2型糖尿病合并高脂血症患者中医体质类型及与血脂指标的相关性研究

Types of TCM constitutions and blood fat indexes in patients with type 2 diabetes combined with hyperlipidemia

目的探讨2型糖尿病合并高脂血症患者的中医体质分布规律,研究中医体质与血脂指标的相关性。方法选择100例2型糖尿病合并高脂血症患者,根据"中医体质分类与判定表"判定体质类型并观察分布情况;通过检测总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、糖化血红蛋白(HbA1c)、体重指数(BMI)、腰臀比(WHR),比较不同体质患者的血脂指标、BMI及WHR,观察BMI,HbA1c与血脂指标的相关性。结果 100例患者中平和质占14.0%,气虚质占22.0%,阳虚质占16.0%,阴虚质占24.0%,瘀血质占7.0%,痰湿质占10.0%,湿热质占5.0%,气郁质占2.0%,特禀质占0.0%。湿热质患者TC,LDL-C均值最高,且与平和质比较差异有统计学意义(P<0.05)。痰湿质患者WHR较平和质患者升高(P<0.05)。超重组、肥胖组与正常组比较HDL-C,ApoA1均降低(P<0.05)。HbA1c良好组、差组与理想组比较TG升高(P<0.05)。结论 2型糖尿病合并高脂血症患者以阴虚质、气虚质为主,湿热质患者TC,LDL-C在各体质类型中最高。

Objective To investigate the distribution laws of TCM constitutions,and study the correlation between TCM constitutions and blood fat indexes.Methods The patients with type 2 diabetes combined with hyperlipidemia （n=100） were selected and their constitutional types were decided according to the TCM Constitution Classification and Judgement and the distribution of constitutional types was observed.The blood fat indexes,body mass index （BMI） and waist hip ratio （WHR） were compared,and the correlation between BMI,HbA1c and blood fat indexes was observed in the patients with different constitutional types through detecting total cholesterol （TC）,triglyceride （TG）,low-density lipoprotein-cholesterol （LDL-C）,high-density lipoprotein-cholesterol （HDL-C）,apolipoprotein A1 （ApoA1）,apolipoprotein B （ApoB）,HbA1c,BMI and WHR.Results Among 100 patients,14.0% of them with normal constitution,22.0% with qi-deficiency constitution,16.0% with yang-deficiency constitution,24.0% with yin-deficiency constitution,7.0% with blood-stasis constitution,10.0% with phlegm-damp constitution,5.0% with damp-heat constitution,2.0% with qi-depression constitution,and 0.0% with special constitution.The mean value of TC and LDL-C was the highest in the patients with damp-heat constitution having statistical significance compared with those with normal constitution （P〈0.05）.WHR increased in the patients with phlegm-damp constitution compared with that in the patients with normal constitution （P〈0.05）.The levels of HDL-C and ApoA1 decreased in the overweight group and obesity group compared with the normal group （P〈0.05）.The level of TG increased in the group with good HbA1c and the group with poor HbA1c compared with the group with ideal HbA1c （P〈0.05）.Conclusion The constitutional types are mainly yin-deficiency constitution and qi-deficiency constitution in the patients with type 2 diabetes combined with hyperlipidemia.The levels of TC and LDL-C are the highest in the patients with damp-heat constitution.