基于“三热”理论分析2型糖尿病中医证型与危险因素及糖脂代谢指标相关性

Analysis on the Correlation of TCM Syndrome Types with Risk Factors and Glucolipid Metabolism Indexes in Type 2 Diabetes Mellitus Based on the Theory of Tripe-Heat

目的:基于“三热”理论研究2型糖尿病(T2DM)的中医证型分布规律,并探讨中医证型与危险因素及糖脂代谢指标之间的相关性。方法:收集410例T2DM患者的四诊资料,确定中医证型,采集患者的一般资料、危险因素及糖脂代谢指标,分析T2DM的中医证型分布特点及其与一般资料、危险因素和糖脂代谢指标的关系。结果:证型分布从高到低依次为瘀热证[48.78%(200/410)]、湿热证[27.80%(114/410)]、燥热证[23.41%(96/410)]。年龄、病程以瘀热证最高(P<0.05),体质量指数(BMI)、腰围、臀围以湿热证最高(P<0.05)。危险因素中糖尿病家族史、不健康饮食和缺乏运动的占比接近或超过50%,其中不健康饮食和缺乏运动以湿热证最多(P<0.05)。空腹C肽(FCP)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)以湿热证最高(P<0.05);胰岛β细胞功能指数(HOMA-β)以瘀热证最低(P<0.05)。结论:以“三热”理论分析T2DM证型,总体以瘀热证居多。湿热证的T2DM患者多存在不健康饮食和缺乏运动,并伴有超重、高胰岛素血症、高TG血症和胰岛素抵抗的临床问题;瘀热证T2DM患者多存在胰岛素缺乏,且年龄较大,病程较长。

Objective:To study the distribution pattern of traditional Chinese medicine(TCM)syndrome types in type 2 diabetes mellitus(T2DM),and to explore the correlation of TCM syndrome types with risk factors and glucolipid metabolism indexes based on the theory of tripe-heat.Methods:The clinical data of 410 cases of T2DM were collected by four diagnostic methods of TCM,and then the TCM syndromes were identified.The general information,risk factors and glucolipid metabolism indexes of the patients were collected.The distribution pattern of the TCM syndrome types of T2DM and the correlation of TCM syndrome types with the general information,risk factors and glucolipid metabolism indexes,were analyzed.Results:The distribution of syndrome types was as follows:stasis-heat syndrome[48.78%(200/410)],dampness-heat syndrome[27.80%(114/410)]and dryness-heat syndrome[23.41%(96/410)].The age and disease course were the highest in stasis-heat syndrome(P<0.05).The levels of body mass index(BMI),waist circumference and hip circumference were the highest in dampness-heat syndrome(P<0.05).The main risk factors for diabetes involved family history of diabetes,unhealthy diet and lack of exercise,which accounted for approach or more than 50%of the total.Unhealthy diet and lack of exercise contributed most to the incidence of the dampness-heat syndrome(P<0.05).The levels of fasting C-peptide(FCP),insulin resistance index(HOMA-IR)and triglyceride(TG)were the highest in dampness-heat syndrome(P<0.05).βcell function index(HOMA-β)was the lowest in stasis-heat syndrome(P<0.05).Conclusion:The stasis-heat syndrome was the most common based on the theory of tripe-heat.T2DM patients with damp-heat syndrome are mostly associated with unhealthy diet and lack of exercise,and they are accompanied by the clinical problems of overweight,hyperinsulinemia,hypertriglyceridemia and insulin resistance.T2DM patients with stasis-heat syndrome are accompanied by insulin deficiency,older age,and longer disease course.