糖尿病视网膜病变中医证候特征研究——603例多中心临床研究报告  

Research on TCM Symdrom Character of Microvascular Complications of Diabetes

作　　者：段俊国[1] 廖品正[1] 吴烈[2] 吴艳乔[3] 王育良[4] 李毓敏[5] 刘晓玲[6] 邱波[7] 余杨桂[8] 阴正勤 樊映川[10] 叶河江[1] 路雪婧[1] 张富文[1] 

机构地区：[1] 成都中医药大学,四川成都610075 [2] 中国中医研究院广安门医院,中国北京100053 [3] 四川大学,四川成都610041 [4] 江苏省中医院,江苏南京210029 [5] 浙江大学医学院第一附属医院,浙江杭州310003 [6] 温州医学院附属眼视光学医院,浙江温州325027 [7] 广东省中医院,广东广州510130 [8] 广州中医药大学第一附属医院,广东广州510405 [9] 第三军医大西南医院,中国重庆400038 [10] 四川省人民医院,四川成都610072

出　　处：《中医眼耳鼻喉杂志》2011年第1期11-14,共4页Journal of Chinese Ophthalmology and Otorhinolaryngology

基　　金：国家十五科技攻关计划（2001BA701A13a）

摘　　要：目的 通过收集糖尿病（DM）及其并发症患者病证信息,建立糖尿病视网膜病变（DR）临床数据库,研究DR证候特征,明确DR证候及病症发生发展规律.方法 以糖尿病视网膜病变（DR）为核心兼顾糖尿病肾损害,运用临床流行病学、生物统计学、计算机信息学等多学科的研究手段,开展了DR大样本、多中心、前瞻性中医证候特征及其规律的探索性临床研究,通过实行严格的质量控制、建立SQL远程数据管理系统的方法,建立了DR病证信息数据库,并对收集到的603例患者病证信息数据进行数据诊断,核查数据无误后采用聚类、相关、logistic回归等Data Mining技术进行统计,研究了DR的证候特征、证候演变规律、风险因子及其影响因素.结论 ①虚实夹杂、本虚标实是DR基本证候特点;②气阴两虚始终贯穿于病变发展的全过程,是DR的基本病机,为致病之本;③气阴两虚,气虚渐重,燥热愈盛,内寒更著,阴损及阳,阴阳两虚是DR的主要证候演变规律;④阳虚是影响DR病情进展的关键证候因素;⑤因虚致瘀、因虚致郁,血瘀肝郁是DR重要兼证;⑥DR为多因素致病,阳虚证、糖尿病病程、糖尿病控制、高血压、尿蛋白排泄率以及生存质量是DR的重要风险因子;⑦中医症状与DR生存质量明显相关,中医症状越重,生存质量越差.Objective By collecting information of syndrome of diabetes mellitus （DM） and its complication from the patients,we established clinical data base on diabetes retinopathy（DR） to study the syndrome characteristic of it, and to find out the rules concerning the occurrence and development of the syndromes and disease of DR. Methods Centering DR due to DM while also taking into consideration the damage DM does to kidney, by applying researching methods of clinical epidemiology, biological statistics and computer informatics ect, exploringly clinical researches featured big sample, multicentric, and forward looking nature on syndrome characters and its rules on DR. Under strict quality control, SQL remote dataadministering method was set up. And with its help, data base of DR Syndromes was set up to analyse information of the 603 patients. After checking the validity of these data,Data Mining was applied in order to study the character, variation rules, risk factors, influencing factors of DR. Conclusion （1） The basic characteristics is deficiency mingled with excess and deficiency in root and excess in superfieiality （2） Deficiency of both Qi and Yin ran through the whole pathological process, and is the basic pathogenesis of DR; （3）The main rule of symptom variation of DR is as following： deficiency of both Qi and Yin, deterioration of Qi deficiency and Dryness-Hot,which results in the aggravation of the internal Cold which leads to the impair of Yang,and finally the deficiency of both Yin and Yang. （4）Yang deficiency is the key factor affecting the progress of DR. （5）There are multi factors attributing to the occurrence of DR. （6）The important risk factors of DR are Yang deficiency,diabetes course, the control of blood sugar, hypertension, Urine protein excretory rate and life quality. （7）The symptom of TCM is closely related with life quality, whereas the severe the former,the worse the latter.

关 键 词：糖尿病视网膜病变 糖尿病微血管病变 证候特征 多中心临床研究 

分 类 号：R774[医药卫生—眼科]