2型糖尿病患者中医证型与血清代谢学指标相关性研究  

Chinese Medicine Syndromes and Serum Metabolic Indices in Type Ⅱ Diabetic Patients:A Correlational Study

作　　者：刘藜 丁小燕 刘晓林 王红芹 祁轶斐 周庆兵[3] 刘艳飞[2] 吴立旗[2] 徐榛敏 陈宝鑫[5] 童文新[2] 徐凤芹[2] 张颖[2] LIU Li;DING Xiao-yan;LIU Xiao-lin;WANG Hong-qin;QI Yi-fei;ZHOU Qing-bing;LIU Yan-fei;WU Li-qi;XU Zhen-min;CHEN Bao-xin;TONG Wen-xin;XU Feng-qin;ZHANG Ying(Graduate School,China Academy of Chinese Medical Sciences,Beijing,100700;General Internal Department,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing,100091;Institute of Geriatric Medicine,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing,100091;Encephalopathy Department,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing,100091;Second Department of Encephalopathy,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing,100078)

机构地区：[1]中国中医科学院研究生院,北京100700 [2]中国中医科学院西苑医院综合内科,北京100091 [3]中国中医科学院西苑医院老年病研究所,北京100091 [4]中国中医科学院西苑医院脑病科,北京100091 [5]北京中医药大学东方医院脑病二科,北京100078

出　　处：《中国中西医结合杂志》2023年第2期137-142,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：科技部国家重点研发计划资助项目(No.2018YFC1704303);国家自然科学基金面上项目(No.81774143);国家中医药管理局中医药传承与创新“百千万”人才工程-中医技术传承骨干人才;中国中医科学院科技创新工程重大攻关项目(No.CI2021A01407)。

摘　　要：目的比较2型糖尿病(T2DM)不同中医证型之间一般情况以及实验室指标的差异。方法于2021年10月9日—11月9日采集北京市海淀区居民一般情况、中医辨证信息及血清样本。筛选符合标准的患者,参考相关糖尿病中医辨证标准将其分为气阴两虚组、痰热互结组、血瘀脉络组、阴阳两虚组;另筛选31名健康人作为对照组。检测患者空腹血糖(FPG)、糖化血红蛋白(HbA1c),甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、同型半胱氨酸(Hcy)水平,采用Logistic回归进行相关性分析。结果完成调查的居民共1189例,符合纳排标准的居民共136例(气阴两虚组35例、痰热互结组34例、血瘀脉络组28例、阴阳两虚组39例)。与对照组比较,阴阳两虚组年龄及BMI升高(P<0.05),气阴两虚组年龄升高(P<0.05)。与阴阳两虚组比较,痰热互结组BMI指数降降低(P<0.05);气阴两虚证组、痰热互结组、血瘀脉络组病程缩短(P<0.05);痰热互结组男性腰围及气阴两虚组女性腰围降低(P<0.05)。与对照组比较,4个证型组HbA1c、SBP偏高(P<0.01);痰热互结组及血瘀脉络组FPG、Hcy水平升高(P<0.05);气阴两虚组TG升高(P<0.05)。与对照组和气阴两虚组比较,痰热互结组、血瘀脉络组Hcy水平升高(P<0.05)。气阴两虚组与FPG(P<0.05)、HbA1c(P<0.01)、SBP(P<0.05)呈正相关;痰热互结组与FPG(P<0.01)、HbA1c(P<0.01)、SBP(P<0.05)呈正相关;血瘀脉络组与FPG(P<0.05)、HbA1c(P<0.01)、Hcy(P<0.05)、BMI指数(P<0.05)、SBP(P<0.05)呈正相关;阴阳两虚证与FPG(P<0.05)、HbA1c(P<0.01)、BMI指数(P<0.05)、SBP(P<0.01)呈正相关。结论2型糖尿病中医证型与血清代谢指标具有一定相关性,血瘀脉络证与Hcy呈正相关。(No.ChiCTR1900025713)Objective To compare differentiation of general conditions and laboratory indices among different syndromes in Chinese medicine(CM) of type Ⅱ diabetes mellitus(T2DM). Methods The study was conducted among residents in Haidian district of Beijing from October 9,2021 to November 9,2021. The data of general conditions among different syndromes in CM and laboratory indices of participants were collected. The participants who met the criteria were assigned to 4 groups with the main syndromes of CM,Qi-Yin deficiency group,phlegm-heat interaction group,blood-stasis group and Yin-Yang deficiency group. And 31 healthy volunteers were recruited as control group. Fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C)and homocysteine(Hcy)were measured. Logistic regression was used for correlation analysis. Results Among a total of 1 189 participants,136 cases who met the inclusion and exclusion criteria completed the study(35cases in the Qi-Yin deficiency group,34 cases in the phlegm-heat interaction group,28 cases in the blood-stasis group and 39 cases in the Yin-Yang deficiency group). Compared with the control group,the age and BMI of the Yin-Yang deficiency group increased(P<0.05),and the age of the Qi-Yin deficiency group was significantly older(P<0.05). Compared with the Yin-Yang deficiency group,the BMI of the phlegm-heat group was lower(P<0.05),the disease duration of the Qi-Yin deficiency group,the phlegm-heat interaction group,and the blood-stasis group were shorter,and the waist circumference of the men in the phlegm-heat group and the women in the QiYin deficiency group were lower(P<0.05). Compared with the control group,the levels of HbA1c and SBP in the four syndrome groups increased(P<0.01),and the levels of FPG and Hcy in the phlegm-heat interaction group and the blood-stasis group increased(P<0.05),and the levels of TG in the Qi-Yin deficiency group also increased(P<0.05). Compared with the control grou

关 键 词：2型糖尿病 中医证型 血瘀证 同型半胱氨酸 动脉粥样硬化 

分 类 号：R259[医药卫生—中西医结合]