2型糖尿病中医始发病机的临床研究

Clinical Study of Initial Pathogenesis of Type 2 Diabetes in Traditional Chinese Medicine

目的:探讨从糖调节受损发展到2型糖尿病的病机变化特点,从而分析2型糖尿病的始发病机,明确病性与病位。方法:采集糖调节受损及初发2型糖尿病人群的四诊信息,研究二者中医症状、舌脉表现及证候分布特点,采用统计学方法将二者进行比较。结果:糖调节受损既可有单纯虚证,也可有单纯实证,虚实夹杂证最多。初发2型糖尿病均为虚证或虚实夹杂证。初发2型糖尿病阳虚证、心虚证明显多于糖调节受损(P<0.05)。结论:2型糖尿病发病以五脏虚损为基础,阳虚证及心虚证的加重起到了至关重要的作用。由糖调节受损发展到2型糖尿病是一个由阴证多、阳证少发展到阴证,由虚证、实证发展到虚证的阶段。

Objective：To investigate the characteristics of pathogenesis of impaired glucose regulation developing into type 2 diabetes,and to further explore the initial pathogenesis,disease location and disease nature of type 2 diabetes in traditional Chinese medicine（TCM）.Methods：We collected the information of four diagnostic methods in patients with impaired glucose regulation and newly diagnosed type 2 diabetes.The clinical symptoms,the tongue and pulse condition,and the syndromes distribution were compared separately by statistical methods.Results：In patients with impaired glucose regulation,both simple deficiency syndrome and simple excess syndrome were presented,while the syndrome of deficiency mingling with excess was dominant.In patients with newly diagnosed type 2 diabetes,deficiency syndrome or the syndrome of deficiency mingling with excess was shown.The incidences of yang deficiency syndrome and heart deficiency syndrome in patients with newly diagnosed type 2 diabetes were more than those in patients with impaired glucose regulation（P 〈 0.05）.Conclusion：Deficiency of the five zang organs is the foundation of the occurrence of type 2 diabetes,and the aggravation of yang deficiency and heart deficiency promote the progress of the pathogenesis.The development of impaired glucose regulation into type 2 diabetes is characterized as yin syndrome with less yang syndrome developing into dominative yin syndrome,and coexistence of deficiency syndrome and excess syndrome developing into deficiency syndrome.