2型糖尿病并发非酒精性脂肪肝患者证素分析  

Analysis on Associated Risk Factors and Syndrome Types in Diabetes Mellitus Type 2 Patients Complicated with Non-alcoholic Fatty Liver

作　　者：陈筑红[1] 夏城东[1] 黄佳娜[1] 韦玮[1] 胡国庆[1] 魏子孝[1] 

机构地区：[1]中国中医科学院西苑医院内分泌科,北京100091

出　　处：《中国中西医结合杂志》2008年第10期879-881,共3页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的探讨2型糖尿病合并非酒精性脂肪肝的主要危险因素及中医的主要证型和病机。方法采用病例对照研究的方法观察180例2型糖尿病并发脂肪肝和无脂肪肝患者的年龄、身高、体重、体重指数、空腹血糖、C肽、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白(LDL-C)、餐后2h C肽等指标。根据2型糖尿病中医证素分型,统计合并脂肪肝患者所占类型比例。结果2型糖尿病并发脂肪肝组与无脂肪肝组年龄、身高、空腹血糖、HbA1c、TC、LDL-C比较,差异无统计学意义(P>0.05);脂肪肝组体重〔(73.4±11.7)kg〕、BMI(26.0±3.67)、空腹C肽〔(4.09±2.40)μg/L〕和餐后2h C肽〔(6.38±5.46)μg/L〕、TG〔(2.81±2.33)mmol/L〕、HDL-C〔(1.07±0.06)mmol/L〕与无脂肪肝组体重〔(61.4±10.1)kg〕、BMI(22.8±3.23)、空腹C肽〔(2.47±1.74)μg/L〕和餐后2h C肽〔(4.35±2.92)μg/L〕、TG〔(1.93±1.92)mmol/L〕、HDL-C〔(1.19±0.32)mmol/L〕比较,差异均有统计学意义(P<0.01,P<0.05);合并脂肪肝组患者更易出现痰湿证。结论肥胖、胰岛素抵抗(insulin resistance,IR)及脂质代谢紊乱在2型糖尿病并发脂肪肝患者中多见,痰湿是2型糖尿病并发脂肪肝的主要病机。Objective To explore the risk factors and the main TCM syndrome types associated with the diabetes mellitus type 2 （DM2） patients complicated with non-alcoholic fatty liver （FL）. Methods Adopted controlled trial method, the age, stature, body weight, and body mass index （BMI） of 180 DM2 patients were compared with those complicated with or without FL. And some related laboratory indexes, including the age, stature, body weight, BMI, fasting blood glucose （FBG） , C-peptide （CP） , glycosylated hemoglobin （HbAle） , triglyceride （TG）, total cholesterol （TC）, high and low density lipoprotein cholesterol （HDL-C and LDL-C）, and 2 h postrandial CP （2 h CP） , were compared as well. Moreover, patients＇ TCM syndrome types were classified. Resuits No significant differences were found between DM2 patients complicated with or without FL in aspects of FBG, HbAle, TC, LDL-C and age, stature （P 〉 0.05）, but significant difference did show between them in aspects of CP （4.09 ±2.40 μg/L vs 2.47 ± 1. 74 μg/L） , 2h CP （6.38 ± 5.46 μg/L vs 4.35 ± 2.92 μg/L） , TG （2.81 ±2.33 mmol/L vs 1.93 ± 1.92 mmol/L） , HDL-C （1.07±0.06 mmol/L vs 1. 19 ±0.32 mmol/L） as well as in body weight （73.4 ±11.7 kgvs61.4±10.1 kg） and BMI （26.0 ±3.67 vs22.8 ±3.23）, respectively （P 〈0.05 or P 〈0. 01 ）. Moreover, phlegm-dampness type was more liable to appear in DM2 patients complicated FL. Conclusions Obesity, insulin resistance and lipid metabolism disorder are the chief risk factors in DM2 patients complicated with FL and phlegm-dampness is the chief pathogenesis.

关 键 词：2型糖尿病 非酒精性脂肪肝 胰岛素抵抗 中医辨证 中医证素 

分 类 号：R259[医药卫生—中西医结合]