350例糖尿病周围神经病变患者的中医证候分布规律分析

An analysis of the distribution regularity of TCM syndromes in 350 cases with diabetic peripheral neuropathy

目的探讨DPN的证候分布规律,为临床辨证治疗DPN提供一定的客观依据。方法选取我院门诊及住院DPN患者350例,参照2016年版《糖尿病周围神经病变中医临床诊疗指南》进行证候分型,再进行频数统计分析,归纳总结其中医证候分布特点。结果各证出现频率由大到小依次为:气虚血瘀证>阴虚血瘀证>肝肾亏虚证>痰瘀阻络证>湿热阻络证>阳虚寒凝证。各个证型的性别分布差异均无统计学意义(P>0.05),但在年龄、病程及严重程度上的分布差异均有统计学意义(P<0.05)。DPN初期以痰瘀阻络证及湿热阻络证为主,随着病程的延长,气虚血瘀证、阴虚血瘀证、肝肾亏虚证及阳虚寒凝证逐渐增多。气虚血瘀证在各不同严重程度的DPN中分布频率均为最高,阳虚寒凝证在重度DPN中分布最多,而湿热阻络证则在轻度DPN中分布最多。结论 DPN属本虚标实之证,实证以痰、湿、热、瘀为主,虚证以气阴两虚、阴损及阳为多,血瘀则贯穿疾病始终。

Objective To research the distribute regulation of TCM Syndromes in patients with DPN,and to provide an objective basis for clinical differentiation and treatment for DPN further. Methods 350 cases with DPN came from out-patient and in-patient department in our hospital were selected,their syndrome differentiation were determined referring to the《TCM clinical treatment guideline of DPN》,and the distribute regulation was summarized after frequencies analysis. Results The occurrence frequency of different TCM Syndromes ranged from high shared papers number to low wereQi deficiency and blood stasis 〉Yin deficiency and blood stasis〉Liver-Kidney insufficiency〉 Intermingled Phlegm and Blood stasis〉dampness-heat stagnation 〉Yang deficiency cold coagulation.There was no significant differences in gender of each TCM Syndrome（P 〉0.05）,but differences were very significant in different age,course and severity（P 〈0.05）,the main TCM Syndromes on the early stages of DPN were Intermingled Phlegm and Blood stasis and dampness-heat stagnation,but other four syndromes increased gradually along with the progression of DPN.The highest occurrence frequency was Qi deficiency and blood stasis no matter what severity of DPN.And the highest occurrence frequency in severe DPN was Yang deficiency cold coagulation while it was dampness-heat stagnation in mild DPN. Conclusion DPN is the syndrome of deficiency in origin and excess in superficiality,deficiency in origin mainly manifests Qi and Yin deficiency,Yan deficiency comes from Yin deficiency,while excess in superficiality mainly manifests Phlegm,dampness,heat,stagnation,blood stasis runs throughout the entire disease.