超重肥胖2型糖尿病病证规律探讨  

Clinical investigation on TCM disease and syndrome principle in type 2 diabetes patients with overweight or obesity

作　　者：徐远[1] 段军[1] 王艳梅[1] 王思轩[1] 叶康杰[2] 

机构地区：[1]中日友好医院,北京100029 [2]广东省中医院,广州510120

出　　处：《中华中医药杂志》2013年第8期2423-2425,共3页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:通过研究超重肥胖2型糖尿病的中医证候分型与肥胖特点、慢性并发症的关系,探讨中医证治。方法:采集100例2型糖尿病患者的病例信息,所有患者均进行调查问卷调查,测量肥胖相关指标,按身体质量指数(BMI)将患者分为正常组及超重组,将超重肥胖患者按中医证候分为气阴两虚证、肝胃郁热证、湿浊内蕴证、脾肾亏虚证,比较各组间肥胖相关指标、血脂及糖尿病血管并发症发生率差异。结果:超重肥胖患者的肥胖相关指标、甘油三酯(TG)水平、血管并发症、血瘀证兼夹情况均高于正常组(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平低于正常组;而肥胖患者中湿浊内蕴证组和脾肾亏虚证组慢性并发症患病率显著高于肝胃郁热组(P<0.05)。结论:2型糖尿病超重肥胖患者糖、脂代谢紊乱较重,易兼夹血瘀证,大、微血管并发症发生风险增大,尤以脾肾亏虚证和湿浊内蕴证为著。Objective： By studing the relationship between features of TCM syndrome and characteristic of obesity, prevalence of chronic complications of overweight and obese type 2 diabetes to investigate the treatment idea of TCM. Methods： 100 cases of T2DM patients received the questionnaire survey. And the obesity-related criterion, blood glucose, lipids and other biochemical criterion were be measured. All cases were divided into overweight or obese and normal weight group according to BMI. The overweight and obese patients were identified by TCM as qi and yin deficiency, liver and stomach stagnant heat, dampness stasis, spleen and kidney deficiency syndrome according to the analysis of information clinically. We compared obesity- related criterion and blood fat and the incidence of diabetic vascular complications among the groups. Results： The overweight and obese patients＇ obesity-related indicators such as body skinfold thickness and waist-hip ratio, body fat content were more than the normal weight patients, TG level, the rate of blood stasis and incidence of vessel and microvascular complications were higher than the normal weight group significantly, HDL-C level was lower than the normal weight group （P〈0.05）. Compared among each group of overweight or obese, incidence of vessels and microvascular complications of dampness stasis group and the spleen and kidney deficiency were significantly higher than liver and stomach stagnant heat group （P〈0.05）. Conclusion： Type 2 diabetic patients with overweight and obesity had much more disorder in glucose and lipid metabolism, and were apt to couple with blood stasis. The risk of vascular complications would be increased in obese diabetic patients, especially in dampness stasis and the spleen and kidney deficiency group.

关 键 词：肥胖 2型糖尿病 并发症 中医证候 

分 类 号：R259[医药卫生—中西医结合]