不同中医证型2型糖尿病合并非酒精性脂肪肝患者临床特征分析  

Analysis of Clinical Characteristics of Patients with Type 2 Diabetes with Different TCM Syndromes and Non-Alcoholic Fatty Liver

作　　者：祁月英[1] 季璇 张忠勇[1] 冉德聪 王笑 QI Yue-ying;JI Xuan;ZHANG Zhong-yong;RAN De-cong;WANG Xiao(Department of Spleen,Stomach and Liver Diseases,Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou Hebei 061000;Graduate School of Hebei University of Traditional Chinese Medicine,Shijiazhuang Hebei 061000)

机构地区：[1]河北省沧州中西医结合医院脾胃肝病科,河北沧州061000 [2]河北中医学院研究生院,河北石家庄061000

出　　处：《世界中西医结合杂志》2021年第10期1881-1885,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2018479)。

摘　　要：目的探讨不同中医证型2型糖尿病合并非酒精性脂肪肝患者的临床特征。方法选取2020年1月—2021年1月期间于河北省沧州中西医结合医院脾胃肝病科诊治的176例2型糖尿病合并非酒精性脂肪肝患者(合并组)及170例2型糖尿病患者(糖尿病组)为研究对象。比较两组患者一般资料、实验室指标及中医证型,分析不同中医证型与2型糖尿病合并非酒精性脂肪肝患者的一般资料关系及不同中医证型与2型糖尿病合并非酒精性脂肪肝患者的实验室指标的关系。结果两组患者性别、年龄、身体质量指数(Body Mass Index,BMI)、病程、舒张压、收缩压、2 h餐后血糖(2 h PG)、糖化血红蛋白(HbA1c)、高密度脂蛋白(high density lipoprotein cholesterol,HDL-C)、总胆固醇(total cholesterol,TC)、总胆红素(total Bilirubin,TBIL)、谷草转氨酶(aspartate aminotransferase,AST)、谷氨酰转肽酶(gamma-glutamyl transferase,GGT)、肌酐(serum creatinine,Scr)比较,差异无统计学意义(P>0.05);合并组空腹血糖(FBG)、低密度脂蛋白(Low density lipoprotein cholesterol,LDL-C)、甘油三酯(Triglyceride,TG)、总胆红素(Total Bilirubin,TBIL)、直接胆红素(Serum direct bilirubin,DBIL)、谷丙转氨酶(A lanine aminotransferase,ALT)、尿酸(Serum uric acid,SUA)、胰岛素抵抗指数(Homeostasis model assessment-insulin resistance index,HOMA-IR)比较,差异有统计学意义(P<0.05)。两组患者不同证型的中医证候比较,差异无统计学意义(P>0.05),其中合并组中以肝郁脾虚证比例最高,其次为肝肾阴虚型、气阴两虚兼瘀证。气阴两虚组男性发病率明显高于痰瘀互结证,差异有统计学意义(P<0.05);气阴两虚证年龄高于脾胃湿热证、肝郁脾虚证、痰瘀互结证,低于肝肾阴虚证,差异有统计学意义(P<0.05);不同证型病程、BMI、舒张压、收缩压相比,差异无统计学意义(P>0.05)。脾胃湿热证TG、ALT水平低于其他证型,差异有统计学意义(P<0.05);肝Objective To explore the clinical characteristics of patients with different TCM syndromes of type 2 diabetes and non-alcoholic fatty liver.Methods From January 2020 to January 2021,176 patients with type 2 diabetes and non-alcoholic fatty liver(combined group)and 170 patients with type 2 diabetes(diabetes Group)were selected as the research object.Compare the general data,laboratory indicators and TCM syndrome types of the two groups of patients,analyze the relationship between the general data of patients with different TCM syndromes and type 2 diabetes with non-alcoholic fatty liver,and analyze the relationship between different TCM syndromes and type 2 diabetes with non-alcoholic fatty liver.The relationship between the patient’s laboratory indicators was analyzed.Results There was no significant difference in gender,age,BMI,course of disease,diastolic blood pressure,systolic blood pressure,2 hPG,HbAlc,HDL-C,TC,IBIL,AST,GGT,Scr between the two groups of patients(P>0.05).Compared with the group FBG,LDL-C,TG,TBIL,DBIL,ALT,SUA,HOMA-IR,the difference was statistically significant(P<0.05).There was no statistically significant difference in the TCM syndromes of the two groups of patients with different syndrome types(P>0.05).Among the combined groups,the proportion of liver-stagnation and spleen-deficiency syndrome was the highest,followed by liver-kidney yin deficiency,qi and yin deficiency and stasis syndrome..The incidence of males in the deficiency of both qi and yin group was significantly higher than that of phlegm and blood stasis,and the difference was statistically significant(P<0.05);the age of qi and yin deficiency was higher than that of spleen and stomach damp-heat syndrome,liver depression and spleen deficiency,and phlegm and blood stasis,Lower than liver and kidney yin deficiency syndrome,the difference was statistically significant(P<0.05);compared with different syndrome types,BMI,diastolic blood pressure,and systolic blood pressure,the difference was not statistically significant(P>0.05).The le

关 键 词：中医证型 2型糖尿病合并非酒精性脂肪肝 气阴两虚证 肝肾阴虚证 

分 类 号：R781.64[医药卫生—口腔医学] R575.5[医药卫生—临床医学]