糖尿病前期患者白睛络脉变化的临床研究

Clinical Study on the Changes of White Eye Collaterals in Patients with Prediabetes Mellitus

目的:观察糖尿病前期患者白睛络脉形态、分区和颜色改变的特点,发掘白睛络脉特征在糖尿病前期诊疗中的潜在价值,以期对糖尿病的早期诊断及干预提供帮助。方法:选取2021年2月—12月在福建中医药大学附属第二人民医院健康管理中心(治未病)进行健康体检的人群90例,根据空腹血糖、餐后2 h血糖以及糖基化血红蛋白的检测结果,分为糖尿病前期组(IGR组)、糖尿病组(DM组)和血糖正常组,每组各30例。采用眼象健康成像仪观察3组人群的白睛络脉特征。结果:3组组间比较,“血脉”“雾漫”特征分布差异具有统计学意义(P<0.01);进一步两两比较,IGR组与DM组的“血脉”“雾漫”特征差异具有统计学意义(P<0.01),IGR组与血糖正常组的“血脉”特征差异具有统计学意义(P<0.05),DM组与血糖正常组“雾漫”特征比较差异具有统计学意义(P<0.05)。3组组间比较,L13即胆区差异具有统计学意义(P<0.05);IGR组与DM组比较,L2即脾区、L8即肾区的区位特征分布差异具有统计学意义(P<0.05)。DM组与血糖正常组比较,“暗色”“黄色”“粉色”的特征分值差异具有统计学意义(P<0.01);IGR组与DM组比较,“暗色”“黄色”“粉色”“青色”的特征分值差异具有统计学意义(P<0.01)。结论:糖尿病前期患者存在白睛络脉形态、分区和颜色的特征性改变,主要分布于脾肾胆区,多由脾肾亏虚、肝胆失于疏泄,产生湿热、痰瘀、气滞等病理因素导致。

Objective:To observe the characteristics of the morphology,zoning and color changes of white-eye collaterals in patients with prediabetes,and to explore the potential value of white-eye collaterals in the diagnosis and treatment of prediabetes,so as to provide help for early diagnosis and intervention of diabetes.Methods:90 people who underwent physical examination in the Health Management Center of the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from February 2021 to December 2021 were divided into prediabetes(IGR)group,diabetes mellitus(DM)group and normal blood glucose group according to the results of fasting blood glucose,two-hour postprandial blood glucose and glycosylated hemoglobin,with 30 patients in each group.The characteristics of white eye collaterals in these three groups were observed by eye health imager.Results:Comparison between the three groups showed statistically significant differences in the distribution of"blood vessels"and"mist diffuse"characteristics(P<0.01).There were statistically significant differences in the distribution of"blood vessels"and"mist diffuse"characteristics between IGR and DM groups(P<0.01),in the distribution of"blood vessels"characteristics between IGR and normal glucose groups(P<0.05),in the distribution of"fog"between MD and normal blood glucose groups(P<0.05).Comparison of location characteristics of collaterals showed that there were significant differences in L13(biliary region)among the three groups(P<0.05),in L2(spleen region)and L8(kidney region)between IGR group and DM group(P<0.05),in the characteristic scores of"dark","yellow"and"pink"between the DM group and the normal blood glucose group(P<0.01),and in the characteristic scores of"dark","yellow","pink"and"cyan"between IGR group and DM group.Conclusion:There are changes in the shape,division and color of white-eye collaterals in patients with prediabetes,which are mainly distributed in the spleen,kidney,and gallbladder areas.The changes are often caused by pathological factors such as spleen and kidney deficiency,failure of liver and gallbladder in free coursing,resulting in dampness heat,phlegm stasis,and qi stagnation.