2型糖尿病患者中医证素研究

Analysis of traditional Chinese medicine syndromes elements in type 2 diabetes mellitus

[目的]分析2型糖尿病(T2DM)患者关键中医病位证素,并探索各病位证素的临床流行病学规律,为中医临床辨治提供依据。[方法]将192例T2DM患者中医病位辨证归属为脾、肾、肝,探讨各组之间的差异。[结果]各组在性别比例、年龄构成、BMI指数不存在统计学差异(P>0.05);在睡眠时间上肝、肾两组的睡眠时间较脾组睡眠时间明显缩短(P<0.05);高血压、冠心病、脂代谢紊乱在各组的发生率没有明显差别(P>0.05)。肝组主要虚性证素为:阴虚(P<0.01);主要实性证素频数由高到低依次为:阳亢、湿、痰、气滞、血瘀、热(P<0.05);脾组主要虚性证素频数由高到低依次为气虚、阳虚(P<0.01),主要实性证素为湿(P<0.05);肾组主要虚性证素为阳虚(P<0.05),主要实性证素为湿(P<0.01)。[结论]T2DM患者病位在肝时,容易出现阴虚;病位在脾、肾时容易出现阳虚。临床辨治T2DM时应注重肝阴的滋养,与脾、肾阳气的温补,同时注重祛除各脏腑湿邪。

Objective] To analyze the key traditional Chinese medicine （TCM） syndromes of patients with type 2 diabetes mellitus （T2DM）, to explore the clinical epidemiological regularity of the syndromes of each disease site and provide the basis for TCM clinical treatment. [Methods] The 197 cases of T2DM patients were divided into spleen, kidney and liver group, and the differences among the groups were discussed. [Results] There were no significant differences in sex ratio, age structure and BMI index among the groups （P﹥0.05）. Sleep time in liver and kidney groups was significantly shorter than that in the spleen group （P〈.05）. There was no significant difference in the incidence of hypertension, coronary heart disease and lipid metabolism in each group （P﹥0.05）. The main deficiency syndromes in liver group is Yin deficiency （P〈.01）. The frequency of the main excess syndrome was from high to low in order to yang hypera ctivitie, wet, phlegm, Qi stagnation, blood stasis and heat （P〈.05）. The frequency of the main deficiency syndrome in spleen group from high to low was in order to qi deficiency and Yang deficiency （P〈.01）, and the main excess syndrome was wet （P〈.01）. The main deficiency syndromes in kidney group was Yang deficiency （P〈.05）, and the main excess syndrome was wet （P〈.01）. [Conclusion] T2DM patients in liver easily appear yin deficiency and T2DM patients in spleen and kidney easily appear Yang deficiency. The clinical treatment of T2DM should pay attention to the nourishment of liver Yin, and warming spleen and kidney Yang, meanwhile, focus on getting rid of the pathogen dampness of organs.