早发2型糖尿病中医证型与危险因素及生化指标的关联性研究  

Study on the Correlation of TCM Syndrome Types with Risk Factors and Biochemical Indexes of Early-Onset Type 2 Diabetes Mellitus

作　　者：胡燕敏 伊娜 王文英 李宝玲 HU Yan-Min;YI Na;WANG Wen-Ying;LI Bao-Ling(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Endocrinology,the Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University,Guangzhou 510130 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广州医科大学附属中医医院内分泌科,广东广州510130

出　　处：《广州中医药大学学报》2023年第12期2957-2964,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省自然科学基金项目(编号:2021A1515012547);广州市中医药和中西医结合科技项目(编号:2022A010015)。

摘　　要：【目的】研究早发2型糖尿病(type 2 diabetes mellitus,T2DM)的中医证型分布规律,并探讨中医证型与危险因素及生化指标之间的关联性。【方法】收集130例早发T2DM患者的四诊资料,确定中医证型,采集患者的一般资料、危险因素及生化指标,运用SPSS 25.0统计软件分析早发T2DM的中医证型分布特点及其与一般资料、危险因素和生化指标的关系。【结果】共收集130例早发T2DM患者,男女比例为3.19∶1,男性发病率偏高。证型分布从高到低依次为湿热困脾证(30.77%)、阴虚热盛证(28.46%)、气阴两虚证(18.46%)、血络瘀阻证(11.54%)、阴阳两虚证(10.77%)。病程早期(≤1年)以湿热困脾证、阴虚热盛证较多,分别为36.49%、33.78%,后期(病程≥5年)以气阴两虚证、阴阳两虚证为主,分别为31.03%、27.59%。平均体质量指数(BMI)为(25.66±4.30)kg/m2,以湿热困脾证最高。主要发病危险因素为:糖尿病家族史、高脂饮食和缺乏运动,其占比均超过50%,其中高脂饮食和缺乏运动以湿热困脾证最多,高糖饮食以阴虚热盛证最多,空腹C肽及餐后1 h C肽以阴虚热盛证最低、湿热困脾证最高,甘油三酯(TG)以湿热困脾证最高,血尿素氮(BUN)、血肌酐(Scr)以阴阳两虚证最高,其次为气阴两虚证,预估肾小球滤过率(eGFR)以阴阳两虚证最低,其次为气阴两虚证。【结论】早发T2DM早期主要以湿热困脾证和阴虚热盛证的实证为主,随着病情进展,逐渐向气阴两虚和阴阳两虚的虚证转变。其中,湿热困脾证多存在高脂饮食和缺乏运动,并伴有体质量超重、高TG血症和胰岛素抵抗的临床问题;阴虚热盛证多存在高糖饮食,伴有血糖偏高和胰岛素缺乏;气阴两虚及阴阳两虚证患者多处于病程的后期,具有肾功能较差的临床问题。Objective To study the distribution pattern of traditional Chinese medicine(TCM)syndrome types in early-onset type 2 diabetes mellitus(T2DM),and to explore the correlation of TCM syndrome types with risk factors and biochemical indicators.Methods The clinical data of 130 cases of early-onset T2DM were collected by four diagnostic methods of TCM,and then the TCM syndromes were identified.The general information,risk factors and biochemical indicators of the patients were collected.SPSS 25.0 statistical software was used to analyze the distribution pattern of the TCM syndrome types of early-onset T2DM and to explore the correlation of TCM syndrome types with the general information,risk factors and biochemical indicators.Results A total of 130 patients with early-onset T2DM were included,the male-to-female ratio was 3.19∶1 and the male had a higher incidence of early-onset T2DM.The distribution of syndrome types was as follows:damp-heat accumulating in the spleen syndrome(30.77%),yin deficiency and heat exuberance syndrome(28.46%),qi and yin deficiency syndrome(18.46%),blood stasis obstructing the collaterals syndrome(11.54%),and yin and yang deficiency syndrome(10.77%).In the early stage of T2DM(≤1 year),damp-heat accumulating in the spleen syndrome and yin deficiency and heat exuberance syndrome were more common,accounting for 36.49%and 33.78%,respectively.In the late stage of T2DM(≥5 years),qi and yin deficiency syndrome and yin and yang deficiency syndrome were predominant,accounting for 31.03%and 27.59%,respectively.The average body mass index(BMI)was(25.66±4.30)kg/m2,and the patients with damp-heat accumulating in the spleen syndrome had the highest BMI.The main risk factors for diabetes involved family history of diabetes,high-fat diet and lack of exercise,which accounted for more than 50%of the total.High-fat diet and lack of exercise contributed most to the incidence of the damp-heat accumulating in the spleen syndrome,high-sugar diet contributed most to the incidence of yin deficiency and heat exub

关 键 词：早发2型糖尿病 中医证型 湿热困脾 阴虚热盛 危险因素 生化指标 

分 类 号：R259.871[医药卫生—中西医结合]