2型糖尿病247例临床辨证分型研究

Study of Differentiation for Classification of Syndrome on Type 2 Diabetes Mellitus,A Report of 247 Cases

目的:观察2型糖尿病的中医辨证分型及其与年龄、病程的关系。方法:将2型糖尿病247例患者辨证分为痰(湿)热互结证、阴虚燥热证、气阴两虚证、阴阳两虚证、肝肾阴虚证5种基本证型,同时记录兼血瘀证者,对其分布例数进行年龄组(≤40岁4、1～59岁,≥60岁)之间、病程组(<2年、2～5年5,～10年和大于10年)之间的比较。结果:各类证型患者在不同年龄阶段的分布有统计学差异(P<0.01),各类证型患者中病程分布不同或不完全相同(P>0.01)。兼血瘀证病例在年龄组之间和病程组之间有显著差别(P<0.01)。结论:气阴两虚型是2型糖尿病的最常见证型;肝肾阴虚型,阴阳两虚型随年龄和病程的增加所占比例增加。痰(湿)热互结型、阴虚燥热型在病程早期发生率高,随着病程的延长发生频率呈下降趋势。血瘀兼证在病程早期即出现,且随着病程和年龄的增加发生比例增加。

： Objective ： To investigate the relationship between differentiation of symptoms and signs for classification of syndrome in Type 2 Diabetes Mellitus and the patients＇age and the course of disease. Methods ： 247 cases of Type 2 Diabetes Mellitus were differentiated and classified into such five patterns of syndromes as syndrome of phlegm - dampness - heat gluing each other, syndrome of yin asthenia leading to dryness - heat, syndrome of defi- ciency of both qi and yin, syndrome of deficiency of both yin and yang, and syndrome of hepatic and renal yin deft-ciency. At the same time the cases holding syndrome of blood stasis to above syndromes were recorded and their distribution were compared with each other on age （ younger than 40 year - old ,from 41 to 59 year - old and older than 60 year -old）, and the course of disease （less than 2 years, from 2 to 5 years, from 5 to 10 years and morethan 10 years）. Results： There were significant differences among different patterns of syndromes in different age distributions （P 〈 0.01 ）, and so was the course of disease （P 〈 0.01 ）. The cases holding syndrome of blood sta- sis showed significant difference on age and the course of disease （P 〈0.01 ）. Conclusion： Syndrome of deficien- cy of both qi and yin is the most common syndrome in Type 2 Diabetes Mellitus. Syndrome of hepatic and renal yin deficiency and syndrome of deficiency of both yin and yang increases with age and the lasting of course of disease. Syndrome of phlegm- dampness -heat gluing each other and syndrome of yin asthenia leading to dryness -heat take high proportion of incidence, but with the lasting of course of disease the incidence rate decreases. Holding syndrome of blood stasis shows up in the early course of disease, and the incidence rate increases with the lasting ofcourse of disease and age.