2型糖尿病胰岛素抵抗(IR)与中医辨证分型的相关性研究

探讨2型糖尿病中医辨证分型与IR、血脂各项、血尿酸（UA）及C反应蛋白（CRP）等指标的相关性。选择186例2型糖尿病病例，按中医辨证分为湿热（痰浊）困脾、阴虚热盛、气阴两虚、血瘀脉络及阴阳两虚血瘀水停等5型，对其进行相关指标检测及分析。结果：①2型糖尿病中医各辨证分型组胰岛素敏感指数（ISI）均低于正常组（P〈0．05，〈0．01）；血脂各项、UA、CRP与正常组比较均有显著性差异（P〈0．05，〈0．01）。组间比较，湿热（痰浊）困脾组和瘀血阻络组大多具有显著性差异（P〈0．05，〈0．01）。②ISI与糖化血红蛋白（HbA1C）、血脂各项（除高密度脂蛋白外）、UA及CRP均呈负相关。结论：2型糖尿病中医各辨证分型在ISI、血脂各项、UA、CRP水平方面存在显著差异，以湿热（痰浊）困脾和血瘀脉络两型为突出。

The Study About Insulin Resistance (IR) In Type 2 Diabetes related to Differentiation of Symptoms and Signs for Classification in Syndrome

Objective:To determinate Differentiation of Symptoms and Signs for Classification in Syndrome in type 2 diabetes related to insulin resistance(IR),uric acid(UA)in the blood and C-reative protein(CRP).186 case with type 2diabetes were divided into 5 groups according to Differentiation of Symptoms and Signs for Classification in Syndrome,the group of stagnation of dampness and heat in the spleen(of phlegm in the spleen),the group of hyperactivity of heat due to yin deficiency,the group of the deficiency of Qi and Yin,the group of blood stasis in the channel,the group of deficiency of Yin and Yang with blood-stasis and fluid-retention,we measured patients insulin,plasma lipid,uric acid(UA)in the blood and C-reative protein(CRP),then we analysed data.Results:1.Insulin sensitivity index(ISI) in each group with type 2 diabetes was lower than normal group.(P<0.05,<0.01).Plasma lipid except for HDL-c,UA in the blood and CRP in each group with type 2 diabetes were significantly greater than those in the normal group.(P<0.05,<0.01).HDL-c in each group with type 2 diabetes is significantly lower than that in the normal group.(P<0.05,<0.01).ISI,plasma lipid except for HDL-c,UA in the blood and CRP in the group of stagnation of dampness and heat in the spleen(of phlegm in the spleen)and in the group of blood stasis in the channel were significantly greater than those in the other groups with type 2 diabetes(P<0.05,<0.01),HDL-c in the group of stagnation of dampness and heat in the spleen(of phlegm in the spleen)and in the group of blood stasis in the channel is significantly lower than that in the other groups with type 2 diabetes(P<0.05,<0.01).2.Negative relation exists between ISI and HbA1c,plasma lipid xcept for HDL-c,UA in the blood and CRP.Conclusion:ISI,plasma lipid,UA in the blood and CRP in each group with type 2 diabetes in Differentiation of Symptoms and Signs for Classification in Syndrome exsist significiantly differance.The group of stagnation of dampness and heat in the spleen(of phlegm in the spleen)and in the group of blood stasis in the channel was considered most significant.