浦东中部社区901例2型糖尿病中医证型情况分析

TCM Syndrome Types of 901 Cases of T2DM in Pudong Center Communities

目的：了解浦东中部社区2型糖尿病患者的中医证型分布情况,为基层中西医结合防治糖尿病提供基础。方法：对浦东六灶社区的2型糖尿病患者进行中医辨证分型,中医证型分5个,即阴虚热盛、湿热困脾、气阴两虚、阴阳两虚、血瘀脉络（作为主证或兼夹证）。结果：年龄阴阳两虚型最大,与阴虚热盛比较有明显差异（P〈0.05）。与60~75岁组比较,〈60岁组的阴阳两虚型少于阴虚热盛、气阴两虚和血瘀脉络型（P〈0.05或P〈0.01）;〉75岁组的阴虚热盛型少于湿热困脾、气阴两虚和阴阳两虚型（P〈0.05或P〈0.01）,血瘀脉络型少于阴阳两虚型（P〈0.05）。病程阴虚热盛型最短,阴阳两虚型最长;阴虚热盛型与气阴两虚、血瘀脉络和阴阳两虚型比较均有差异（P〈0.05或P〈0.01）。与〈5年和5~10年组比较,〉10年组的阴虚热盛型少于其余四型（P〈0.01）,阴阳两虚型多于湿热困脾和气阴两虚型（P〈0.05）。结论：社区中医证型分布以气阴两虚最多,阴阳两虚最少;阴虚热盛型的年龄最小,病程最短,兼血瘀证比例最低;阴阳两虚型的年龄最大,病程最长,兼血瘀证比例最高。

Objective： To evaluate the relationship between the traditional Chinese medicine（ TCM） syndromes and the concomitant diseases of diabetes mellitus（ DM） in communities. To provide prevention and treatment reference for community diabetes by integrated Chinese and Western medicine. Methods： A total of 901 type 2 diabetes patients in communities were included.The TCM syndromes were divided into 5 types： extreme heat with Yin asthenia（ EHYA）,damp- heat stagnating in the spleen（ DHSS）,deficiency of both Qi and Yin（ DQY）,asthenia of both Yin and Yang（ AYY） and blood stasis in collaterals（ BS）. Results： The average age of AYY group was the largest and significantly different with that of the EHYA group（ P 0. 05）. Comparing to the group（ age 60- 75）,the group（ age 60） had fewer AYY than EHYA,DQY and BS（ P 0. 05 or P 0. 01）. The group（ age 75） had fewer EHYA than DHSS,DQY and AYY（ P 0. 05 or P 0. 01）,fewer BS than AYY（ P 0. 05）. The course of disease of EHYA group was the shortest and AYY group the longest. EHYA was different with DQY,BS and AYY（ P 0. 05 or P 0. 01）. Comparing to the groups（ course 5 years and course 5- 10 years）,the group（ course 10 years） showed less EHYA than DHSS,DQY,AYY and BS（ P 0. 01） but more AYY than DHSS and DQY（ P 0. 05）. Conclusion： Among all the TCM syndromes,DQY and AYY had the highest and lowest occurrence rate,respectively. EHYA had the smallest average age,the shortest course and the lowest rate of accompanying BS. AYY had the largest average age,the longest course and the highest rate of accompanying BS syndrome.