2型糖尿病患者中医证型分析及其与糖尿病慢性并发症关系的探讨

目的 分析2型糖尿病患者的中医证型分布，探讨各种中医证型与血糖控制水平和糖尿病慢性并发症的关系。

Analysis of Chinese Medicine Syndrome Pattern in Patients with Type 2 Diabetes Mellitus and Its Relationship with Diabetic Chronic Complications

Objective To analyze the Chinese medicine （CM） syndrome pattern of patients with type 2 diabetes mellitus （DM2） and the relationship of CM patterns with the different blood glucose levels controlled and the incidences of diabetic chronic complications. Methods CM syndromes in 557 DM2 patients were sorted into 7 patterns, A. the Fei-Wei yin-deficiency with exuberant heat pattern; B： the Pi-qi deficiency pattern; C： the Shen-qi deficiency pattern; D： the Pi-Shen qi-deficiency pattern; E： the Gan-Shen yin-deficiency pattern; F： the both qi-yin deficiency pattern; and G： the both yin-yang deficiency pattern, the concurrent or accompanied excessive syndromes were not taken as the indication for sorting. The blood glucose level, duration of illness and incidence of diabetic chronic complications in patients of different patterns were compared. Results The CM syndrome patterns commonly encountered in mostly of the 557 patients was pattern F （ in 264 patients, accounting for 47.4%）; the next was pattern C （95 patients, 17. 1%） and E （92 patients, 16.5%）. The concurrent syndromes appeared in most patients was blood stasis （501 patients, 89.9% ）, Gan-qi stagnation was the second （225 patients, 40.4% ）, and the portion of clamp-heat syndrome was also rather large （180 patients, 32.3% ）. The duration of diabetes mellitus for patients with various patterns was significantly different （ P 〈 0. 01 ）, the Iongest appeared in patients of pattern G, followed by pattern D, C, F, and E in sequence, and patients of pattern A and B had a rather shorter duration. Level of fasting blood glucose was rather higher in patients of pattern A, C, D, F, and G than in those of pattern B and E. Level of glycosylated hemoglobin in patients of pattern G was the highest and in pattern A the second, while in pattern B and E was rather lower. Incidences of diabetic chronic complications, including diabetic peripheral neuropathy, diabetic retinopathy, diabetic nephropathy, cerebral infarction, and atherosclerosis in patients of pattern A and B were lower than in those of other 5 patterns （ P 〈 0.05） ; but the highest incidence of multiple chronic complications revealed in pattern D and G, and that of coronary heart disease revealed in pattern C and G, all showed significant different as compared with other patterns （ P 〈 0.01 ）. Conclusion The most commonly encountered CM syndrome patterns in DM2 patients of early stage are pattern A and B; and those of middle stage are pattern C, D, E and F, various diabetic chronic complications may reveal in this stage; pattern G could be found in patients accompanied with multiple chronic complications and with uncontrolled blood glucose for a long time.