2型糖尿病中医证型与临床生化指标相关性分析

Correlation Analysis of TCM Syndromes and Clinical Biochemical Indexes in Type 2 Diabetic Patients

目的:分析2型糖尿病患者中医证型与相关临床生化指标的关系。方法:对广州市中医院内分泌科住院的113例2型糖尿病患者的相关资料进行回顾分析和整理,记录一般情况(性别、年龄、病程)及中医证型、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、C-反应蛋白(CRP)、血尿酸(UA),并比较分析各证型与临床生化指标的相关性。结果:2型糖尿病患者中医证型分布依次为:湿热困脾证>阴虚内热证>气阴两虚证>阴阳两虚证。各证型的HbA1c比较,阴阳两虚证的HbA1c明显高于其他证型,差异有统计学意义(P<0.01);与其他中医证型比较,阴阳两虚证TC、TG高于其他中医证型,差异有统计学意义(P<0.05);湿热困脾证、阴虚内热证CRP高于其他证型,差异有统计学意义(P<0.05);与其他中医证型比较,阴阳两虚证UA高于其他证型,差异有统计学意义(P<0.05)。结论:2型糖尿病辨证分型以湿热困脾证为主,TC、TG、HbA1c、CRP、UA指标在一定程度上可以反映2型糖尿病中医证型的变化。

Objective:To analyze the relationship between TCM syndromes and related clinical biochemical indexes in patients with type 2 diabetes. Methods:Retrospective analysis and collation of 113 cases of type2 diabetes patients hospitalized in the department of endocrinology,Guangzhou Hospital of Traditional Chinese Medicine,recorded general conditions(gender,age,course of disease),TCM syndrome,glycosylated hemoglobin(HbA1 c),total cholesterol(TC),triacylglycerol(TG),C-reactive protein(CRP),blood uric acid(UA),and the correlation between each syndrome and clinical biochemical indexes were compared. Results:The distribution of TCM syndromes in patients with type 2 diabetes from high to low was as follows:dampness-heat encumbering spleen syndrome,yin deficiency and internal heat syndrome,qi and yin deficiency syndrome,yin and yang deficiency syndrome. Compared with other syndrome types,HbA1 c in yin and yang deficiency syndrome was signifi cantly higher than that in other syndromes,and the difference was statistically significant(P< 0.01). Compared with other TCM syndrome types,TC and TG in yin and yang deficiency syndrome were higher than those in other TCM syndromes,the difference was statistically significant(P< 0.05). The CRP in dampness-heat encumbering spleen syndrome and yin deficiency and internal heat syndrome was higher than those in other syndromes,and the difference was statistically significant(P< 0.05).Compared with other TCM syndromes,UA in yin and yang deficiency syndrome was higher than that in other TCM syndromes,and the difference was statistically significant(P< 0.05). Conclusions:TCM syndrome differentiation of type 2 diabetes patients is mainly characterize d by dampness-heat encumbering spleen syndrome. The levels of TC,TG,HbA1 c,CRP and UA can reflect the changes of TCM syndromes in patients with type 2 diabetes to some extent.