一对糖尿病双生子肾虚证动态变化观察

Observation on Dynamic Changes of Kidney Deficiency Syndrome of A Monozygotic Twin with Type 2 Diabetes Mellitus

目的:以病证结合的方法调查一对2型糖尿病(Type 2 Diabetes Mellitus,T2DM)双生子,分析双生子肾虚证随病程延长的动态变化特征。方法连续2年每年5次评估双生子病情,采用包含39项症状指标的肾虚证量表对双生子各临床症状逐项进行四级评分。结果:大双和小双的肾虚程度均随病程延长而逐渐加重,但是加剧的程度不一致,小双重于大双。肾虚证细化分型可见二者都辨为肾阴阳两虚证,随病程递增,以肾阴虚程度加重更为突出,小双的这种表现更明显。讨论:同卵双生子由于遗传物质完全相同,双生子间表现出西医病和中医证的属性也基本相同。但是由于个体差异、外在环境等的影响,二者在病情程度和发病进程上有明显的差异。

Objective ： To analyze the dynamic changes of kidney deficiency syndrome of a monozygotic twin along with the progression of their type 2 diabetes mellitus （T2DM）. Methods：A questionnaire included 39 items was applied to ana- lyze the symptom differentiations of twin sisters at 5 time points in 2 years. Results ： The kidney deficiency degree of twins became serious with the prolongation of T2DM course. Both twin sisters were differentiated with deficiency of kidney Yin and Yang, and the deficiency of kidney Yin was more prominent with the progression of T2DM, and this trend was manifes- ted more obviously on younger sister than the older one. Conclusions：Due to identical genetic material of monozygotic twins, the property of their disease and traditional Chinese medicine syndrome is basically the same. But because of the influences of individual differences and the external environment, the twins have obvious differences in the severity and progression of T2DM.