同型半胱氨酸与2型糖尿病中医证候关系研究

Study on relationship between homocysteine and traditional Chinese medicine syndrome of type 2 diabetes mellitus

目的研究同型半胱氨酸(Hcy)与2型糖尿病中医证候的关系。方法选择2017年1月~2018年6月于北京中医医院顺义医院内分泌科接受治疗的2型糖尿病合并高Hcy血症患者200例作为研究对象。按中医辨证分型,主证分为脾虚胃热证96例、气阴两虚证38例、肝肾阴虚证36例、阴阳两虚证30例,兼证分为浊证30例、痰证33例、湿证59例、瘀证78例。采用全自动生化分析仪测定受试者血清Hcy水平。结果不同中医主证证型患者Hcy水平比较,差异有统计学意义(P <0.05)。不同中医主证证型Hcy水平两两比较,差异均有统计学意义(P <0.05),表现为阴阳两虚证型>肝肾阴虚证型>气阴两虚证型>脾虚胃热证型。不同中医兼证证型患者Hcy水平比较,差异有统计学意义(P <0.05)。不同中医兼证证型Hcy水平两两比较,差异均有统计学意义(P <0.05),表现为瘀证>湿证>痰证>浊证。结论 Hcy可能是2型糖尿病发生、发展的重要因素。Hcy水平与2型糖尿病不同中医证型之间存在一定关联,可以为2型糖尿病中医辨证分型的标准化、规范化研究提供一定的借鉴。

Objective To study the relationship between homocysteine(Hcy) and traditional Chinese medicine syndrome of type 2 diabetes mellitus. Methods Two hundred patients with type 2 diabetes mellitus combined with hyperhomocysteinemia received treatment in Department of Endocrinology of Shunyi Hospital, Beijing Hospital of Traditional Chinese Medicine from January 2017 to June 2018 were selected as research subjects. All patients were divided into syndrome of spleen deficiency and stomach heat(96 cases), syndrome of deficiency of both qi and yin(38 cases), syndrome of yin deficiency of liver and kidney(36 cases), syndrome of deficiency of both yin and yang(30 cases) according to principal syndrome differentiation. In addition, they were divided into syndrome of turbidity(30 cases), syndrome of phlegm(33 cases), syndrome of dampness(59 cases), syndrome of stasis(78 cases) according to incidental symptom differentiation. The fully automatic biochemical analyser was used to determine the levels of Hcy. Results Hcy levels of patients with different traditional Chinese medicine main syndromes were significantly different(P < 0.05). There was significant difference in Hcy level between two types of traditional Chinese medicine main syndromes(P < 0.05), which was manifested as syndrome of deficiency of both yin and yang, syndrome of yin deficiency of liver and kidney, syndrome of deficiency of both qi and yin, syndrome of spleen deficiency and stomach heat. There was significant difference in Hcy level among different traditional Chinese medicine syndromes(P < 0.05). There was significant difference in Hcy level between two types of traditional Chinese medicine accompanying symptoms(P < 0.05), which was manifested as syndrome of stasis, syndrome of dampness, syndrome of phlegm, syndrome of turbidity. Conclusion Hcy may be the important factor in the development of diabetes mellitus. There is a certain correlation between Hcy level and different traditional Chinese medicine syndrome types of type 2 diabetes mellitus, which can provide some reference for the standardization and standardization of traditional Chinese medicine syndrome differentiation of type 2 diabetes mellitus.