广东地区代谢综合征患者中医体质类型及其相关因素研究

Study on Relevant Factors of TCM Constitution Types in Patients with Metabolic Syndrome in Guangdong Area

目的:探讨广东地区人群代谢综合征(MS)患者的中医体质分布特征及其与MS关联指标的相关性,为中医药防治MS提供参考依据。方法:收集441例代谢综合征患者的体重指数(BMI)、血压、血糖、血脂、糖化血红蛋白等指标,并根据《中医体质分类与判定》标准对纳入的患者进行标准化中医体质辨识,比较各体质类型在不同年龄、性别中的分布特征,并分析各体质类型与MS相关生化指标的相关性。结果:代谢综合征患者的主要体质类型是气虚质、痰湿质、湿热质、平和质、阴虚质和阳虚质。男性痰湿质显著高于女性(P<0.05);在不同年龄中,中老年组(≥45岁)各体质类型与青年组比较,差异均无统计学意义(P>0.05)。气虚合并湿热、气虚合并痰湿、气虚合并阴虚、气虚合并气郁和气虚合并血瘀为MS患者的常见合并体质类型。女性患者气虚合并气郁的比例显著高于男性(P<0.01),男性气虚合并湿热的比例显著高于女性(P<0.05)。多元Logistic回归分析表明,性别与湿热质、痰湿质、气虚质、气郁质、特禀质、阳虚质呈独立相关,年龄与湿热质、气郁质、特禀质、阴虚质相关,BMI与痰湿质呈正相关,糖化血红蛋白水平与阴虚质呈正相关,血脂水平与阳虚质呈正相关。结论:气虚质、痰湿质和湿热质是广东地区MS患者的主要体质类型,多种体质类型常合并存在,气虚合并湿热、气虚合并痰湿、气虚合并阴虚、气虚合并气郁和气虚合并血瘀为MS的常见合并体质类型。性别、年龄、BMI、糖化血红蛋白和血脂水平与体质有一定的相关性,提示对MS的防治要重视体质的调养。

Objective:To explore the distribution characteristics of Chinese medicine constitution and its correlation with metabolic syndrome(MS)related indexes in Guangdong area,so as to provide reference for the prevention and treatment of MS by Chinese medicine.Method:The body mass index(BMI),blood pressure,blood glucose,blood lipid(including triglyceride,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol),glycosylated hemoglobin and other indexes of 441 patients with metabolic syndrome were collected,and the included patients were identified according to The Standard of Classification and Judgment of Constitution of Traditional Chinese Medicine,and statistical methods were used.The distribution characteristics of each constitution t ype in different ages and genders were compared,and the correlation between each constitution type and MS related biochemical indexes were analyzed.Results:The main type of biased constitution in patients with MS is constitution of Qi deficiency,constitution of phlegm-dampness,constitution of damp-heat,constitution of Yin-Yang harmony,constitution of Yin deficiency and constitution of Yang deficiency.The phlegm-dampness of males was significantly higher than that of females(P<0.05).At different ages,there was no significant difference in constitution types between the group over or equal to 45 years old and group less than 45 years old(P>0.05).Constitution of Qi deficiency combined with damp-heat,constitution of Qi deficiency combined with phlegm-dampness,constitution of Qi deficiency combined with Yin deficiency,constitution of Qi deficiency combined with Qi stagnation,constitution of Qi deficiency combined with blood stasis are common combined constitutional types in patients with MS.The Qi deficiency combined with Qi stagnation of females was significantly higher than that of males(P<0.01).The Qi deficiency combined with damp-heat of males was significantly higher than that of females(P<0.05).Multivariate logistic regression analysis showed that:gender is independently correlated with constitution of damp-heat,phlegm-dampness,Qi deficiency,Qi stagnation,allergic constitution and constitution of yang deficiency.Age is correlated with constitution of damp-heat,Qi stagnation,allergic constitution and constitution of Yin deficiency.BMI is positively correlated with phlegm-dampness.HbA1C is positively correlated with Yin deficiency.Blood fat is positively correlated with Yang deficiency.Conclusion:Constitution of Qi deficiency,constitution of phlegm-dampness and constitution of damp-heat are main constitutional types in patients with MS.Multiple types often merged,constitution of Qi deficiency combined with damp-heat,Qi deficiency combined with phlegm-dampness,Qi deficiency combined with Yin deficiency,Qi deficiency combined with Qi stagnation,Qi deficiency combined with blood stasis are common combined constitutional types in patients with MS.There is a certain correlation with gender,age,BMI,HbA1C,lipid level and constitution types.It prompts that attention should be paid to constitution recuperation for the prevention and treatment of MS.