儿童单纯性肥胖中医辨证分型与西医各项实验室指标 并发症关系探讨  

The Relationship between Some Medical Indexes Syndrome and the Characteristics of Difference of Tranditional Chinese Medicine Obesity Types in Obese Children

作　　者：熊江波[1] 黄金城[1] 林玲[1] 王秀敏[2] 沈小芬[1] 

机构地区：[1]杭州市中医院儿科,浙江杭州310006 [2]浙江大学医学院附属儿童医院,浙江杭州310003

出　　处：《中医药学刊》2006年第12期2289-2292,共4页Study Journal of Traditional Chinese Medicine

摘　　要：目的:探讨儿童单纯性肥胖的辨证分型特点与西医临床和实验室指标的关系。方法:将单纯性肥胖儿童42例按照中医辨证分型分成4组(肝郁气滞型,脾胃湿热型,痰热夹虚型,肾虚痰浊型),并收集西医临床资料和B超检查资料,进行血糖、血清ALT、Tch、TG、HDL、LDL、ApoA、ApoB、血胰岛素、血尿酸水平测定等,运用SPSS11.5软件分析以上资料的相关性。结果:单纯性肥胖儿童各中医辨证分型各组之间BM I有显著性差异(P=0.026),而年龄、性别、病程、血压等无显著性差异(P>0.05)。各组间血清TCH、TG、HD L、LDL、Apo-a、Apo-b、FPG等方面无显著性差异(均P>0.05);痰热夹虚型组较肝郁气滞型组的UA有显著性差异(P=0.034);各组的ALT、F ins、HOMA-IR差异显著(均P<0.01)。各组脂肪肝、脂肪肝炎、良性黑棘皮病、胰岛素抵抗等发生率差异具有显著性意义(P<0.05),其中,痰热夹虚型较肝郁气滞型及脾胃湿热型均有显著性差异(P<0.05)。结论:儿童单纯性肥胖症以实症为多,并发症易出现于虚实夹杂型中,BM、IALT、FINS、HOMA-IR等实验室指标和脂肪肝、脂肪肝炎、胰岛素抵抗、良性黑棘皮病等并发症可能为对儿童肥胖进行中医辨证分型提供一定的参考依据。Objective ： This study was to analyze the relationship between some medical indexes syndrome and the characteristics of difference of Tranditional Chinese Medicine obesity types in obese children. Methods ： Obese children （ n = 42） were divided into four groups according to its mechanism in Tranditional Chinese Medicine ： Group 1 （ Syndrome of liver qi stagnation）, Group 2 （Syndrome of damp heat encumbering the spleen and stomach）, Group 3 （Mixture of phlegmatic heat and asthenia） and Group 4 （Syndrome of damp phlegm due to kidney asthenia）, clinical characteristics were collected, and laboratory indexes such as blood sugar,insulin, lipoid ,uric acid etc were tested and B type echograph was simultaneously performed. Differences between parameters were evaluated by SPSS11.5 software. Results ： Obese children of different Tranditional Chinese Medicine types had differences in BMI（ P =0.028） ,There were no differences in age, gender, blood pressure and duration of obesity among groups（ P 〉 0. 05 ）. TCH,TG,HD L, LDL,Apo - a,Apo - b and FPG showed no differences among groups （ 均 P 〉 0. 05 ）, but there were significant differences in ALT,Fins,HOMA- IR（ P 〈0. 01 ）,there was difference in UA between children of syndrome of liver qi stagnation and children of mixture of phlegmatic heat and asthenla （ P = 0. 034）. The prevalence of Fatty liver, nonalcohol ic steatohepatitis, Insulin resistance and benign acanthosis nigricans showed significant differences among four groups （ P 〈 0. 05 ）, The difference between children of syndrome of liver qi stagnation and children of mixture of phlegmatic heat and asthenia was significant （ P 〈 0. 05 ）. Conclusions ： Sthenia syndrome was obvious in obese children; obese children with Mixture of asthenia and sthenia were prone to the complications of obesity. It would be helpful to Differentiate obese children in Traditional Chinese Medicine when some laboratory indexes and complications such as Fatty liver, nonalcoholi

关 键 词：儿童 单纯性肥胖 中医辨证分型 

分 类 号：R723.14[医药卫生—儿科]