2型糖尿病中医辨证分型研究

Study on Correlation between Type 2 Diabetes and TCM Syndrome Differentiation-typing

目的:探讨2型糖尿病患者年龄、病程、家族史、体重指数、并发症及合并症对中医辨证分型的影响。方法:对在我院内分泌科住院的2型糖尿病患者545例的相关资料进行回顾分析整理。结果:年龄及病程与证型显著相关,表现为:随年龄增加热盛伤津证比例递减,气阴两虚夹瘀证比例递增;随病程增加热盛伤津证、肝肾阴虚证及气阴两虚证比例递减,肝肾阴虚夹瘀证、气阴两虚夹瘀证、阴阳两虚证比例递增(P均<0.01﹚。体重指数与证型无明显相关性(P均>0.05﹚。并发酮症者热盛伤津证比例明显增加,有显著差异(P<0.05﹚;并发周围神经病变、肾病及眼病者肝肾阴虚夹瘀证及气阴两虚夹瘀证比例明显增加,有显著差异(P均<0.001﹚。高血压、脂代谢紊乱、脑血管病变及其他合并症(高尿酸血症、痛风及冠心病)与证型无相关性,且各合并症之间与证型亦无相关性(P均>0.05)。

Objective： To approach the influence factors on TCM syndrome differentiation -typing such as age of disease onset, duration, family history, body mass index, associated symptoms, medication history and living habits in patients with symptoms of type 2 diabetes. Method ： The data from 545 inpatient cases of type 2 dia- betes in department of endocrinology, The First Affiliated Hospital of Yunnan University of TCM, were investiga- ted by epidemiological method, and all the patients were interviewed in this study. Results： It showed that the age of disease onset and duration significantly correlated to TCM differentiation - typing respectively. Further more, the incidence of excessive heat damaging fluid syndrome in old patients was less than that in non - old patients. In con- trast, the rate of Qi and Yin deficiency with blood - stasis syndrome were gradually raised with the increasing of age. The rate of excessive heat damaging fluid syndrome, liver and kidney Yin deficiency and Qi and Yin deficien- cy of lung decreased proportionally with longer duration of diabetes, but the rate of liver and kidney Yin deficiency with blood - stasis syndrome, Qi and Yin deficiency with blood - stasis syndrome and deficiency of both yin and yang syndrome increased （P 〈0. 01 significant）. Studies showed that body mass index were no correlation with TCM syndrome differentiation - typing （P 〉 0. 05 ）. Compared with other syndrome - type groups, the percentage of excessive heat damaging fluid syndrome in patients complicated by ketosis - prone was much higher （ P 〈 0. 05 significant）. There was significant increasing both in liver and kidney deficiency with blood stasis syndrome and Qi and Yin deficiency with blood - stasis syndrome groups in patients complicated by diabetic oculopathy, diabetic ne- phropathy and diabetic peripheral neuropathy （P 〈0. 01 significant）. Other factors such as high blood pressure, lipid metabolism disorders, cerebral vascular disease and other complications （hyperuricemia, gout and coronary heart disease） weren＇t show significant correlation with TCM differentiation- typing of diabetes （P 〉0. 05）.