2型糖尿病中医辨证分型与心率变异性、IGF-1、CRP/PA相关性研究

Study on correlation between TCM syndrome differentiation and heart rate variability,IGF-1and CRP/PA in type 2diabetes mellitus

目的:探讨2型糖尿病(T2DM)中医辨证分型与心率变异性、胰岛素样生长因子-1(IGF-1)、C反应蛋白/前白蛋白(CRP/PA)相关性。方法:回顾性选取2021年10月~2023年10月合肥市第八人民医院收治的T2DM患者200例为研究对象。统计患者中医证型分布,比较不同中医证型患者心率变异性、IGF-1、CRP/PA。结果:T2DM患者中医证型构成由高到低分别为气阴两虚证75例、痰淤滞络证64例、阴虚风动证31例、气虚血瘀证20例、热盛伤阴证10例;T2DM患者病程、空腹血糖、餐后2h血糖值为气阴两虚证>气虚血瘀证>阴虚风动证>痰淤滞络证>热盛伤阴证(P<0.05);T2DM患者心率变异性指标24h窦性心博R-R间期标准差(SDNN)、每5min正常R-R间期平均值标准差(SDANN)、相邻R-R间期差值均方根(RMSSD)、相邻RR间期之差大于50ms百分比(PNN50)、心率变异性(HRV)三角指数、极低频功率(VLF)、低频功率(LF)、高频功率(HF)为热盛伤阴证>痰淤滞络证>阴虚风动证>气阴两虚证>气虚血瘀证(P<0.05);T2DM患者IGF-1水平为热盛伤阴证>阴虚风动证>痰淤滞络证>气虚血瘀证>气阴两虚证,CRP/PA为痰淤滞络证>热盛伤阴证>阴虚风动证>气阴两虚证>气虚血瘀证(P<0.05)。结论:T2DM患者中医证型与心率变异性、IGF-1、CRP/PA具有良好的相关性,可以为中医辨证施治的提供参考。

Objective To investigate the relationship between TCM syndrome differentiation and hea77rt rate variability,insulin-like growth factor-1(IGF-1)and C-reactive protein/prealbumin(CRP/PA)in type 2diabetes mellitus(T2DM).Methods A total of 200T2DM patients admitted from October 2021to October 2023Hefei Eighth People’s Hospital were retrospectively selected as the study objects.The distribution of TCM syndrome types of patients was analyzed,and the heart rate variability,IGF-1and CRP/PA of patients with different TCM syndrome types were compared.Results From high to low,the composition of TCM syndrome types in T2DM patients were deficiency of both qi and yin 75cases,phlegm stagnation of collaterals 64cases,yin deficiency and wind movement 31cases,qi deficiency and blood stasis 20cases,excessive heat and yin injury 10cases.In T2DM patients,the disease course,fasting blood glucose and 2h postmeal blood glucose values were deficiency of both qi and yin>deficiency of qi and blood stasis>deficiency of yin and wind>stagnation of phlegm and collaterals>excessive heat and damaging yin(P<0.05).For heart rate variability indicators in T2DM patients,standard diviation of NN intervals(SDNN),standard deviation of all 5-min averaged intervals(SDANN),root mean square of successive differences(RMSSD),percent difference between adjacent NN interval are more than 50ms(PNN50),and triangular index of heart rate variability(HRV),very low frequency power(VLF),low frequency power(LF)and high frequency power(HF)were excessive heat and yin injury>phlegm stagnation of collaterals>Yin deficiency and wind movement>deficiency of both qi and yin>qi deficiency and blood stasis(P<0.05).In T2DM patients,the IGF-1level were excessive heat and yin injury>Yin deficiency and wind movement>phlegm stagnation of collaterals>qi deficiency and blood stasis>deficiency of both qi and yin,and CRP/PA were phlegm stagnation of collaterals>excessive heat and yin injury>yin deficiency and wind movement>deficiency of both qi and yin>qi deficiency and blood stasis(P<0.05).Conclusion There is a good correlation between TCM syndrome type and heart rate variability,IGF-1and CRP/PA in T2DM patients,which can provide reference for TCM dialectical treatment.