2型糖尿病肾病伴或不伴视网膜病变患者的中医证型特点和临床特点  

TCM Syndrome Types and Clinical Characteristics of Type 2 Diabetes Nephropathy with or without Retinopathy

作　　者：王艳 林华坚 钟玲莉 WANG Yan;LIN Huajian;ZHONG Lingli(Minhou County People's Hospital,Fuzhou 350119,China)

机构地区：[1]闽侯县人民医院,福建福州350119

出　　处：《中国医药指南》2023年第27期119-121,共3页Guide of China Medicine

摘　　要：目的探究2型糖尿病肾病伴或不伴视网膜病变患者的中医证型特点和临床特点。方法病例选取闽侯县人民医院2020年1月至2022年1月收治的2型糖尿病肾病患者240例作为研究对象,按照是否伴有视网膜病变分为伴视网膜病变组(147例)和不伴视网膜病变组(93例),观察伴视网膜病变组和不伴视网膜病变组的中医症状和中医证型特点。结果2型糖尿病肾病不伴视网膜病变患者的中医症状从高到低前5项的分别是视物模糊、夜尿增多、口唇紫暗、健忘、神疲乏力;2型糖尿病肾病伴视网膜病变患者的中医症状从高到低前5项的分别是视物模糊、健忘、夜尿增多、口唇紫暗、水肿;2型糖尿病肾病不伴视网膜病变患者中医证素本虚证前3项分别是阳虚证、气虚证和阴虚证,标实证前3项分别气郁证、湿热证和痰湿证;2型糖尿病肾病伴视网膜病变患者中医证素本虚证前3项分别是阳虚证、气虚证73例和血虚证,标实证前3项分别为气郁证68例、血瘀证64例和燥热证;不伴视网膜病变组的血虚证、燥热证、血瘀证的占比更低(χ^(2)=4.076、6.131、6.773;P<0.05)。与伴视网膜病变患者比较,不伴视网膜病变患者的糖化血红蛋白、三酰甘油、LDL、血红蛋白、eGFR水平更高;尿素氮、肌酐、尿酸水平更低(P<0.05)。结论2型糖尿病肾病的基本病机是本虚标实、虚实夹杂,该病的本质是本虚。对于2型糖尿病肾病患者应注重虚实证的辨证论治,并根据是否合并糖尿病视网膜病变,遣方药,兼顾主次,提高治疗针对性。Objective To explore the TCM syndrome characteristics and clinical characteristics of type 2 diabetes nephropathy with or without retinopathy.Methods The 240 patients with type 2 diabetes nephropathy admitted to Minhou County People's Hospital from January 2020 to January 2022 were selected as the study subjects.They were divided into the group with retinopathy(147 cases)and the group without retinopathy(93 cases)according to whether they were accompanied by retinopathy.The TCM symptoms and TCM syndrome characteristics of the group with retinopathy and the group without retinopathy were observed.Results The first five symptoms of type 2 diabetes nephropathy without retinopathy from high to low were blurred vision,increased nocturia,purple lips,forgetfulness,and fatigue.The first 5 TCM symptoms of type 2 diabetes nephropathy with retinopathy from high to low are blurred vision,amnesia,increased nocturia,purple lips and edema.In type 2 diabetes nephropathy patients without retinopathy,the first three syndromes of deficiency of essence in TCM are yang deficiency,qi deficiency and yin deficiency,and the first three syndromes of standard excess are qi stagnation,damp heat and phlegm dampness.In type 2 diabetes nephropathy patients with retinopathy,the first three syndromes of deficiency of essence in TCM are yang deficiency,qi deficiency and blood deficiency,and the first three syndromes of standard excess are qi depression,blood stasis and dryness heat.The proportion of blood deficiency syndrome,dry heat syndrome,and blood stasis syndrome in the group without retinopathy is lower(χ^(2)=4.076,6.131,6.773,P<0.05).Compared with patients with retinopathy,patients without retinopathy have higher levels of glycated hemoglobin,triglycerides,LDL,hemoglobin,and eGFR;lower levels of urea nitrogen,creatinine,and uric acid(P<0.05).Conclusion The basic pathogenesis of type 2 diabetes nephropathy is the combination of deficiency and excess,and the essence of the disease is deficiency.For patients with type 2 diabetes nephropathy,

关 键 词：2型糖尿病 肾病 视网膜病变 中医证型 症状 

分 类 号：R578.1[医药卫生—消化系统]