2型糖尿病伴阻塞性睡眠呼吸暂停综合征患者中医痰证素变化的影响因素分析  

Analysis of Influencing Factors of Changes of Phlegm Syndrome Elements in Patients with Type 2 Diabetes Mellitus Complicated with Obstructive Sleep Apnea Syndrome

作　　者：王顺花 苏伟娟[1] 张玉娴[1] 张佳玉 王丽英[1] WANG Shunhua;SU Weijuan;ZHANG Yuxian;ZHANG Jiayu;WANG Liying(Endocrine Diabetes Department of Integrated Traditional Chinese and Western Medicine,the First Affiliated Hospital of Xiamen University,Xiamen 361000,Fujian,China)

机构地区：[1]厦门大学附属第一医院中西医结合内分泌糖尿病科,福建厦门361000

出　　处：《糖尿病新世界》2024年第23期49-52,共4页Diabetes New World

基　　金：厦门市医疗卫生指导项目(3502Z20244ZD1015);国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药人教发[2023]127号)。

摘　　要：目的 探讨影响2型糖尿病(type 2 diabetes mellitus, T2DM)伴阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome, OSAS)患者出现痰证素的危险因素。方法 选取2022年1月-2023年12月厦门大学附属第一医院中西医结合内分泌糖尿病科收治的89例T2DM伴OSAS患者为研究对象,收集所有患者的一般资料并通过中医四诊(望、闻、问、切)收集患者信息,利用“证素辨证”软件获取痰证素积分,按照痰证素积分水平分为两组,分别为有痰证素组(n=67,痰证素积分≥100分)和无痰证素组(n=22,痰证素积分<100分),使用单因素及多因素Logistic回归分析痰证素与体重、体重指数(body mass index, BMI)、颈围、睡眠呼吸暂停相关指数[低通气指数(apnea hypopnea index, AHI)、最低血氧饱和度(minimal saturation of oxygen, SaO_(2min))]、Epworth嗜睡评分(Epworth Sleep Scale, ESS)、糖尿病病程等因素之间的关系。结果 单因素分析发现,有痰证素组的BMI、ESS评分、AHI均高于无痰证素组,差异均有统计学意义(P均<0.05)。多因素Logistic回归分析结果显示,BMI≥24.0 kg/m^(2)、ESS≥9分为增加痰证素的危险因素(P均<0.05)。结论 超重/肥胖和嗜睡是T2DM伴OSAS患者出现痰证素的影响因素,建议患者适当减重进行预防。Objective To explore the risk factors of phlegm syndrome elements in patients with type 2 diabetes melli-tus(T2DM)and obstructive sleep apnea syndrome(OSAS).Methods From January 2022 to December 2023,89 pa-tients with T2DM and OSAS admitted to Endocrine Diabetes Department of Integrated Traditional Chinese and West-ern Medicine,the First Affiliated Hospital of Xiamen University were selected as the research objects.The general data of all patients were collected and the patient information was collected through the four diagnostic methods of tra-ditional Chinese medicine(observation,auscultation,interrogation and palpation).The phlegm syndrome elements score was obtained by using the"syndrome differentiation"software.According to the level of phlegm syndrome ele-ments score,they were divided into two groups:phlegm syndrome elements group(n=67,phlegm syndrome elements score≥100 points)and non-phlegm syndrome elements group(n=22,phlegm syndrome elements score<100 points).Univariate and multivariate Logistic regression analysis were used to analyze the relationship between phlegm syn-drome elements and body weight,body mass index(BMI),neck circumference,sleep apnea-related index[apnea hy-popnea index(AHI),minimal saturation of oxygen(SaO_(2min))],Epworth Sleep Scale(ESS),duration of diabetes mellitus and other factors.Results Univariate analysis showed that BMI,ESS score and AHI in the phlegm syndrome elements group were higher than those in the non-phlegm syndrome elements group,and the differences were statistically sig-nificant(all P<0.05).Multivariate Logistic regression analysis showed that BMI≥24.0 kg/m^(2) and ESS≥9 points were risk factors for increasing phlegm syndrome elements(both P<0.05).Conclusion Overweight/obesity and somnolence are the influencing factors of phlegm syndrome in patients with T2DM and OSAS.It is suggested that patients should lose appropriate weight for prevention.

关 键 词：2型糖尿病 阻塞性睡眠呼吸暂停综合征 痰证素 超重 肥胖 

分 类 号：R259[医药卫生—中西医结合]