摘要
目的探讨2型糖尿病(T2DM)患者证候要素发生情况与实验室指标、基础情况的关系。方法选取175例T2DM患者作为研究对象进行横断面调查研究,分析患者证候要素分布情况及组合分布情况;并收集患者基线资料及实验室指标,采用多因素logistic回归分析其与T2DM证候要素的关系。结果175例患者本虚证中占比最高的为阴虚证(67.4%),标实证中占比最高的为痰湿证(65.1%),16种证候要素中占比最高的前5位证候要素为阴虚证、痰湿证、血瘀证、郁热证、气虚证,占比最低的2位证候为饮停证、热毒证。复合中医证型过于分散,五证组合占比最高。按照组合分类发现,组合以虚实夹杂证为主,占比高达84.6%。年龄是血瘀证、水湿证、结热证的影响因素,病程是痰热证、阳虚证、湿浊证的影响因素,血压是阴虚证、湿热证、痰热证的影响因素,体质量指数为痰湿证、水湿证的影响因素,性别是气虚证、血虚证的影响因素,游离三碘甲状腺原氨酸为阴虚证、气虚证的影响因素,游离甲状腺素为郁热证、血虚证的影响因素,促甲状腺激素为阳虚证、血瘀证的影响因素,抗甲状腺球蛋白抗体为郁热证、肝阳证的影响因素,促甲状腺激素受体抗体为痰热证、痰湿证的影响因素,C肽为阴虚证、血瘀证、湿热证的影响因素,胰岛素是气虚证的影响因素,糖化血红蛋白为湿热证的影响因素。结论T2DM患者以阴虚证、痰湿证、血瘀证、郁热证、气虚证为主,但复合中医证型以虚实夹杂证为主,不同证型与糖代谢指标、基础情况、甲状腺功能存在明显的关系。
Objective To investigate the relationship between the occurrence of syndrome elements,laboratory indexes and basic conditions in patients with type 2 diabetes mellitus(T2DM).Methods In total,175 patients with T2DM were selected as subjects for cross-sectional investigation.The distribution of syndrome elements and their combination distribution were analyzed,and baseline data and laboratory indexes were collected.Multivariate Logistic regression was used to analyze their relationship with syndrome elements of T2DM.Results Among the 175 patients,the proportion of Yin deficiency syndrome was the highest(67.4%),and that of phlegm-dampness syndrome was the highest(65.1%),Yin deficiency syndrome,phlegm-dampness syndrome,blood stasis syndrome,heat stagnation syndrome and Qi deficiency syndrome accounted for the highest proportion of the top 5 syndrome elements of 16 syndrome elements,while,the bottom 2 syndrome elements with the lowest proportion were syndrome of fluid retention and heat and toxin syndrome.The compound TCM syndrome type were too scattered,and the combination of five syndromes accounted for the highest proportion.According to the combination classification,it was found that the combination was mainly composed of deficiency and solid mixed syndrome,accounting for 84.6%.Age was the influencing factor of blood stasis syndrome,water dampness syndrome and heat stagnation syndrome,while course of disease was the influencing factor of phlegm-heat syndrome,Yang deficiency syndrome and dampness-turbidity syndrome.Blood pressure was the influencing factor of Yin deficiency syndrome,dampness syndrome and phlegm-heat syndrome,body mass index was the influencing factor of phlegm-dampness syndrome and water-dampness syndrome,and gender was the influencing factor of Qi deficiency syndrome and blood deficiency syndrome.Free triiodothyrine was the influencing factor of Yin deficiency and Qi deficiency syndrome,free thyroxine was the influencing factor of stagnation heat syndrome and blood deficiency syndrome,thyrotropin was the influencing factor of Yang deficiency syndrome and blood stasis syndrome,anti-thyroglobulin antibody was the influencing factor of stagnation heat syndrome and liver-Yang syndrome,and thyrotropin receptor antibody was the influencing factor of phlegm-heat syndrome and phlegm-dampness syndrome.C-peptide was the influencing factor of Yin deficiency syndrome,blood stasis syndrome and dampness syndrome,insulin was the influencing factor of Qi deficiency syndrome,and glycated hemoglobin was the influencing factor of dampness syndrome.Conclusion Yin deficiency syndrome,phlegm-dampness syndrome,blood stasis syndrome,heat stagnation syndrome and Qi deficiency syndrome are the main syndromes in T2DM patients,but the complex TCM syndrome types are mainly characterized by a combination of deficiency and excess syndrome.Different syndrome types have obvious relationship with glucose metabolism index,basic condition and thyroid function.
作者
赵博旭
陈弘东
ZHAO Boxu;CHEN Hongdong(Department of Endocrinology,Beijing Hepingli Hospital,Beijing 100013,China)
出处
《临床误诊误治》
2025年第2期77-82,共6页
Clinical Misdiagnosis & Mistherapy
基金
北京市重点实验室开放基金资助项目(10025220108)
东城区卫生科技计划项目(东卫健研[2024]-5)
糖尿病防治及管理研究项目专项课题(MBZX0022023-006)
北京市和平里医院科研项目(2024-1-08)。
关键词
糖尿病
2型
中医证候
影响因素分析
糖化血红蛋白
游离三碘甲状腺原氨酸
C肽
促甲状腺激素
Diabetes mellitus,type 2
TCM syndrome
Analysis of influencing factors
Glycated hemoglobin
Free triiodothyronine
C-peptide
Thyroid stimulating hormone
