2型糖尿病合并脑梗死的中医证候学研究

Research on TCM Syndrome of 2 Type Diabetes Companying Cerebral Embolism

目的:通过临床观察研究2型糖尿病合并脑梗死的中医证候学特点。方法:选择符合2型糖尿病合并脑梗死标准的患者89例,通过中医证型分型标准进行辨证分型,并进行BMI、FPG、Hb A1c及颈动脉彩超检测,观察患者各证型的分布及各证型与不同检测指标之间的差异性。结果:各证型的发生率分别为气虚血瘀型32.6%、痰浊阻络型28.1%、阴虚风动型20.2%、风火上扰型19.1%;痰浊阻络型BMI最高,与其他3型相比差异有统计学意义(P<0.05);颈部血管彩超显示痰浊阻络型的斑块检出率最高(88.0%),与其他各型相比差异有统计学意义(P<0.05)。结论:2型糖尿病合并脑梗死的中医证型表现以痰、瘀、虚为主,且痰浊阻络型与BMI及颈动脉斑块情况关系密切。

Objective ： To research the features of TCM syndrome of 2 type diabetes companymg cerebral embolism through clinical observation. Methods ： We chose 89 patients who met the standards of Ⅱ type diabetes companying cerebral embolism, and typed them based on syndrome differentiation by typing criteria of TCM syndrome types. BMI, FPG, HbA1 c and carotid duplex ultrasound were detected. The distribution of different syndrome types of patients and the differencebetween various syndrome types and different detected indices were observed. Results： The share rate of various syndrome types were respectable blood stasis due to qi deficiency （32. 6% ）, collaterals obstruction due to turbid phlegm（28. 1% ） ,stirring wind due to yi deficiency （20. 2% ） ,wind-fire upward invading （ 19. 1% ）. BMI of collaterals obstruction due to turbid phlegm was the highest; compared with the other three types, the differences were statistically significant （ P ~ 0. 05 ）. Carotid duplex ultrasound displayed that the plaques detection rate （88.0%）of turbid phlegm obstructing collaterals type was highest; compared with the other types, the difference was statistically significant （P 〈 0.05 ）. Conclusion ： Manifestations of TCM syndrome types of 2 type diabetes companying cerebral embolism were mainly phlegm, stasis and deficiency, and the syndrome type of turbid phlegm obstructing collaterals has close relation with BMI and cases of carotid plaques.