2型糖尿病合并脑小血管病临床特点及证候规律研究  

Clinical characteristics and syndrome regularity of patients with type 2 diabetes mellitus complicated with cerebral small vessel disease

作　　者：李艳杰 吴善瑛 吴倩 倪青[3] LI Yanjie;WU Shanying;WU Qian;NI Qing(Beijing Nuclear Industry Hospital,Beijing 102400;Beijing University of Chinese Medicine;Guang'anmen Hospital,China Academy of Chinese Medical Sciences)

机构地区：[1]北京核工业医院,北京102400 [2]北京中医药大学 [3]中国中医科学院广安门医院

出　　处：《现代中医临床》2023年第5期17-23,共7页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金面上项目(No.82174354)。

摘　　要：目的对2型糖尿病合并脑小血管病患者临床特点及中医证候规律进行初步探索与分析。方法统计2型糖尿病合并脑小血管病系列调查表,结合电子病历系统和现场调查,采集一般信息及四诊资料,同时进行神经心理状况评估,建立数据库后采用SPSS 26.0进行描述性统计分析临床特点,以聚类分析联合专家意见归纳中医证候,对证候规律进行初步探索。结果①2型糖尿病合并脑小血管病患者以60岁以上人群为主,常伴随多种血管并发症,且存在不同程度的认知功能损害和抑郁症状;②常见中医证候为肝肾阴虚证、脾肾气虚证、心肾阳虚证、痰瘀闭阻证、肝胃郁热证、肾虚髓亏证,其中4种证候均与肾虚相关,可统归为肾虚证,肾虚证患者占比最高。结论衰老、多血管损害、神经心理学障碍是2型糖尿病合并脑小血管病重要临床特点,肾虚为关键病机之一。Objective Preliminary exploration and analysis of the clinical characteristics and TCM syndrome regularity of patients with type 2 diabetes mellitus complicated with cerebral small vessel disease(CSVD).Methods A series of questionnaires for type 2 diabetes mellitus complicated with CSVD were designed,which were used to collect general information and TCM four-diagnosis data in combination with electronic medical record system and on-site investigation,and the patients’neuropsychological status was assessed at the same time.The TCM syndromes were summarized by cluster analysis and expert opinions,and the regularity of syndromes was preliminarily explored.Results Type 2 diabetes patients with CSVD were mainly people over 60 years old,often accompanied by a variety of vascular complications,and had different degrees of cognitive impairment and depressive symptoms;②The common TCM patterns identified in the study were liver-kidney yin deficiency,spleen-kidney qi deficiency,heart-kidney yang deficiency,phlegm and blood stasis obstruction,liver-stomach stagnation-heat,kidney and marrow deficiency syndrome.Four of them were classified as kidney deficiency patterns,and the proportion of patients with kidney deficiency syndrome was the highest.Conclusion Aging,polyvascular damage and neuropsychological disorders are important clinical features of type 2 diabetes mellitus complicated with CSVD,and kidney deficiency is one of the key pathological factors.

关 键 词：脑小血管病 2型糖尿病 临床特点 证候规律 肾虚证 

分 类 号：R256[医药卫生—中医内科学]