上海市某社区居民代谢综合征的一般情况及中医证候特点调查研究

Epidemiological investigation on metabolic syndrome and its patterns of Chinese medicine in Shanghai residents

目的研究上海市田林社区居民代谢综合征的一般情况和中医证候特点,为本病的临床防治提供依据。方法对393例上海市田林社区代谢综合征患者的年龄、性别等一般情况,BMI、腰围及腰臀比等生物学指标及血糖、血脂等实验室指标进行描述性分析;并对中医证候进行频数和聚类分析,对不同证型之间的MS危险因素进行Logistic回归分析。结果①患者平均年龄为(69.91±9.52)岁;男女比例为0.60∶1;50岁以下,男性多于女性,大于等于50岁时,女性多于男性。②频数大于50%的证候变量依次为:发槁齿落、健忘、腰膝酸软、视物模糊、失眠多梦、头晕和烦躁易怒;证候聚类结果提示393例患者可分为肝肾亏虚、肝阳偏亢兼心气亏虚型(复合证型)和肝肾亏虚型(单一证型)。两类证型之间只有"缺少运动"危险因素差异有统计学意义(P<0.05)。结论代谢综合征以中老年多见;肝肾亏虚为基本病机,中医辨治应以补益肝肾为基本治法。

Objective To investigate the epidemiological features of metabolic syndrome（MS） and its patterns in TCM.To provide evidence for the prevention and treatment for MS in clinic.Methods The age,gender,body mass index,ratio of waist to hips,blood sugar and blood lipid in 393 patients in Tianlin Community were analyzed.Then the TCM syndromes were clustered by the multivariate statistical analysis,and the risk factors（RF） of different patterns of MS were analyzed by Logist statistics.Results ①The average age of MS patients was 69.91±9.52.Male to female ratio was 0.60∶ 1.Under 50 years,the men were more than women,while the women were more than men at age of 50,or more than 50 years.②The frequency of syndrome variables over 50% include： withered hair and tooth,amnesia,soreness and weakness of waist and knees,blurred vision,insomnia,dreaminess,dizziness and vexation;The 393 patients with MS can be classified into two patterns： asthenia of liver and kidney or hyperactivity of liver yang combined with asthenia of heart-qi（compound pattern）;another pattern was asthenia of liver and kidney（single pattern）.There was statistical significance in the sports of RF between the two patterns（P0.05）.Conclusion The morbidity of MS is higher in senior citizens.The earlier and multiple interferences for MS are preferred.The basic pathogenesis of MS in TCM is asthenia of liver and kidney,so nourishing liver and kidney should be regarded as the treatment principle.