早期糖尿病肾病中医体质与中医证候相关性研究

Study on Correlation Between Chinese Medicine Constitutions of Patients with Early Diabetic Nephropathy and Chinese Medicine Syndromes

目的:探讨早期糖尿病肾病中医体质与中医证候的相关性。方法:选取300例早期糖尿病肾病患者作为研究组,另选取未发糖尿病肾病的300例2型糖尿病患者作为对照组。统计2组中医体质类型及中医证候分布情况,统计研究组不同中医体质类型患者的中医证候分布情况,分析研究组中医体质与中医证候之间的相关性。结果:研究组气虚质、血瘀质占比高于对照组(P<0.01),平和质、阳虚质占比低于对照组(P<0.01)。2组阴虚质、痰湿质、湿热质、气郁质及特禀质分布情况比较,差异均无统计学意义(P>0.05)。研究组气虚证、阴虚证、血瘀证占比高于对照组(P<0.05,P<0.01),阳虚证占比低于对照组(P<0.01)。2组水湿证、湿热证及湿浊证分布情况比较,差异均无统计学意义(P>0.05)。研究组不同体质患者中,气虚质患者表现为气虚证、阴虚证较多,阴虚质患者表现为气虚证和阴虚证,血瘀质患者多表现为气虚证、血瘀证,平和质患者多表现为气虚证和阳虚证,痰湿质患者多表现为水湿证,湿热质患者表现为湿热证、水湿证,气郁质患者多表现为血瘀证,阳虚质患者表现为阳虚证、气虚证。气虚质与气虚证、阴虚证强相关;阴虚质与气虚证、阴虚证强相关;痰湿质与水湿证强相关,与湿热证中等相关;湿热质与水湿证、湿热证中等相关;血瘀质与气虚证强相关,与血瘀证中等相关;气郁质与血瘀证强相关。结论:糖尿病气虚质、血瘀质患者更易发生早期糖尿病肾病。中医证候与中医体质存在明确的相关性,不同体质可能决定糖尿病患者发病及发病后的中医证候特点。

Objective:To discuss correlation between Chinese medicine constitutions of patients with early diabetic nephropathy and Chinese medicine syndromes.Methods:A total of 300 cases of patients with early diabetic nephropathy were enrolled in the study group.Another 300 cases of patients with type 2 diabetes and without diabetic nephropathy were enrolled in the control group.In the two groups,distribution of Chinese medicine constitution types and Chinese medicine syndromes was counted.Among the patients of different Chinese medicine constitution types in the study group,the distribution of Chinese medicine syndromes was counted.The correlation between Chinese medicine constitutions and Chinese medicine syndromes in the study group was analyzed.Results:In the study group,the proportions of qi-deficiency constitution and blood stasis constitution were larger than those in the control group(P<0.01),and the proportions of balanced constitution and yang-deficiency constitution were lower(P<0.01).When compared the distribution of yindeficiency constitution,phlegm-dampness constitution,dampness-heat constitution,qi-depression constitution,and special intrinsic constitution between the two groups,there was no significance being found in differences(P>0.05).In the study group,the proportions of qi-deficiency syndrome,yin-deficiency syndrome,and blood stasis syndrome were larger than those in the control group(P<0.05,P<0.01),and the proportion of yang-deficiency syndrome was lower than that in the control group(P<0.01).When compared the distribution of water-dampness syndrome,dampness-heat syndrome,and dampness-turbidity syndrome between the two groups,there was no significance being found in differences(P>0.05).Among the patients with different constitutions in the study group,patients with qi-deficiency constitution were more likely to show qi-deficiency syndrome and yin-deficiency syndrome;patients with yin-deficiency constitution showed qideficiency syndrome and yin-deficiency syndrome;patients with blood stasis constitution were more likely to show qideficiency syndrome and blood stasis syndrome;patients with balanced constitution were more likely to show qi-deficiency syndrome and yang-deficiency syndrome;patients with phlegm-dampness constitution were more likely to show waterdampness syndrome;patients with dampness-heat constitution showed dampness-heat syndrome and water-dampness syndrome;patients with qi-depression constitution were more likely to show blood stasis syndrome;patients with yangdeficiency constitution showed yang-deficiency syndrome and qi-deficiency syndrome.Qi-deficiency constitution and yindeficiency constitution were strongly correlated with qi-deficiency syndrome and yin-deficiency syndrome;phlegmdampness constitution was strongly correlated with water-dampness syndrome,and moderately correlated with dampnessheat syndrome;dampness-heat constitution had a moderate correlation with water-dampness syndrome and dampnessheat syndrome;blood stasis constitution was strongly correlated with qi-deficiency syndrome,and moderately correlated with blood stasis syndrome;there was a strong correlation between qi-depression constitution and blood stasis syndrome.Conclusion:Diabetes patients with qi-deficiency constitution and blood stasis constitution are more likely to be susceptible to early diabetic nephropathy.There is certain correlation between Chinese medicine syndromes and Chinese medicine constitutions,and constitution types may determine characteristics of Chinese medicine syndromes at the onset of the disease and after it in diabetes patients.