2型糖尿病肝郁气滞证腹证特点及相关性研究  

Study on the Characteristics and Correlation of Type 2 Diabetes of Liver Qi Stagnation and Abdominal Symptoms

作　　者：刘轶凡 张则业 孟繁章 赵进喜[1] LIU Yifan;ZHANG Zeye;MENG Fanzhang;ZHAO Jinxi(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Beijing University of Chinese Medicine,Beijing 102488,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学,北京102488

出　　处：《山东中医杂志》2021年第8期834-839,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：赵进喜教学名师工作坊(编号:MSGZF-201824)。

摘　　要：目的:总结2型糖尿病肝郁气滞证的常见腹证特点,探讨不同腹证与四诊信息、中医证候的内在联系,挖掘辨证意义较大的典型腹证,提高临床辨证的准确性。方法:对北京中医药大学东直门医院门诊及住院治疗的90例2型糖尿病肝郁气滞证患者进行腹诊诊察及四诊信息调查,判定中医证候及积分,录入并分析数据。结果:常见腹证出现频率从高到低依次为心下痞硬、胸胁苦满、腹皮拘急、腹痛、心下痞;胸胁苦满、心下痞与肝郁气滞证的严重程度相关;胸胁苦满与舌边有浊沫存在相关性;心下痞硬、腹痛、胸胁苦满、心下冷凉与失眠多梦相关。结论:腹诊对于2型糖尿病的临床辨证论治有较大价值;胸胁苦满和心下痞可作为辅助2型糖尿病肝郁气滞证诊断的典型腹证;部分腹证与临床症状存在关联性,也为治疗原则的确立与疗效评估提供了思路方法。Objective:To summarize the common abdominal symptoms of type 2 diabetes with liver qi stagnation,to explore the relationship between different abdominal symptoms and four diagnoses information or traditional Chinese medicine(TCM)syndromes,to excavate typical abdominal symptoms with significant differentiation indications,and to improve the accuracy of clinical syndrome differentiation in type 2 diabetes.Methods:Ninety patients with type 2 diabetes of liver qi stagnation from the clinic or hospitalized in Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,were given abdominal diagnosis and four examinations,to determine TCM syndrome and syndrome scores,and the results were recorded for analysis.Results:The common abdominal symptoms with frequency from high to low were as follows:stuffy and hard sensation in epigastrium,fullness and discomfort in chest and hypochondrium,spasm of abdominal skin,abdominal pain,and stuffy sensation in epigastrium.Fullness and discomfort in chest and hypochondrium and stuffy sensation in epigastrium were related to the severity of liver qi stagnation;fullness and discomfort in chest and hypochondrium was related to turbid foam on the tongue edge;stuffy and hard sensation in epigastrium,abdominal pain,fullness and discomfort in chest and hypochondrium,cold sensation in epigastrium were related to insomnia and dreamfulness.Conclusions:Abdominal diagnosis is of great significance for the clinical differentiation and treatment of type 2 diabetes;fullness and discomfort in chest and hypochondrium,stuffy sensation in epigastrium could be used as a typical abdominal symptom for diagnosis assistantly;there are correlations between some abdominal symptoms and clinical symptoms,which could provide a paradigm for establishing treatment principles and efficacy evaluation.

关 键 词：2型糖尿病 腹证 腹诊 肝郁气滞 中医证候 胸胁苦满 心下痞 

分 类 号：R255.4[医药卫生—中医内科学]