2型糖尿病中医证型与FFA、TNF-α及VEGF相关性研究

Study on the correlation among traditional Chinese medicine syndrome types of diabetes mellitus type 2 and FFA,TNF-αand VEGF

目的研究2型糖尿病(diabetes mellitus type 2,T2DM)的中医证型与游离脂肪酸(free fatty acid,FFA)、肿瘤坏死因子(tumor necrosis factor-α,TNF)-α及血管内皮生长因子(vascular endothelial growth factor,VEGF)的相关性,归纳实验室指标与T2DM中医证型的关系。方法收集2019年1月至2020年3月于上海中医药大学附属龙华医院内分泌科门诊及住院部就诊的T2DM患者300例,其中气阴两虚证65例,湿热困脾证65例,阴虚热盛证50例,阴阳两虚证55例,血瘀脉络证65例。监测并观察各证型组与FFA、TNF-α及VEGF间的相关性。结果血瘀脉络证组TNF-α水平高于气阴两虚证组、湿热困脾证组、阴虚热盛证组及阴阳两虚证组,差异均具有统计学意义(P<0.05)。湿热困脾证组、血瘀脉络证组VEGF水平高于气阴两虚证组、阴阳两虚证组及阴虚热盛证组,差异均具有统计学意义(P<0.05)。血瘀脉络证组FFA水平高于气阴两虚证组及阴阳两虚证组,差异均具有统计学意义(P<0.05)。结论FFA、TNF-α、VEGF与T2DM的血瘀脉络证及湿热困脾证关系密切,但并非早期诊断T2DM相关并发症的敏感性指标。

Objective To study the relationship between traditional Chinese medicine(TCM)syndromes of diabetes mellitus type 2(T2DM)and free fatty acid(FFA),tumor necrosis factor(TNF)-αand vascular endothelial growth factor(VEGF),and summarize the relationship between laboratory indexes and TCM syndrome types of T2DM.Methods A total of 300 patients with T2DM were collected from the outpatient and inpatient department of endocrinology of LongHua hospital affiliated to Shanghai university of TCM from January 2019 to March 2020,including 65 cases of Qi and Yin deficiency syndrome,65 cases of damp heat trapped spleen syndrome,50 cases of Yin deficiency and heat excess syndrome,55 cases of Yin and Yang deficiency syndrome,and 65 cases of blood stasis venation syndrome.The relationship between each syndrome group and FFA,TNF-αand VEGF was measured and observed.Results TNF-αin blood stasis venation syndrome group was significantly higher than those of Qi and Yin deficiency syndrome group,damp heat trapped spleen syndrome group,Yin deficiency and heat excess syndrome group and Yin and Yang deficiency syndrome group(P<0.05).The levels of VEGF in damp heat trapped spleen syndrome group and blood stasis venation syndrome group were significantly higher than those in Qi and Yin deficiency syndrome group,Yin and Yang deficiency syndrome group and Yin deficiency and heat excess syndrome group(P<0.05).The level of FFA in blood stasis venation syndrome group was higher than those in Qi and Yin deficiency syndrome group and Yin and Yang deficiency syndrome group,and the difference were statistically significant(P<0.05).Conclusion FFA,TNF-αand VEGF are closely related to blood stasis venation syndrome and damp heat trapped spleen syndrome of T2DM,but they are not sensitive indexes for early diagnosis of syndrome types of T2DM related complications.