中医药治疗与糖尿病视网膜病变发生相关性的病例对照研究

A case-control study on the correlation between TCM treatment and onset of diabetic retinopathy

目的运用病例对照研究探讨中医药治疗与糖尿病视网膜病变发生的相关性,为该病的防治提供依据。方法应用病例对照研究设计,在北京4家医院收集研究对象,以2型糖尿病合并视网膜病变的患者为病例组,以2型糖尿病不合并视网膜病变的患者为对照组,病例与对照以1∶4的比例按照年龄、性别匹配研究对象。自行设计调查问卷,采用一对一调查的方式收集资料,应用EpiData 3.1软件录入数据,采用条件logistic回归的方法,应用SPSS 22.0软件分析中医药(治疗糖尿病或相关并发症为目的)与糖尿病视网膜病变患病的相关性。结果病例组共纳入72例2型糖尿病合并视网膜病变的患者,对照组纳入236例2型糖尿病患者。病例组男性36人、女性36人,平均年龄(62.3±10.0)岁,病程[13(6,19)]年;对照组男性112人、女性124人,平均年龄(61.5±9.6)岁,病程[10(5,15)]年。单因素条件logistic回归分析显示病例组与对照组既往接受中医药治疗比例分别为52.8%和33.5%,差异有统计学意义(OR=2.505,95%CI:1.412-4.443)。调整病程后,多因素条件logistic回归分析显示病例组与对照组既往接受中医药治疗比例差异有统计学意义(OR=2.296,95%CI:1.269-4.156)。结论中医药治疗与2型糖尿病患者是否合并视网膜病变具有相关性,有糖尿病视网膜病变的患者接受过中医药治疗的比例高且中医药治疗的平均时间较长,但鉴于病例对照研究的局限性,尚需要进一步前瞻性的研究设计结果加以证实。

Objective To evaluate the correlation between TCM treatment and the onset of diabetic retinopathy with a case-control study,and to provide a basis for the prevention and treatment of the disease.Methods Participants were collected from four hospitals in Beijing.Patients with type 2 diabetes mellitus complicated with diabetic retinopathy were selected as the case group,and patients with type 2 diabetes without diabetic retinopathy were selected as the control group.The cases and controls were matched by age and sex at a ratio of 1 to 4.Self-designed questionnaires were used to collect data by one-to-one survey,and the data were recorded by EpiData 3.1 software.The conditional logistic regression method was used to analyze the correlation between TCM(to treat diabetes or related complications)and the onset of diabetic retinopathy by SPSS 22.0 software.Results 72 patients with type 2 diabetes mellitus complicated with diabetic retinopathy were included as the case group,and 236 patients with type 2 diabetes were included in the control group.There were 36 males and 36 females in the case group,with an average age of(62.3±10.0)years and a disease course of[13(6,19)]years.Meanwhile,the control group consisted of 112 males and 124 females,with an average age of(61.5±9.6)years and a disease course of[10(5,15)]years.Univariate logistic regression analysis showed that the proportion of patients receiving previous TCM treatment was 52.8%and 33.5%respectively in the case group and control group,with statistically significant differences(OR 2.505,95%CI:1.412 to 4.443).After adjusting the course of disease,multiple logistic regression analysis showed that there was a statistically significant difference between case group and control group in the proportion of patients who had received previous TCM treatment(OR 2.296,95%CI:1.269 to 4.156).Conclusion There seems to be a correlation between TCM treatment and the onset of diabetic retinopathy in type 2 diabetes patients.The patients with diabetic retinopathy has a higher proportion in previous TCM treatment,and an average longer duration of TCM treatment too.Given the limitations of case-control studies,this conclusion needs to be confirmed by further prospective study Results.