糖尿病伴脂代谢异常患者的中医证型与炎症细胞因子的相关性研究  

Correlation between TCM Syndromes and Inflammatory Cytokines in Patients with Diabetes and Abnormal Lipid Metabolism

作　　者：张黎洋 唐红[1] ZHANG Li-yang;TANG Hong(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201103)

机构地区：[1]上海中医药大学附属龙华医院,上海201103

出　　处：《世界中西医结合杂志》2022年第5期954-958,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市科学技术委员会科研计划项目(17401970200)。

摘　　要：目的探究糖尿病伴脂代谢异常患者的中医证型与炎症细胞因子的相关性。方法选取2015年6月—2017年6月期间上海中医药大学附属龙华医院收治的300例糖尿病伴脂代谢异常患者作为研究对象,根据中医证型不同进行分组,其中痰浊阻遏型118例(痰浊阻遏组)、气阴两虚型91例(气阴两虚组)、脾肾阳虚型22例(脾肾阳虚组)、肝肾阴虚型28例(肝肾阴虚组)、血瘀脉络型41例(血瘀脉络组),比较各组一般资料、脂代谢指标[甘油三酯(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)]、血清炎症细胞因子[白细胞介素6(Interleukin 6,IL-6)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子(Tumor necrosis factor,TNF-α)]水平,并统计各组糖尿病视网膜病变(Diabetic retinopathy,DR)、糖尿病肾病(Diabetic nephropathy,DN)发生率,采用Pearson相关系数模型探究TG、TC与血清炎症细胞因子的相关性,采用Logistic多因素回归分析模型评价血清炎症细胞因子与糖尿病伴脂代谢异常患者发生DR、DN的关联性。结果各组TG、TC、血清IL-6、CRP、TNF-α水平比较,差异有统计学意义(P<0.05),TG水平:肝肾阴虚组最高,脾肾阳虚组最低;TC、血清IL-6、CRP、TNF-α水平:均为肝肾阴虚组最高,痰浊阻遏组最低;各组DR发生率比较,差异有统计学意义(P<0.05),其中肝肾阴虚组DR发生率(50.00%)最高,脾肾阳虚组(20.00%)最低;各组DN发生率比较,差异有统计学意义(P<0.05),其中肝肾阴虚组DN发生率(53.85%)最高,脾肾阳虚组(25.00%)最低;糖尿病伴脂代谢异常患者TG、TC与血清IL-6、CRP、TNF-α呈正相关(P<0.05);糖尿病伴脂代谢异常患者血清IL-6、CRP、TNF-α水平升高均会增加DR、DN发生风险(P<0.05)。结论糖尿病伴脂代谢异常患者的中医证型呈多样化,主要为痰浊阻遏型、气阴两虚型,不同中医证型患者的血清IL-6、CRP、TNF-α水平存在明显差异,明确各因子表达情况能辅助临床评估不同中医证Objective To explore the relationship between TCM syndromes and inflammatory cytokines in patients with diabetes and abnormal lipid metabolism.Methods A total of 300 patients with diabetes and abnormal lipid metabolism treated in theLonghua Hospital,Shanghai University of Traditional Chinese Medicine from June 2015 to June 2017 were enrolled in this study.The patients were grouped according to different TCM syndromes,including 118 patients with the syndrome of phlegm stasis,91 patients with the syndrome of qi and yin deficiency,22 patients with the syndrome ofyang deficiencyin spleen and kidney,28 patients with the syndrome of yin deficiency in liver and kidney,and 41 patients with the syndrome of blood stasis incollateralsand vessels.The general information,lipid metabolism indicators[triglyceride(TG)and total cholesterol(TC)],and serum inflammatory cytokines[interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-alpha(TNF-α)]were compared among different syndrome groups.The incidence of diabetic retinopathy(DR)and diabetic nephropathy(DN)in each group were statistically analyzed.Pearson correlation analysis was carried out to analyzed the correlationsofTG and TC with serum inflammatory cytokines.Logistic multivariate regression analysiswas conducted to reveal the correlations of serum inflammatory cytokines with DR and DN in the diabetic patients with abnormal lipid metabolism.Results The levels of TG,TC,IL-6,CRP,and TNF-αhad significant differences among different groups(P<0.05).The TG level was the highest in thegroup of yin deficiency in liver and kidney and thelowest in the group of yang deficiency in spleen and kidney.The TC,IL-6,CRP,and TNF-αlevels were the highest in the group of yin deficiency in liver and kidney and the lowest in the group of phlegm stasis.The incidence of DR varied among the groups(P<0.05),being the highest in the group of yin deficiency in liver and kidney(50.00%)and the lowest in the group of yang deficiency in spleen and kidney(20.00%).The incidence of DN also var

关 键 词：糖尿病 脂代谢异常 中医证型 炎症细胞因子 糖尿病视网膜病变 糖尿病肾病 

分 类 号：R587.1[医药卫生—内分泌]