2型糖尿病(消渴病)微观辨证的临床研究  

Clinical Study on Micro-Differentiation of Type II Diabetes

作　　者：吴同玉[1] 李植延[2] 刘燕池[1] 

机构地区：[1]北京中医药大学,北京100029 [2]福建中医学院,福建350003

出　　处：《北京中医药大学学报（中医临床版）》2003年第3期1-4,共4页Journal of Beijing University of Traditional Chinese Medicine

摘　　要：目的　为糖尿病的临床辨证、治疗用药提供客观依据和帮助。方法　观察 2型糖尿病 (消渴病 ,diabetesmellitus)不同证型患者各 30例 ,正常对照组 30例 ,检测血清一氧化氮 (NO)、血浆α -颗粒膜蛋白 (GMP 14 0 )、血浆D -二聚体 (D D)、血清白细胞介素 - 6 (IL 6 )这些微观指标的变化 ,探讨其与中医辨证分型的关系。结果　①血清NO值在各组中的变化是阴虚热盛组 >正常对照组>气阴两虚组 >气滞血瘀组 ,每两组间具有显著性差异 (P <0 0 5 ) ,其中气滞血瘀组与其它 3组具有非常显著性差异 (P <0 0 1)。②糖尿病各组患者血浆GMP 14 0、D D值均较正常对照组有非常显著性增高 (P <0 0 1) ,在糖尿病组各证型中 ,呈阴虚热盛组 <气阴两虚组 <气滞血瘀组变化趋势 ,且血浆GMP 14 0和D D的变化呈正相关 (r=0 6 6 )。③血清IL 6在糖尿病组较正常对照组升高 ,其变化呈阴虚热盛组 <气阴两虚组 <气滞血瘀组趋势 ,每两组间具有非常显著性差异 (P <0 0 1)。结论　糖尿病发病以正气不足为内在依据。随着病程的进展 ,脾肾亏虚及血瘀加重是必然趋势。Objective To provide objective basis and help for the clinical differentiation, treatment and use of medicine on diabetes. Methods The cases suffered from type II diabetes (consumptive thirst) divided into syndrome groups according to their syndrome differentiation were observed. Every group included 30 cases. The control group also included 30 cases. Some micro indexes, such as NO, GMP 140, D D and IL 6 in serum or plasma, were tested and their changes and relationship between them with syndrome differentiation were studied. Results 1. The index of NO of serum showed as follows: the group of exuberance heat due to yin deficiency>the control group>the group of insufficiency of qi and yin>the group of qi and blood stasis. There was remarkable difference between every two groups ( P <0 05) and extremely remarkable difference between the group of qi and blood stasis and other groups ( P <0 01). 2. The indexes of GMP 140 and D D in plasma in the syndrome groups increased more significantly than that in the control group ( P <0 01). The changes of these indexes in the syndrome groups showed as follows: the group of exuberance heat due to yin deficiency<the group of insufficiency of qi and yin<the group of qi and blood stasis. The changes of GMP 140 and D D of serum showed positive correlations (r=0 66). 3. The index of IL 6 of serum in the syndrome groups increased than that in the control group and its change showed as follows: the group of exuberance heat due to yin deficiency<the group of insufficiency of qi and yin<the group of qi and blood stasis. There was extremely remarkable difference between every two groups ( P <0 01). Conclusion The cause of diabetes was mainly the deficiency of the genuine qi. As the development of the disease deficiency of both spleen and kidney and worsened blood stasis will be the results. So the treatment of the disease should be focused on tonifying spleen and kidney and promoting blood circulation by removing stasis.

关 键 词：2型糖尿病 消渴病 辨证论治 辨证分型 中医药疗法 

分 类 号：R255.4[医药卫生—中医内科学] R259.871[医药卫生—中医学]