1569例2型糖尿病患者中医证型与临床指标相关性研究  

Correlation between TCM Syndrome Types and Clinical Indexes in 1569 Patients with Type 2 Diabetes Mellitus

作　　者：薛哲哲 孙卫卫[1] 王艺 张佳乐 魏蜀吴 姜伟民 柳红芳[1] 王耀献[1] 刘晴晴[1] XUE Zhe-zhe;SUN Wei-wei;WANG Yi;ZHANG Jia-le;WEI Shu-wu;JIANG Wei-ming;LIU Hong-fang;WANG Yao-xian;LIU Qing-qing(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《中医药导报》2021年第8期66-70,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中医药行业科研专项基金资助项目(201207012)。

摘　　要：目的:研究2型糖尿病患者中医证型与临床指标的相关性,筛选有相关性的指标指导临床辨证治疗。方法:对纳入的1569例2型糖尿病患者进行辨证,并运用二元Logistic回归分析探讨年龄、性别、合并疾病、体质量指数(BMI)、腰臀比、收缩压、舒张压、空腹血糖、糖化血红蛋白、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、肌酐、尿酸等临床指标与中医证型的相关性。结果:1569例2型糖尿病患者中医辨证分为50种,肝肾阴虚证最常见,其次为肝阳上亢证和气阴两虚证。气虚血瘀证、瘀血阻络证、痰瘀互阻证与心血管疾病呈正相关(P<0.05,OR=1.420,OR=1.688,OR=1.430);瘀血阻络证、痰瘀互阻证与脑血管疾病呈正相关(P<0.05,OR=1.504,OR=1.492);肝阳上亢证与高血压呈正相关(P<0.05,OR=1.909);气阴两虚证与高血压呈负相关(P<0.05,OR=0.499);痰瘀互阻证与BMI呈正相关(P<0.05,OR=1.164);肝肾阴虚证、气阴两虚证与BMI呈负相关(P<0.05,OR=0.938,OR=0.929);湿热内蕴证与BMI呈正相关(P<0.05,OR=1.067),与血肌酐呈负相关(P<0.05,OR=0.991)。结论:肝肾阴虚证和肝阳上亢证是2型糖尿病患者主要的中医证型。2型糖尿病患者的心脑血管疾病、高血压、BMI、血肌酐等临床指标与中医证型之间存在着一定的相关性。Objective:To study the correlation between TCM syndromes and clinical indicators in patients with type 2 diabetes mellitus,and screen related indicators to guide clinical syndrome differentiation and treatment.Methods:A total of 1569 patients with type 2 diabetes mellitus were selected for syndrome differentiation,the correlation of age,sex,combined diseases,body mass index(BMI),waist-to-hip ratio,systolic pressure,diastolic pressure,fasting blood glucose,glycated hemoglobin,triglyceride,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,creatinine,uric acid and other clinical indexes with TCM syndrome types w as analyzed by binary Logistic regression.Results:There were 50 kinds of TCM syndrome differentiation in 1569 patients with type 2 diabetes mellitus.Liver-kidney Yin deficiency syndrome was the most common syndrome,followed by liver-Yang hyperactivity syndrome and Qi-Yin deficiency syndrome.There was a positive correlation between the syndrome of Qi deficiency and blood stasis,the syndrome of blood stasis blocking collateral,the syndrome of phlegm and blood stasis blocking each other and cardiovascular diseases(P<0.05,OR=1.420,OR=1.688,OR=1.430),the syndrome of blood stasis blocking collateral,the syndrome of phlegm and blood stasis blocking each other and the syndrome of cerebrovascular disease blood stasis were positively correlated(P<0.05,OR=1.504,OR=1.492).Liver-Yang hyperactivity syndrome was positively correlated with hypertension(P<0.05,OR=1.909),Qi-Yin deficiency syndrome was negatively correlated with hypertension(P<0.05,OR=0.499),phlegm-stasis syndrome was positively correlated with BMI(P<0.05,OR=1.164),liver-kidney yin deficiency and Qi-Yin deficiency were negatively correlated with BMI(P<0.05,OR=0.938,OR=0.929),while dampness-heat syndrome was positively correlated with BMI(P<0.05,OR=1.067)and negatively correlated with serum creatinine(P<0.05,OR=0.991).Conclusion:Liver-kidney Yin deficiency syndrome and liver-Yang hyperactivity syndrome are the major TCM

关 键 词：2型糖尿病 中医证型 临床指标 心血管疾病 脑血管疾病 高血压 体质量指数 血肌酐 相关分析 

分 类 号：R241.9[医药卫生—中医诊断学]