695例糖尿病周围神经病变中医证候特点分析  

Analysis of characteristics of TCM syndromes in 695 cases of diabetic peripheral neuropathy

作　　者：王超[1] 张倩[1] 孙青[1] 吴群励[1] 梁晓春[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院中医科,北京100730

出　　处：《北京中医药》2016年第8期715-719,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：首都医学发展科研基金资助项目(2002-Ⅱ-8)

摘　　要：目的研究糖尿病周围神经病变(DPN)的中医证候特点及其影响因素。方法收集695例DPN患者的病历资料,根据统一的辨证标准辨为气虚证、阴虚证、阳虚证、血瘀证、痰湿证、气滞证6个单证,将单一证候组合形成复合证型,利用统计学方法对数据进行分析。结果血瘀证(78.71%)、阴虚证(63.31%)比例较高,阳虚证比例随病程延长逐渐增加;血瘀证比例随年龄的增长和病程延长而增加,阳虚证、血瘀证均与糖尿病病程具有显著相关性(r=0.122和0.115,P<0.01);不同病程组证型构成比差异有统计学意义(P<0.01),随着病程的延长,气虚、阴虚、气阴两虚证比例有降低趋势,阳虚、阴阳两虚证所占比例增加。阳虚证较非阳虚证患者神经传导功能异常率明显增高(P<0.05);体重指数与痰湿证、糖化血红蛋白与阴虚证、空腹血糖与气虚证均有显著相关性(r=0.181和0.105和0.117,P<0.05或0.01)。结论探讨糖尿病周围神经病变中医证候特点,可以为DPN的中医辨证提供临床依据。Objective To explore the characteristics of traditional Chinese medicine syndromes in diabetic peripheral neuropathy （DPN） as well as the influential factors. Methods The medical records of 695 DPN patients were collected, and their conditions were differentiated according to the unified criteria of traditional Chinese medicine as syndromes of Qi-deficiency, Yin-deficiency, Yangdeficiency, blood-stasis, pldegm-dampness and Qi-stagnation. The single syndrome was combined into the complicated syndromes. Statistics were used to analyze the data obtained. Results The proportion of bloed-stasis syndrome（78.71% ） and Yin-deficiency syndrome （63.31% ） accounted the most, and Yang-deficiency syndrome accounted more and more with the longer duration of disease, blood-stasis syndrome accounted more and more with the increasing ages and the longer duration of disease, Yang-deficiency syndrome and blood-stasis syndrome were both obviously associated with the course of DM （r = 0. 122 and 0. 115, P 〈 0. 01 ） . Concerning excess and deficiency, the proportional ratio of syndromes during different course had statistically significant difference （ P 〈 0. 01 ）. With the prolonging of disease, the proportion of Qi-deficiency, Yin-deficiency and deficiency of qi and yin tend to reduce, that of Yang-deficiency and deficiency of Yin-Yang to rise. Neuron transmission abnormality in Yang-defieiency patients enhanced compared that in non Yang-deficiency patients （P 〈 0. 05 ） ; HbAlc and Yin-deficiency syndrome, FBG and Qi-deficiency syndrome, BMI and phlegm-damp syndrome were correlated with other（ r =0. 181, 0. 105 and 0. 117, P 〈0.05 or 0. 01 ） . Conclusion Discussion about the characteristics of TCM syndromes in diabetic peripheral neuropathy can provide clinical evidence for the syndrome differentiation of DPN.

关 键 词：糖尿病周围神经病变 中医证候 证型 

分 类 号：R259[医药卫生—中西医结合]