2型糖尿病病人中医证型与临床指标的相关性分析

Correlation of Traditional Chinese Medicine Syndrome Type and Several Clinical Indicators in Type 2 Diabetes Mellitus

目的分析2型糖尿病(T2DM)病人中医型证与相关临床指标的关系。方法将162例T2DM病人按照中医相关诊疗指南辨证分为湿热困脾证、阴虚热盛证、气阴两虚证、血瘀脉络证、阴阳两虚证五个证型。检测病人总胆固醇(TC)、三酰甘油(TG)、糖化血红蛋白(Hb A1c)、空腹血糖(FPG)、餐后2 h血糖(PPG)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)指标,并分析各中医证型与TC、TG、Hb A1c、FPG、PPG、Hcy、CRP等指标间的关系。结果 T2DM病人中医证型分布依次为:湿热困脾证>阴虚热盛证>气阴两虚证>血瘀脉络证>阴阳两虚证。与其他中医证型比较,湿热困脾证TC、TG高于其他证型,差异有统计学意义(P<0.05);阴虚热盛证Hb A1c、FPG、PPG均高于其他证型,差异有统计学意义(P<0.05);血瘀脉络证Hcy高于其他证型,差异有统计学意义(P<0.05);阴阳两虚证CRP高于其他证型,差异有统计学意义(P<0.05)。结论 T2DM病人中医辨证分型以湿热困脾证为主。TC、TG、Hb A1c、FPG、PPG、Hcy、CRP指标水平的高低在一定程度可以上反应T2DM病人中医证型的病情变化,可以作为T2DM病人中医证型病情变化的参考指标,与T2DM病人中医证型具有一定相关性。

Objective To research the correlation between traditional Chinese medicine(TCM)syndrome type and several clinical indi-cators in type 2 diabetes mel itus(T2DM).Methods In accordance with the relevant guidelines for diagnosis and treatment of TCM syndrome differentiation,one hundred and sixty two patients with T2DM were divided into 5 groups:spleen damp heat syndrome, yin deficiency and heat syndrome,Qi and yin deficiency syndrome,blood stasis syndrome,yin and yang deficiency syndrome.Cho-lesterol (TC),triglyceride (TG),glycosylated hemoglobin A1c (HbA1c),fasting plasma glucose (FPG),2 hour postprandial plas-ma glucose(PPG),homocysteine (Hcy),C reactive protein (CRP)were observed.The relations between TCM syndrome type and TC,TG,HbA1c,FPG,PPG,Hcy,CRP were analyzed.Results TCM syndrome types in patients with T2DM was as fol ows in turn:spleen damp heat syndrome,yin deficiency and heat syndrome,Qi and yin deficiency syndrome,blood stasis syndrome,yin and yang deficiency syndrome.The levels of TC,TG in patients with spleen damp heat syndrome were higher than that in in patients with other syndrome types(P<0.05).The levels of HbA1c,FPG,PPG in patients with yin deficiency and heat syndrome were higher than that in in patients with other syndrome types(P<0.05).The levels of Hcy in patients with blood stasis syndrome were higher than that in patients with other syndrome types(P<0.05).The levels of CRP in patients with yin and yang deficiency syndrome were high-er than that in patients with other syndrome types(P<0.05).Conclusion The main TCM syndrome type in patients with T2DM is spleen damp heat syndrome.There is some correlation between syndrome type and the levels of TC,TG,HbA1c,FPG,PPG,Hcy, CRP in patients with T2DM.