老年2型糖尿病合并冠心病不同中医证型与UA、HCY、颈动脉IMT相关性分析  

Correlation Analysis of Different TCM Syndromes of Elderly Type 2 Diabetes Complicated with Coronary Heart Disease and UA,HCY and Carotid IMT

作　　者：张珂珂 袁占盈[1] 魏桂梅[1] 赵璐[1] ZHANG Keke;YUAN Zhanying;WEI Guimei;ZHAO Lu(The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450008)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008

出　　处：《中医学报》2022年第11期2446-2451,共6页Acta Chinese Medicine

基　　金：郑州市普通科技攻关计划项目(2017ZY2114)。

摘　　要：目的:分析老年2型糖尿病(type 2 diabetes,T2DM)合并冠状动脉粥样硬化性心脏病(简称冠心病)患者中医证型与尿酸(uric acid,UA)、同型半胱氨酸(homocysteine,HCY)、颈动脉内膜厚度(intimal thickness,IMT)的相关性。方法:对326例老年T2DM合并冠心病患者的相关资料进行回顾性整理和分析,统计中医证型、血糖[空腹血糖(fasting blood-glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)]、血脂[总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin,LDL-C)]、UA、HCY及颈动脉IMT,分析各中医证型与上述指标的关系。结果:4种中医证型(气阴两虚证、阴阳两虚证、痰浊阻滞证、心脉瘀阻证)以气阴两虚证最多;阴阳两虚证患者平均年龄、平均病程、HbA1c及UA水平均高于其他3种证型(P<0.05);痰浊阻滞证患者TC、TG、LDL-C、HCY、颈动脉IMT均高于其他3种证型(P<0.05);在颈动脉内膜增厚及斑块形成的患者中,阴阳两虚证患者UA水平高于其他3种证型(P<0.05),痰浊阻滞证患者HCY水平高于其他3种证型(P<0.05)。结论:老年T2DM合并冠心病患者中医证型以气阴两虚证最多;阴阳两虚证患者年龄、病程、HbA1c及UA均高于其他证型;痰浊阻滞证的TC、TG、LDL-C、HCY及颈动脉IMT均高于其他证型;颈动脉内膜增厚及斑块形成时,阴阳两虚证的UA高于其他证型,痰浊阻滞证的HCY高于其他证型。Objective:To analyze the relationship between TCM syndrome types and uric acid(UA),homocysteinein elderly patients with type 2 diabetes(T2 DM)complicated with coronary atherosclerotic heart disease(HCY)and carotid intima thickness(IMT).Methods:The data of 326 elderly patients with T2 DM complicated with coronary heart disease were retrospectively sorted and analyzed.TCM syndrome types,blood glucose[fasting blood-glucose(FPG),glycosylated hemoglobin(HbA1 c)],blood lipids were counted.[Total cholesterol(TC),triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)],UA,HCY,and cervical IMT,and analyzed the relationship between each TCM syndrome type and the above indicators.Results:The four types of TCM syndromes(Qi-Yin deficiency syndrome,Yin-Yang deficiency syndrome,Phlegm-turbidity block syndrome,and Heart-Medid stasis syndrome)were the most common in Qi-Yin deficiency syndrome.The levels of HbA1 c and UA were higher than those of the other three syndromes(P<0.05);TC,TG,LDL-C,HCY,and carotid artery IMT in patients with phlegm block syndrome were higher than those of the other three syndromes(P<0.05);Among the patients with carotid intima thickening and plaque formation,the UA level in patients with yin and yang deficiency syndrome was higher than that in the other three syndrome types(P<0.05),and the HCY level in patients with phlegm turbidity block syndrome was higher than that in the other three syndrome types(P<0.05).Conclusion:The traditional Chinese medicine syndrome types of elderly T2 DM patients with coronary heart disease are mostly qi and yin deficiency syndrome;the age,course of disease,HbA1 c and UA of patients with yin and yang deficiency syndrome are higher than other syndrome types;TC,TG,LDL-C,HCY and IMT were higher than other syndromes;when carotid intima thickening and plaque formation,UA of Yin-yang deficiency syndrome was higher than other syndromes,and HCY of phlegm blockage syndrome was higher than other syndromes.

关 键 词：老年2型糖尿病 冠状动脉粥样硬化性心脏病 颈动脉粥样硬化 尿酸 同型半胱氨酸 颈动脉内膜厚度 血糖 血脂 

分 类 号：R259.871[医药卫生—中西医结合]