2型糖尿病中医证型与下肢动脉病及颅内动脉狭窄关系研究

Study on Relationship between TCM Syndromes of T2DM with Lower Extremity Arterial Disease and Intracranial Arterial Stenosis

目的探讨2型糖尿病中医证型与下肢动脉病及颅内动脉狭窄的关系。方法对2013年2-8月我院住院及门诊的139例2型糖尿病患者进行中医辨证分型,选取正常体检者25例作为正常对照组,分析中医不同证型与下肢动脉病及颅内动脉狭窄的关系。结果⑴气阴两虚型和阴阳两虚型的糖尿病病程较湿热困脾型和阴虚热盛型更长;⑵湿热困脾型、阴虚热盛型、气阴两虚型、阴阳两虚型患者的踝臂指数(ABI)值依次递减,说明狭窄程度趋于严重;⑶所有患者中,气阴两虚型和阴阳两虚型发生颅内动脉狭窄的比例最高,分别为18.7%、12.9%;35例阴阳两虚型患者中,颅内动脉狭窄发生率占该证型的51.4%,高于其他3个证型。结论气阴两虚型和阴阳两虚型更易发生下肢动脉病和颅内动脉狭窄。中西医结合筛查可显著延迟或预防2型糖尿病高危人群(阴阳两虚型和气阴两虚型患者)颅内动脉狭窄和下肢动脉病的发生。

Objective To discuss the relationship between TCM syndromes of type 2 diabetes （T2DM） withlower extremity arterial disease and intracranial arterial stenosis. Methods From February 2013 to August, 139hospitalized patients and outpatients with T2DM were studied for TCM syndrome differentiation. 25 normalsubjects were chosen as normal control group. Relationship between TCM different syndromes with lowerextremity arterial disease and cranial artery stenosis was analyzed. Results （1） The duration of diabetes of qi-yindeficiency type and yin-yang deficiency type were longer than types of damp heat in the spleen and yindeficiency and excessive heat; ⑵ ABI value was in descending order： damp heat in the spleen typr, yindeficiency type and excessive heat type, qi-yin deficiency type and yin-yang deficiency type, indicating the moresevere stenosis; ⑶ Among all the patients, the incidence for intracranial arterial stenosis in qi-yin deficiencytype （18.7%） and yin-yang deficiency （12.9%） was the highest; among the 35 cases of yin-yang deficiency type,the incidence of intracranial arterial stenosis occupied 51.4%, higher than the other three types. Conclusion Qiyindeficiency type and yin-yang deficiency type are more likely to lead to lower extremity arterial disease andintracranial arterial stenosis. Integrated traditional Chinese and Western medicine combining screening can significantlydelay or prevent T2DM in high-risk population （qi-yin deficiency type and yin-yang deficiency type）.