367例社区2型糖尿病患者中医体质与心血管危险因素分析

TCM Constitutional Types and Cardiovascular Risk Factors on 367 Type 2 Diabetic Patients

目的:分析社区2型糖尿病患者中医体质类型与心血管危险因素的相关性。方法:将2014年10月—2015年9月期间在广州市天河区五山街社区进行免费健康体检的367例2型糖尿病患者纳入调查,建立健康档案,进行中医体质判定及心血管危险因素的判定。结果:367例2型糖尿病患者中,平和体质54例,偏颇体质313例,最常见的3种偏颇体质为痰湿质(26.98%)、阴虚质(16.62%)及气虚质(16.08%);痰湿质、阳虚质、气虚质具有高龄倾向,与平和质比,差异有统计意义(P<0.05);痰湿质超重和肥胖率最高,与平和质、血瘀质、特禀质、阳虚质、阴虚质、气虚质比较,差异有统计意义(P<0.05);痰湿质心电图异常率最高,与湿热质、气郁质、平和质比较,差异有统计意义(P<0.05);湿热质吸烟喝酒率最高,与其它体质比较,差异有统计意义(P<0.01),血瘀质缺乏运动率最高,与平和质、阴虚质、湿热质、气虚质、特禀质比较,差异有统计意义(P<0.05);多元Logistic回归分析显示,痰湿质肥胖和超重的危险性分别是平和质的24.830倍(CI:6.327~97.436)和11.091倍(CI:4.649~26.460),湿热质肥胖和超重的危险性分别是平和质的9.843倍(CI:1.964~49.341)和5.605倍(CI:1.954~16.076),差异有统计学意义(P<0.01)。结论:社区2型糖尿病患者心血管危险因素与中医体质具有一定的相关性,社区管理中应重点加强对痰湿体质肥胖和超重患者的社区干预。

Objective：To analyze the relativity between TCM constitution types and cardiovascular risk factors on type 2 diabetic patients. Methods ： A total of 367 type 2 diabetic patients who have done the health examination in Tianhe district Wushan community of Guangzhou during October 2014 to September 2015 were included into the survey. They have been established the personal health files and estimated the TCM constitution types and cardiovascular risk factors. Results ： A- mong the 367 cases of type 2 diabetes mellitus, 91 were normal constitutions and 276 biased constitutions. Phlegm- dampness constitution（26.98% ） ,Yin deficiency constitution （ 16.62% ） and qi deficiency constitution（ 16.08% ） were the most common constitutions of biased constitutions. Phlegm - dampness, Yang deficiency and qi deficiency constitu- tions had the tendency of old age than peace constitution （ P 〈 0. 05 ）. Phlegm - dampness constitution had more over- weight or obesity rate than other except qi depression and dampness - heat constitution（P 〈 0. 05 ）. The phlegm - damp- ness constitution had more electrocardiographic abnormality rate than dampness- heat, qi depression and peace constitu- tions（P 〈0. 05 ）. The dampness- heat constitution had more drinking and smoking rate than others （P 〈 0. 01 ）. The blood stasis constitution had more allergic and lack of exercise rate than peace constitution and qi deficiency, Yin deficien- cy and phlegm- dampness（P 〈0. 05）. Multiple Logistic regression analysis showed that the risk of phlegm -dampness constitution becoming obese was 24. 830 times （ CI ： 6.327 -97. 436） more than normal constitution ; for overweight, it was 11.091 times （ C1：4. 649- 26. 460）. Dampness - heat constitution had 9. 843 times （ CI ： 1. 964 - 49. 341 ） risk of becom-ing obese than normal constitution;for overweight, it was 5. 605 times （ CI： 1. 954- 16. 076 ）. There was a significant difference in those constitution types （ P 〈 0. 01 ）. Conclusion ： There is a certain correlation between the distribution of cardiovascular risk factors and TCM constitution types on type 2 diabetic patients. Community management should focus on the intervention of the phlegm - dampness constitution of obesity and overweight patients.