糖尿病下肢动脉病变中医证型与临床指标的关系

Relation between the Chinese Medicine Syndrome and Clinical Index in type 2 Diabetes with Lower Extremity Arterial Disease

目的:探讨糖尿病下肢动脉病变中医辨证分型与客观指标的关系,为该病辨证分型提供客观依据。方法:选择2型糖尿病下肢动脉病变患者174例,进行辨证分型,收集客观指标建立数据库,观察客观指标在各中医证型中的分布规律。结果:气滞痰阻证的糖尿病病程最短。慢性并发症发生率在阳虚痰凝证中最高。阳虚痰凝证和血瘀热蕴证的ABI显著低于气滞痰阻证;且两者血浆黏度、TC、LDL-C、FIB和股动脉IMT均显著高于气滞痰阻证。结论:血浆粘度、TC、LDL-C、FIB、ABI、股动脉IMT 6项指标与本病辨证分型相关,推测其有望成为评价本病辨证分型的客观参考指标。

Objective： To analyze the relationship between traditional Chinese medicine（TCM） syndrome patterns in patients with lower extremity arterial disease of type 2 diabetes mellitus （T2DM） and objective clinical testing indices. Methods： A total of 174 patients were included ia this analysis. TCM patterns were differentiated according to their clinical manifestations, and the data concerning laboratory examination was collected to establish a database. The aim was to observe the distribution of various clinical indices in different TCM syndrome patterns. Results： The durations of yang- deficiency phlegm-dampness pattern and blood stasis heat deposition pattern are significantly longer than that of the Qi- deficiency phlegm-dampness pattern. Diabetic complications have happened most frequently in yang-deficiency phlegm- dampness pattern. The ABI of yang-deficiency phlegm-dampness pattern and blood stasis heat deposition pattern are significantly less than that of qi-deficiency phlegm-dampness pattern （ P 〈 0. 05 ）. Moreover, the femoral artery intima medial thickness （FA-IMT） , total cholesterol （ TC ） , low-density lipoprotein （LDL） and fibrinogen （FIB） of the two patterns are significantly higher than those of qi-deficiency phlegm-dampness pattern （ P 〈 0. 05 ）. However, there are no statistically significant difference between the distribution of yang-deficiency phlegm-dampness pattern and that of blood stasis heat deposition pattern, and also no significant difference in the distribution of all patterns on fasting blood glucose, HbA1C, triglyceride and high-density lipoprotein （ P 〉 0.05 ）. Conclusion： Lower extremity arterial disease of type 2 diabetes mellitus （DM2） will get compounded with the progression of the diabetes, and the lower extremity arteriosclerosis proves to be the most serious case with yang-deficiency phlegm-dampness pattern. The six indices, namely, Blood Viscosity, TC, LDL-C, FIB, ABI, and IMT, are relevant to the TCM syndrome differentiation of diabetic lower extremity arterial disease. It is thus oredicted that this could be an objective reference index for the evaluation of this disease.