不同中医证型糖尿病前期患者血清学指标的变化

Changes of the serum markers in predibetes with different traditional Chinese medicine syndromes

目的：探讨糖尿病前期血清血糖、血脂、肿瘤坏死因子-α（TNF-α）、脂联素（APN）水平与中医证型的关系。方法：筛选出气滞痰阻型、脾虚痰湿型和阴虚气滞型3组证型糖尿病前期患者各30例,同时选择体检中心健康者20名作为正常对照组。分别测定空腹血糖（FPG）、餐后2 h血糖（2 h PG）、三酰甘油（TG）、总胆固醇（TCH）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、肿瘤坏死因子-α（TNF-α）、脂联素（APN）水平。结果：与正常对照组比较,3种证型患者FPG、TG、TCH、TNF-α升高,APN降低。3种证型比较,FPG和2 h PG差异均无统计学意义（P〉0.05）,TG、TCH以气滞痰阻型最为显著（P〈0.05）,和LDL-C差异无统计学意义（P〉0.05）,TNF-α和APN差异均有统计学意义（P〈0.05-P〈0.01）。结论：TCH、TG、TNF-α、APN与糖尿病前期证型有一定相关性,以气滞痰阻型变化最显著,可作为糖尿病前期中医辨证分型的参考依据。

Objective： To identify the correlations of between the levels of plasma glucose,blood cholesterol,tumor necrosis factor-α（ TNF-α） and adiponectin（ APN） and traditional chinese medicine syndromes in prediabetes. Methods： The levels of fasting plasma glucose（ FPG）,2-hour plasma glucose（ 2 h PG）,triglyceride（ TG）,total cholesterol（ TCH）,high density lipoprotein cholesterol（ HDLC）,low density lipoprotein cholesterol（ LDL-C）,TNF-α and adiponectin in 90 prediabetes patients with phlegm of Qi stagnation,dampness of spleen deficiency and Qi stagnation of Yin deficiency syndrome（ 30 cases each syndrome） and 20 healthy people（ the control group） were detected. Results： Compared with the normal control group,the levels of FPG,TG and TCH and TNF-α increased,and the level of APN decreased in three syndromes patients,the differences of the levels of FPG and 2 h PG between three syndromes patients were not statistically significant（ P〉0. 05）. The levels of TG and TCH were the most significant（ P〉0. 05）,but the difference between and LDL-C was not statistically significant in phlegm of Qi stagnation patients（ P〈0. 05）. The differences of the levels of TNF-α and APN between three syndromes patients were statistically significant（ P〈0. 05 to P〈0. 01）. Conclusions： There are certain correlations between the levels of TCH,TG,TNF-α and APN and traditional chinese medicine syndromes in prediabetes,especial for in phlegm of Qi stagnation syndrome patients,which can provide a reference in identifying different syndromes in prediabetes.