2型糖尿病中医证型与糖、骨代谢主要实验室指标的相关性研究

Correlation study between TCM syndrome types and main laboratory indexes of glucose and bone metabolism in type 2 diabetes mellitus

目的:为研究2型糖尿病患者中医证型与糖、骨代谢主要实验室指标的相关性,为早期发现及早干预2型糖尿病合并骨质疏松提供一定的理论依据。方法:收集2019年至2020年上海市普陀区甘泉街道社区卫生服务中心门诊收治的2型糖尿病患者153例,完成临床症状归纳表,收集患者基本资料、病史、四诊信息进行辨证分型,同时检测、分析血清胰岛素、C肽、25羟维生素D、骨钙素等糖、骨代谢实验室检测指标,了解2型糖尿病的中医证型分布规律及特点。运用单因素方差分析的统计方法,研究中医辨证分型与糖、骨代谢主要实验室指标的相关性。结果:153例2型糖尿病患者5种中医证型间比较,空腹C肽、餐后2 h C肽、25羟维生素D、骨钙素与中医证型之间有相关性(P<0.05);空腹胰岛素及餐后2 h胰岛素与中医证型之间无相关性(P>0.05)。结论:2型糖尿病中医证型的演变规律为阴虚热盛证-湿热困脾证-气阴两虚证-阴阳两虚血瘀水停证-血瘀脉络证。血清C肽和25羟维生素D可反映中医证型的动态变化,与中医证型之间存在一定的相关性。

Objective:To study the correlation between TCM syndrome types and main laboratory indexes of glucose and bone metabolism in patients with type 2 diabetes mellitus,to provide a theoretical basis for early detection and early intervention of type 2 diabetes mellitus combined with osteoporosis.Methods:One hundred and fifty-three patients with type 2 diabetes mellitus admitted to the outpatient clinic of the Community Health Service Center in Ganquan Community,Putuo District,Shanghai from 2019 to 2020 were collected,the clinical symptom induction table was completed,the patient’s basic data,medical history and four diagnosis information for syndrome differentiation were collected,at the same time,the laboratory test indexes of glucose and bone metabolism such as serum insulin,C peptide,25 hydroxyvitamin D and osteocalcin were detected and analyzed to understand the distribution pattern and characteristics of TCM syndromes of type 2 diabetes mellitus.The statistical method of one-way ANOVA was used to study the correlation between TCM syndrome differentiation and the main laboratory indexes of glucose and bone metabolism.Results:Compared with the 5 TCM syndromes of 153 patients with type 2 diabetes mellitus,there was a correlation between fasting C peptide,postprandial 2 h C peptide,25 hydroxyvitamin D,osteocalcin and TCM syndrome types(P<0.05);there was no correlation between fasting insulin and 2 h postprandial insulin and TCM syndrome types(P>0.05).Conclusion:The evolution pattern of TCM syndromes of type 2 diabetes mellitus is Yin deficiency heat accumulation syndrome-dampness heat dampness spleen syndrome-Qi Yin two deficiency syndrome-Yin and Yang two deficiency,blood stasis and water stop syndrome-blood stasis syndrome.serum C peptide and 25 hydroxyvitamin D can reflect the dynamic changes of TCM syndrome types,and there is a certain correlation with TCM syndrome types.