新诊断2型糖尿病慢性并发症的调查分析及其中医证型的研究  

Epidemiology of Chronic Diabetic Complications and Research of Symptoms of Traditional Chinese Medicine of Newly-diagnosed Type 2 Diabetes

作　　者：龚光明[1] 亓鲁光[1] 李洁[2] 杨兴智[2] 钟文[2] 文俊[1] 

机构地区：[1]成都中医药大学第一附属医院内分泌科,四川成都610000 [2]成都中医药大学

出　　处：《辽宁中医杂志》2012年第1期26-30,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:调查新诊断2型糖尿病(T2DM)患者的临床特征及慢性并发症情况,探讨新诊断T2DM的中医证型与慢性并发症的关系。方法:根据本研究的病例纳入及排除标准,按照统一制定的调查表对成都中医药大学附属医院2008年12月—2010年12月内分泌科的门诊及住院新诊断T2DM患者,采集其临床及中医辨证分型资料,按照有无并发症分组,进行相关统计学分析,比较两组间的差异。结果:被纳入的188例新诊断T2DM患者中,有111例存在至少1种慢性并发症,患病率高达59.04%。在有慢性并发症组中,合并脂代谢紊乱的患病率最高,达61.3%。经非条件Logistic回归分析,WHR、低密度脂蛋白胆固醇(LDL-C)、胰岛素分泌指数对数值(lnHOMA-β)低下、血流变学异常均为T2DM慢性并发症发生的危险因素。新诊断T2DM的中医证型仍以气阴两虚证为主,虚证证候比例显著高于实证,气虚证候频率大于阴虚证候,实热证候频率不足20%,两组的虚证证候之间无显著性差异(P>0.05),实证证候中痰湿证(χ2=17.257)和血瘀证(χ2=10.235)的P值均<0.01,有显著性差异;糖尿病大血管病变与气虚、阴虚、血瘀证呈正相关(r=0.102、0.1070、.118,P<0.05),与痰湿证呈显著性正相关(r=0.166,P<0.01);糖尿病微血管病变与气虚证呈正相关(r=0.113,P<0.05),与血瘀证呈显著性正相关(r=0.196,P<0.01)。结论:新诊断T2DM慢性并发症患病率高,知晓率低。"糖毒性"和"脂毒性"可能是加速慢性并发症形成的重要原因,防治应注重多重危险因素的控制。DM慢性并发症的病机特点为:"本虚标实"。"虚、瘀"贯穿T2DM及其并发症始终。"气阴两虚,痰浊瘀血闭阻脉络"可能是DM慢性并发症发生的共同病理基础。Objective ：To investigate clinical characteristics and the chronic complications status of newly -diagnosed type 2 diabetes mellitus, and discuss the relationship between the Chinese medicine patterns and the chronic complications of newly - diagnosed type 2 diabetes mellitus. Methods ： According to the research＇s case integrated and eliminated standards,in terms of unitive survey form to investigate the Chengdu University of Traditional Chinese Medicine affiliated hospital from October,2008 to October,2010 Department of Endocrinology outpatient and inpatient of newly - diagnosed type 2 diabetes mellitus, gather their clinical and the Chinese syndrome differentiation materials, group whether there is complications, to do the related statistics analysis, comparing differences between two groups. Results：In 188 newly -diagnosed type 2 diabetes mellitus patients which are integrated, 111 patients exist at least one kind of chronic complications ,the morbidity reaches as high as 59.04%. In the chronic complications group,the morbidity of combination with lipid metabolic disorder is highest, reaching 61.3 %. After the non - condition Logistic regression analysis, WHR, lowdensity lipoprotein cholesterol, inferior natural logarithm of insulin secretion index, abnormal hemorheology are the risk factors which cause the T2DM chronic complications. The Chinese pattern of syndrome of newly - diagnosed type 2 diabetes mellitus patients is still mainly qi and yin deficiency ,deficient syndrome ratio is obviously higher than sufficient syndrome,the frequency of the qi deficient syndrome is above the yin deficient syndrome,the frequency of excess heat syndrome is less than 20%, deficient syndrome between two groups have no significant difference, in sufficient syndrome, both P value of phlegm - damp syndrome （ χ2 = 17. 257 ） and blood stasis syndrome （ χ2 = 10. 235 ） is smaller than 0.01, have the significant difference. Diabetic great vessel pathological changes have positive correlation with qi deficiency syn

关 键 词：2型糖尿病 新诊断 慢性并发症 中医证型 早期防治 

分 类 号：R203[医药卫生—中医学]