2型糖尿病患者中医证素与血脂达标情况相关性的临床研究

Clinical study on the relationship between TCM syndrome factors and blood lipid level in patients with type 2 diabetes mellitus

目的分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者中医证素与血脂达标情况的相关性。方法收集T2DM患者667例,根据制定的中医证素判定表,包括气虚证、血虚证、阴虚证、阳虚证、热盛证、气滞证、湿热证、血瘀证、痰浊证九种证素,进行中医证素的判定。并记录其年龄、性别及病史等资料,测量血压(blood pressure,BP),检测糖化血红蛋白(hemoglobin A1c,Hb A1c)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)和低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)。根据指南制定TC、TG、HDL-C和LDL-C达标的标准,分为TC达标组(n=271例)和TC未达标组(n=396例),TG达标组(n=306例)和TG未达标组(n=361例),HDL-C达标组(n=328例)和HDLC未达标组(n=339例),LDL-C达标组(n=235例)和LDL-C未达标组(n=432例)。采用卡方检验,比较各达标组与未达标组中医证素的分布差异,分析中医证素与血脂达标情况的相关性。结果T2DM患者667例,血脂中TC、TG、HDL-C、LDL-C的达标率分别是40. 63%(271/667)、45. 88%(306/667)、49. 18%(328/667)、35. 23%(235/667)。TC达标组的年龄、气滞证高于TC未达标组(P<0. 05)。TG达标组的年龄高于TG未达标组(P <0. 05),气虚证、血瘀证低于TG未达标组(P <0.05)。HDL-C达标组的男性高于HDL-C未达标组(P <0. 05),痰浊证低于HDL-C未达标组(P <0.05)。LDL-C达标组的男性高于LDL-C未达标组(P <0. 05),气虚证低于LDL-C未达标组(P <0. 05)。四组BP达标率和Hb A1c达标率的比较,差异无统计学意义(P> 0. 05)。结论 2型糖尿病患者中医证素和血脂达标情况具有相关性,其中,气虚证、瘀血证与TG达标相关,痰浊证和HDL-C达标相关,气虚证和LDL-C达标相关。

Objective To analyze the correlation between TCM syndrome factors and serum lipids in patients with type 2 diabetes mellitus(T2DM).Methods A total of 667 patients with T2DM were collected.According to the established TCM syndrome determination form,including qi deficiency syndrome,blood deficiency syndrome,yin deficiency syndrome,yang deficiency syndrome,heat syndrome,qi stagnation syndrome,damp heat syndrome,blood stasis syndrome and phlegm syndrome,nine syndromes were used to determine TCM syndromes.Their names,gender and medical history were recorded.Blood pressure(BP),hemoglobin A1c(HbA1c),total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C)and low density lipoprotein-cholesterol(LDL-C)were measured.According to the guidelines,the criteria for TC,TG,HDL-C and LDL-C compliance were established and divided into TC compliance group(n=271)and TC non-compliance group(n=396),TG compliance group(n=306)and TG non-compliance group(n=361),HDL-C compliance group(n=328)and HDL-C non-compliance group(n=339),LDL-C compliance group(n=235)and LDL-C non-compliance group(n=432).The chi-square test was used to compare the differences in the distribution of TCM syndromes between the standard group and the non-compliance group,and to analyze the correlation between TCM syndromes and blood lipid compliance.Results In 667 patients with T2DM,the compliance rates of TC,TG,HDL-C,and LDL-C in serum lipids were 40.63%(271/667),45.88%(306/667),49.18%(328/667),and 35.23%(235/667),respectively.The age and qi stagnation in the TC compliance group were higher than those in the TC non-compliance group(P<0.05).The age of the TG compliance group was higher than that of the TG non-compliance group(P<0.05),and the qi deficiency syndrome and blood stasis syndrome were lower than the TG non-compliance group(P<0.05).The men in the HDL-C compliance group were higher than those in the HDL-C non-compliance group(P<0.05),and the phlegm syndrome was lower than that in the HDL-C non-compliance group(P<0.05).Men in the LDL-C compliance group were higher than those in the LDL-C non-compliance group(P<0.05),and qi deficiency was lower than that in the LDL-C non-compliance group(P<0.05).There was no significant difference in the BP compliance rate and HbA1c compliance rate between the four groups(P >0.05).Conclusion There is a correlation between TCM syndromes and blood lipid compliance.Among them,qi deficiency syndrome and blood stasis syndrome are related to TG compliance,phlegm turbidity syndrome is related to HDL-C compliance,and qi deficiency syndrome is related to LDL-C compliance.