2型糖尿病中医证型与临床生化指标的关系
Relationship Between TCM Syndrome Types and Clinical Biochemical Indexes in Type 2 Diabetes Mellitus
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摘要: 目的 探讨2型糖尿病中医证型与临床生化指标的关系,为2型糖尿病中医辨证提供客观依据。方法 收集187例符合标准的2型糖尿病病例,按阴虚热盛、脾虚痰瘀、气阴两虚、气虚血瘀辨证分型,同时以40例同期健康体检者做对照。分析不同证型与年龄、体质量指数(BMI)、糖代谢、脂代谢、超敏C反应蛋白(hs-CRP)、胰岛素抵抗指数(HOMA-IR)、血清胰岛素(FINS)等的关系。结果 与正常对照组比较,①阴虚热盛组BMI显著下降(P<0.01),脾虚痰瘀型BMI显著增加(P<0.01);②糖尿病组TC、TG、LDL指标均升高(P<0.05),HDL指标下降(P<0.05);③糖尿病组FPG、HOMA-IR、HbA1c、hs-CRP水平均升高(P<0.05~0.01); FINS指标除阴虚热盛组外其余3组均下降与正常对照组比较有统计学意义(P<0.05~0.01)。结论 2型糖尿病各中医证型与脂代谢、糖代谢、体质量指数、胰岛素抵抗指数等存在相关性,通过其关系的研究,将有助于糖尿病中医辨证的客观化。Abstract: OBJECTIVE To study the relationship between TCM syndrome types and clinical biochemical indexes in type 2 diabetes mellitus, and to an objective basis for TCM syndrome differentiation of type 2 diabetes mellitus. METHODS 120 type 2 diabetes mellitus patients corresponding to the study criteria were collected. Syndrome differentiation was made for these patients according to yin deficiency and heat excess, spleen deficiency, phlegm accumulation, deficiency of both Qi and Yin and qi deficiency and blood stasis. At the same time, 40 healthy subjects were matched as controls. The relationships between different types and age, body mass index (BMI), glucose metabolism, lipid metabolism, hypersensitivity C reactive protein (hs-CRP), insulin resistance indexes (HOMA-IR) and serum insulin (FINS) were analyzed. RESULTS ①Compared with the normal control group, BMI in the yin deficiency and heat excess group decreased significantly (P<0.01), BMI in the spleen deficiency and phlegm accumulation group increased significantly (P<0.01). ②Compared with the normal control group, all indexes of TC, TG and LDL in the diabetes mellitus group increased (P<0.05), HDL index decreased (P<0.05). ③All FPG, HOMA-IR, HbA1c and hs-CRP levels in the diabetes mellitus group increased compared with the normal control group (P<0.05~0.01). Apart for the yin deficiency and heat excess group, FINS indexes in the rest three group had significant differences compared with the normal control group (P<0.05). CONCLUSION There are correlations between various TCM syndromes of type 2 diabetes mellitus and lipid metabolism, glucose metabolism, body mass index and insulin resistance index. The study of the relationship between them will contribute to the objectification of TCM syndrome differentiation in diabetes mellitus.
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