糖尿病下肢动脉硬化闭塞症的中医证型分布规律浅探

Exploration on the Distribution Law of Different Traditional Chinese Medicine Syndrome Types in Diabetic Lower Limb Arteriosclerosis Obliterans

目的:探讨糖尿病下肢动脉硬化闭塞症(Diabetes Lower Extremity Arteriosclerosis Obliterans,DLASO)的中医证型分布规律。方法:对2009年9月至2012年9月住院的DLASO患者进行中医辨证分型,比较不同证型与性别、年龄、糖尿病病程、体重指数、糖化血红蛋白、血脂等因素的关系。结果:454例DLASO患者的合并症和并发症中高血压病最多,其次为糖尿病周围神经病变、血脂异常症、冠心病、糖尿病视网膜病变、糖尿病肾病。合并高血压、糖尿病周围神经病变、血脂异常症的患者均超过60%。患者以气阴两虚兼血瘀型为最多(381例,83.92%)与湿热困脾兼血瘀型、阴阳两虚兼血瘀型相比,差异有统计学意义(P<0.05)。患者男女比例为1.29∶1,差异有统计学意义(P<0.01)。阴阳两虚兼血瘀型的体重指数为(26.43±4.11)kg/m2,高于气阴两虚兼血瘀型(24.91±3.12)kg/m2(P<0.05)。结论:DLASO患者多合并高血压病、糖尿病周围神经病变、血脂异常症;气阴两虚兼血瘀型是DLASO最常见的证型;男性患DLASO的危险性高于女性;阴阳两虚兼血瘀型体重指数偏高。

Objective：To investigate the distribution law of different TCM syndrome types in the patients with diabetic lower limb arteri -osclerosis obliterans （DLASO）.Methods：Patients with DLASO admitted to our hospital from September 2009 to September 2012 were classified into different Traditional Chinese Medicine syndromes , and the data of sex , age, duration of DM, BMI, HbA1c, blood lipid in different syndromes were compared .Results： Among the 454 cases of with DLASO , hypertension was the complication occurred the most, followed by diabetic peripheral neuropathy , dyslipidemia, coronary heart disease, diabetic retinopathy, and diabetic nephropathy. Hypertension, diabetes peripheral neuropathy , dyslipidemia disease were more than 60%of patients.Deficiency of both Qi and Yin with blood stasis were seen in the majority of patients （381 cases, 83.92%）, and the differences were statistically significant compared with humid and heat trapped spleen with blood stasis , deficiency of both Yin and Yang with blood stasis （P〈0.05）.The ratio of male pa-tients to female was 1.29∶1, and the difference was significant （P〈0.01）.BMI in deficiency of both Yin and Yang with blood stasis group （26.43 ±4.11 kg/m2） was higher than deficiency of both Qi and Yin with blood stasis group ’s（24.91 ±3.12 kg/m2） （P〈0.05）.Conclusion：Most DLASO patients complicate with hypertension , diabetic peripheral neuropathy , dyslipidemia.Deficiency of both Qi and Yin with blood stasis is the most common syndrome in DLASO .Male has higher risk of DLASO than female .BMI in the group of deficiency of both Yin and Yang with blood stasis is high .