基于数据挖掘技术的2型糖尿病辨证规范前瞻性研究

Prospective Study on Specification of Syndrome Differentiation of Type 2 Diabetes

目的探讨2型糖尿病辨证规范。方法将350例2型糖尿病患者按入组先后顺序分别进行中医证候信息采集,形成数据库,采用聚类分析和判别分析等数据挖掘方法,对证候及其动态演变规律进行分析,形成辨证规范。结果 2型糖尿病症状以乏力、口渴烦渴、多尿为主;证候以阴虚热盛、气阴两虚、阴阳两虚为主;兼夹证为湿热、血瘀和气滞。阴虚热盛型多见于2型糖尿病早期,病程在5年以内,年龄多小于45岁,并发症少,肥胖者约占55.4%,胰岛素抵抗明显;气阴两虚型多见于中期,病程在5～15年,年龄45～60岁者易患,单一并发症较多见,血糖控制欠佳;阴阳两虚型见于晚期,病程在16年以上,老年人易患,2种或2种以上并发症多见。结论 2型糖尿病不同病程患者其证型有别,不同年龄者证型亦明显不同。随着病程的进展、年龄的增加,病情逐渐加重,由阴虚热盛证发展为气阴两虚证,最后为阴阳两虚证。

Objective To investigate the specification of syndrome differentiation of type 2 diabetes.Methods Traditional Chinese medical（TCM） syndrome differentiation information of 350 patients with type 2 diabetes,according to their orders into the group,were collected respectively and formed a database.With data mining methods,e.g.cluster analysis and discriminant analysis,differentiation syndromes and their rules of dynamic evolution were analysed,and the specification of syndrome differentiation was formed.Results In type 2 diabetes,the symptoms were mainly fatigue,thirsty,polydipsia and polyuria,and their differentiation syndromes were mainly syndrome of Yin deficiency and heat excess,deficiency syndrome of both Qi and Yin,and deficiency syndrome of both Yin and Yang;the accompanied syndromes were mainly damp-heat,blood stasis and Qi stagnation.The syndrome of Yin deficiency and heat excess was often found in the early course of type 2 diabetes,uaually within 5 years,in younger patients with ages less than 45 years,with fewer complications,with obesity accounting for 55.4%,and with significant insulin resistance;the deficiency syndrome of both Qi and Yin was often found in the middle of the disease,with an course within 5 to 15 years,generally 45 to 60 years of age,with a single complication,and with poor glycemic control;and the deficiency syndrome of both Yin and Yang is often found in the late of the disease,with a course of more than 16 years,generally in the elderly,and with two or more complications.Conclusion Different durations of type 2 diabetes were with different syndromes,differentiation syndromes were often with different ages.With the disease progressing and age increasing,the condition of type 2 diabetes will gradually get worsened,often with the evolution from the syndrome of Yin deficiency and heat excess to the deficiency syndrome of both Qi and Yin,and at last,the deficiency syndrome of both Yin and Yang.