2型糖尿病性骨质疏松症中医体质与临床指标相关性分析

An analysis of the correlation between TCM constitution distribution and clinical indexes of type 2 diabetic osteoporosis patients

目的:分析2型糖尿病性骨质疏松症患者中医体质分布与临床指标的相关性,从体质方面为治疗及预防糖尿病性骨质疏松提供理论依据。方法:随机选取就诊于西安市中医医院内分泌科的2型糖尿病性骨质疏松患者200例,采用收集患者自测表的方法计算并判定纳入病例的体质,收集纳入病例的基本信息、临床指标等。采用SPSS 25.0统计软件分析2型糖尿病性骨质疏松患者中医体质与临床指标之间的相关性。结果:(1)糖尿病性骨质疏松患者的体质分布以阴虚质、平和质、痰湿质、血瘀质、阳虚质所占比例较大,气郁质、气虚质、湿热质、特禀质所占比例较小;(2)随着年龄增加,2型糖尿病性骨质疏松患者的中医体质多倾向于阴虚质、阳虚质;肥胖或超重的2型糖尿病性骨质疏松患者多倾向于痰湿质;空腹血糖偏高的2型糖尿病性骨质疏松患者多倾向于阴虚质;血脂偏高的2型糖尿病性骨质疏松患者多倾向于痰湿质、血瘀质;阴虚质2型糖尿病性骨质疏松患者羟基维生素D水平偏高;尿微量白蛋白偏高的2型糖尿病性骨质疏松患者多为阳虚质。结论:随着年龄增加,2型糖尿病性骨质疏松患者的中医体质类型多倾向于阴虚质、阳虚质,且多存在兼夹体质。体质个体间的差异性往往对某种或某一类致病因素的易感性及病变的倾向性起着相当大的作用,应重视中医体质学的应用,早期辨识各类型体质,将中医辨证与体质辨识相结合,从而更好地防治糖尿病性骨质疏松。

Objective:To provide a theoretical basis for the treatment and prevention of type 2 diabetic osteoporosis(DOP) by analyzing the correlation between TCM constitution distribution and clinical indexes of patients.Methods:A total of 200 DOP patients were randomly selected from Endocrinology Department of Xi'an Hospital of Traditional Chinese Medicine.The method of collecting patient self-test table was used to calculate and determine the physique of included patients.The basic information and clinical indicators of the included patients were collected.A statistical analysis was carried out by SPSS25.0 statistical software to analyze the correlation between TCM constitution distribution and clinical indicators of DOP patients.Results:(1) In terms of the TCM constitution distribution of type 2 diabetic osteoporosis,Yin( 阴) deficiency constitution,balanced constitution,phlegm-dampness constitution,bloodstasis constitution,Yang( 阳) deficiency constitution accounted for a large proportion,while Qi( 气) stagnation constitution,Qi deficiency constitution,dampness-heat constitution,and inherited-special constitution accounted for a small proportion.(2) With the increase of age,the TCM constitution of DOP patients tended to be Yin deficiency constitution and Yang deficiency constitution.The TCM constitution of obese or overweight DOP patients tended to be phlegm-dampness constitution.The TCM constitution of DOP patients with high fasting plasma glucose tended to be Yin deficiency constitution.The TCM constitution of DOP patients with high blood lipids tended to be phlegm-dampness constitution and blood-stasis constitution.The TCM constitution of DOP patients with high hydroxyl vitamin D was Yin deficiency constitution.The TCM constitution of DOP patients with high urinary microalbumin were mostly Yang deficiency constitution.Conclusion:With the increase of age,the TCM constitution types of DOP patients tend to be Yin deficiency constitution and Yang deficiency constitution,and many patients have mixed TCM constitutions.The differences between individuals often play a considerable role in the susceptibility of a certain or a certain type of pathogenic factors and the tendency of lesions.We should attach importance to the application of TCM constitution,identify various types of TCM constitutions early,and combine TCM syndrome differentiation with constitution identification,so as to better prevent and treat DOP.