摘要
【目的】探讨2型糖尿病(T2DM)患者不同中医证型与其下肢动脉粥样硬化病变程度及足部微血管改变的相关性。【方法】回顾性分析2021年3月至2022年6月海口市第四人民医院收治的183例T2DM患者,按照中医辨证分型标准,将其分为阴虚热盛型61例、气阴两虚型68例和阴阳两虚型54例。采用单因素及多因素分析T2DM患者不同中医证型与患者的性别、年龄、体质量指数(BMI)、血糖指标、动脉壁内-中膜厚度(IMT)、斑块厚度、踝肱动脉血压比值(ABI)以及足部微血管改变情况[分别采用血管经皮氧分压(TcPO_(2))和激光多普勒(LDP)测量]。【结果】(1)单因素结果提示,T2DM患者不同中医证型的年龄、空腹胰岛素(FINS)、IMT、斑块厚度、ABI、TcPO_(2)以及LDP值比较,差异均有统计学意义(P<0.05或P<0.01)。其中,以阴阳两虚型患者的年龄最大,FINS、IMT、斑块厚度升高以及ABI、TcPO_(2)、LDP降低最明显。(2)多因素分析结果提示,年龄、FINS、IMT、斑块厚度、ABI、TcPO_(2)以及LDP是T2DM患者不同中医证型的独立影响因素(P<0.05或P<0.01)。【结论】T2DM患者下肢动脉粥样硬化病变程度及足部微血管改变与中医证型存在相关性;阴阳两虚型患者的下肢动脉粥样硬化病变程度较严重,IMT及斑块厚度较厚,下肢供血情况较差,足部组织灌注较差。
Objective To investigate the correlation of traditional Chinese medicine(TCM)syndrome types in type 2 diabetes mellitus(T2DM)patients with the lesion degree of lower extremity atherosclerotic disease(LEAD)and foot microvascular changes.Methods A retrospective analysis of 183 T2DM patients admitted to the Fourth People’s Hospital of Haikou from March 2021 to June 2022 was performed.The patients were classified into 61 cases of yindeficiency and heat-exuberance type,68 cases of qi and yin deficiency type,and 54 cases of yin and yang deficiency type according to the criteria of TCM syndrome differentiation.Univariate analysis and multivariate analysis were adopted to investigate the correlation of TCM syndrome types in T2DM patients with the gender,age,body mass index(BMI),blood glucose indexes,arterial intima-media thickness(IMT),plaque thickness,ankle brachial index(ABI),and foot microvascular changes measured by transcutaneous oxymetry(TcPO_(2))and laser Doppler flowmetry(LDP)in the patients.Results(1)The univariate analysis results suggested that the differences in age,fasting insulin(FINS),IMT,plaque thickness,ABI,TcPO_(2),and LDP values were statistically significant among the T2DM patients with various TCM syndrome types(P<0.05 or P<0.01).Among them,the patients with yin and yang deficiency type were the oldest,and had the obviously elevated FINS,IMT,and plaque thickness as well as the obviously reduced ABI,TcPO_(2),and LDP.(2)The results of multivariate analysis suggested that age,FINS,IMT,plaque thickness,ABI,TcPO_(2),and LDP were the independent influencing factors of TCM syndrome types in patients with T2DM(P<0.05 or P<0.01).Conclusion The degree of lower extremity atherosclerotic disease(LEAD)and foot microvascular changes in patients with T2DM are correlated with TCM syndrome types,and the patients with yin and yang deficiency syndrome have severer LEAD,thicker IMT and plaque thickness,poorer lower limb blood supply,and poorer foot tissue perfusion.
作者
符诗
王永和
陈奕奕
FU Shi;WANG Yong-He;CHEN Yi-Yi(The Fourth People’s Hospital of Haikou,Haikou 571101 Hainan,China)
出处
《广州中医药大学学报》
CAS
2023年第11期2697-2701,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
海南省卫生健康行业科研项目(编号:21A200421)。
关键词
2型糖尿病
中医证型
阴阳两虚型
下肢动脉粥样硬化病变
微血管改变
diabetes mellitus type 2
traditional Chinese medicine(TCM)syndrome type
yin and yang deficiency
lower extremity atherosclerotic disease
microvascular changes
