2型糖尿病中医辨证分型与胰岛素抵抗的关系

Relationship Between TCM Syndromes and Insulin Resistance in Type 2 Diabetes

探讨中医证型与胰岛素抵抗 (IR)的关系 ,为 2型糖尿病临床辨证提供参考指标。选择 83例 2型糖尿病患者按中医辨证分为阴虚热盛型、气阴两虚型、阴阳两虚型 ,进行相关指标检测。结果发现 :1 2型糖尿病中医各证型胰岛素敏感指数 (ISI)均低于正常 (P<0 .0 1 ) ,其 IR的程度依证型变化呈阴虚热盛、气阴两虚、阴阳两虚逐渐加重 ;血清肿瘤坏死因子 -α(TNF-α)、甘油三酯 (TG)较正常显著升高 (P<0 .0 5 ,P<0 .0 1 ) ,高密度脂蛋白胆固醇 (HDL-C)以阴阳两虚型下降明显 (P<0 .0 1 )。 2 ISI与病程、TG、TNF-α呈负相关 ,与 HDL-C呈正相关。结论 :2型糖尿病中医各证型在 ISI、血脂、细胞因子水平方面存在显著差异。

To study the relationship between the TCM syndromes and insulin resistance(IR)and provide the reference for TCM differentiation in type 2 diabetes,83 cases were differentiated into the syndromes of deficiency YIN producing heat(S1),deficiency of QI and YIN(S\-2),deficiency of YIN and YANG(S\-3),and then the related indexes were tested .The results showed that the insulin sensitivity indexes(ISI)in type 2 diabetes were lower the normal,the degree of IR was gradually aggravating from S\-1,S\-2 to S\-3.The serum tumor necrosis factor(TNF α)and triglycerides(TG)were higher than the normal(P<0.05,P<0.01).The decrease of high density lipoprotein cholesterol(HDL C)in S\-3 was the most serious.The ISI showed the negative correlation with courses,TG,TNF α,while the positive correlation with the HDL C.It can be concluded that ISI,blood lipid and cytokines are obviously different among the TCM syndromes in type 2 diabetes.\;