2型糖尿病伴颈动脉内膜中层增厚血瘀证证候特点分析  

An analysis of the characteristics of blood stasis syndrome of type 2 diabetes mellitus with carotid intima-media thickening

作　　者：陈松姬[1] 江婷 CHEN Songji

机构地区：[1]福建中医药大学附属人民医院,福建福州350004

出　　处：《中医临床研究》2021年第31期82-85,共4页Clinical Journal Of Chinese Medicine

基　　金：福建省卫生计生委青年科研课题(2015-1-82)。

摘　　要：目的:观察2型糖尿病伴颈动脉内膜中层增厚血瘀证的证候特点。方法:将符合纳入标准的79例2型糖尿病患者分为颈动脉内膜中层厚度增厚组(简称增厚组)54例、正常组25例。对两组性别、年龄、病程、颈动脉内膜中层厚度、血瘀证症状及体征、并发症及合并症、血压、身体质量指数、体质量、腹围以及空腹血糖等实验室检查结果等进行比较分析。结果:与正常组相比,增厚组,①血瘀证发生率高(P<0.01);②皮下瘀斑、舌质紫暗(瘀斑/瘀点)、舌脉粗张、善忘发生率高(P<0.01),肌肤甲错、痴癫狂躁发生率高(P<0.05);③年龄大(P<0.01);④糖尿病足、糖尿肾病发生率高(P<0.01),缺血性脑血管病、下肢血管超声异常、白内障发生率高(P<0.05);⑤收缩压、血肌酐、尿蛋白阳性率高(P<0.05),肌酐清除率低(P<0.01)。结论:2型糖尿病颈动脉内膜中层增厚者的血瘀证发生率更高。糖尿病患者出现皮下瘀斑、舌质紫暗(瘀斑/瘀点)、舌脉粗张、善忘、肌肤甲错、痴癫狂躁等症状体征提示大血管病变的概率增大。Objective:To observe the characteristics of blood stasis syndrome of type 2 diabetes mellitus with carotid intimamedia thickening.Methods:79 patients with type 2 diabetes were divided into the thickening group(54 cases)and the normal group(25 cases).The gender,age,course of disease,carotid intima-media thickness,blood stasis syndrome symptoms and signs,complications,blood pressure,BMI,body weight,abdominal circumference and results of laboratory tests such as fasting blood glucose,were compared between the two groups.Results:Compared with the normal group in the thickening group,①the incidence of blood stasis syndrome in the thickening group was higher(P<0.01);②the incidence of subcutaneous ecchymosis,purplish tongue(ecchymosis),coarse tongue vein,forgetfulness(P<0.01),and the incidence of skin nail fault and mania were higher(P<0.05);③the patients were older(P<0.01);④the incidence of diabetic foot and diabetic nephropathy was higher(P<0.01),the incidence of ischemic cerebrovascular disease,abnormal ultrasound of lower extremity vessels and cataract was higher(P<0.05);⑤the systolic blood pressure,serum creatinine and the positive rates of urinary protein were higher(P<0.05),and creatinine clearance rate was lower(P<0.01).Conclusion:The incidence of blood stasis syndrome was higher in patients with type 2 diabetes mellitus with carotid intima-media thickening;the symptoms and signs such as subcutaneous ecchymosis,dark tongue(ecchymosis),tongue vein coarseness,forgetfulness,skin nail error,mania,indicate that the probability of macrovascular disease in diabetic patients was increased.

关 键 词：2型糖尿病 颈动脉内膜中层厚度 血瘀证 证候特点 

分 类 号：R587.1[医药卫生—内分泌]