin deficiency or deficiency in Qi and Yin to deficiency in Yin and Yang;while concerning excess,blood stagnation occurs all the time.