老年2型糖尿病相关失眠的中医证型分析  

Analysis of TCM syndrome types of insomnia in elderly patients with type 2 diabetes

作　　者：温伟波[1] 房昉 孙朝辉[1] 

机构地区：[1]云南省中医医院,云南昆明650021

出　　处：《湖南中医杂志》2015年第1期1-5,共5页Hunan Journal of Traditional Chinese Medicine

摘　　要：目的:探讨老年2型糖尿病相关失眠的中医证型分布特征。方法:确立纳入标准及排除标准,收集300例年龄大于60岁、同时存在2型糖尿病及失眠症状的患者,调查其一般情况、2型糖尿病相关病史,记录其临床症状、舌脉特点及体质量指数、腰围、空腹血糖、糖化血清蛋白、糖化血红蛋白检测结果。采用频数分析、K类中心聚类等数理统计方法,并结合证素辨证等中医辨证方法,探讨老年2型糖尿病相关失眠的中医证型分布特征,并使用因子分析了解各个不同中医证型组的公因子特征。结果:(1)临床症状特点及舌脉特点。出现频率>60%的症状有失眠、口干、口渴多饮、头晕、便秘、夜尿增多、倦怠乏力、肢体麻木,出现频率>60%的舌脉特点有细脉、白苔。(2)K类中心聚类结果。聚类数为7时的各个聚类分组的辨证意义最佳,根据各聚类组相应的辨证意义,可分为气虚、阴虚、火热、气阴两虚、肾阴阳两虚、肝阴虚、肾精亏虚7组证型;(3)因子分析结果。血糖控制综合情况因子是所有证型组的共有公因子,其他公因子各个证型有所不同,且部分证型之间差别较大。结论:(1)老年2型糖尿病相关失眠的中医证型可分为气虚、阴虚、火热、气阴两虚、肾阴阳两虚、肝阴虚、肾精亏虚7组证型;(2)各个证型组的公因子均有所不同,且部分证型之间公因子的差别较大。Objective： To investigate the distribution characteristics of traditional Chinese medicine（ TCM） syndromes of insomnia in elderly patients with type 2 diabetes. Methods： According to the established inclusion criteria and exclusion criteria,300 patients aged over 60 years who had type 2 diabetes and insomnia. Their general status and history of type 2 diabetes were investigated,and the clinical symptoms,tongue veins,body mass index,waist circumference,fasting blood glucose,glycosylated serum protein,and glycosylated hemoglobin were recorded. Frequency analysis and k- means clustering,as well as syndrome element differentiation,were used to investigate the distribution characteristics of TCM syndromes of insomnia in elderly patients with type 2 diabetes,and factor analysis was used to investigate the common factor characteristics of different groups of TCM syndromes. Results：（ 1） Characteristics of clinical symptoms and tongue veins： the symptoms with a frequency of〉 60% included insomnia,dry mouth,thirst and frequent drinking,dizziness,constipation,nocturia,fatigue and weakness,and limb numbness; the features of tongue veins with a frequency of 60% were fine veins and white fur.（ 2） Results of k- means clustering： the significance of clustering for syndrome differentiation was the best when the number of clusters was7; TCM syndromes could be clustered into qi deficiency,yin deficiency,fire heat,deficiency of both qi and yin,kidney yin- yang deficiency,liver yin deficiency,and deficiency of kidney- essence.（ 3） Results of factor analysis： the general condition of blood glucose control is the common factor that all groups of TCM syndromes shared; other common factors varied between different TCM syndromes,substantially between some ones. Conclusion：（ 1） The TCM syndromes of insomnia in elderly patients with type 2 diabetes can be clustered into qi deficiency,yin deficiency,fire heat,deficiency of both qi and yin,kidney yin- yang deficiency,liver yin deficiency,and deficiency of k

关 键 词：老年2型糖尿病 失眠 中医证型 

分 类 号：R259.872[医药卫生—中西医结合]