糖尿病胫前色素斑的中医证候特点研究

Analysis of TCM syndrome distribution characteristics in diabetic pretibial pigmented patches patients

目的:探询糖尿病伴有胫前色素斑患者的中医证候分布特点,为临床诊治提供依据。方法:将231例2型糖尿病住院患者按有无胫前色素斑分为两组,按患者症状、体征辨证,比较两组间差异。结果:单证素分析显示血瘀证、气虚证、肾虚证、阳虚证为糖尿病胫前色素斑患者最常见证型;与对照组相比,阳虚证、肾虚证、肝血虚证、血瘀证、气郁证和湿热证发病率较高(P<0.05,P<0.01)。复合证型研究提示各种血瘀兼证发生率均较高,气虚血瘀、肝血虚血瘀、阳虚血瘀证最为常见。结论:糖尿病胫前色素斑的中医证候特点为本虚标实,瘀血证为最常见的标实证贯穿病程始终。且随着糖尿病病程的逐渐延长,瘀血兼证逐渐出现从阴虚血瘀向气虚血瘀、阳虚血瘀转化的趋势。

Objective： To analyze the TCM syndrome distribution characteristics of diabetic pretibial pigmented patches patients, and to provide a reference for the clinic diagnosis and treatment. Methods： 231 cases of type 2 diabetes patients were divided into two groups： patients with pretibial pigmented patches and patients without pretibial pigmented patches. According to the syndrome differentiation based on clinical symptoms and signs, the differences of TCM type between the two groups were compared. Results： The main types of TCM syndrome in diabetic pretibial pigmented patches patients were： blood stasis syndrome, qi deficiency syndrome, kidney deficiency syndrome and yang deficiency syndrome. Compared to the other group, the prevalence rates of yang deficiency syndrome, kidney deficiency syndrome, liver blood deficiency syndrome, blood stasis syndrome, qi stagnation syndrome and damp-heat syndrome were much higher （P〈0.05, P〈0.01）. Among the compound syndrome types, qi-deficiency and blood stasis, liver-blood deficiency and blood stasis, yang-deficiency and blood stasis were the most common syndromes in the observation group. Conclusion： The feature of TCM syndrome of diabetic pretibial pigmented patches was mixed insufficiency and excessiveness syndromes. Blood stasis is the main syndrome of pretibial pigmented patches and ran through all the courses of it. And as the course of the disease, there is a tendency that the TCM syndrome changed from yin- deficiency and blood stasis to qi-deficiency and blood stasis, then to the yang-deficiency and blood stasis at last.