2型糖尿病合并代谢综合征中医证候演变规律研究

目的总结和探讨2型糖尿病合并代谢综合征（MS）患者的证候分布特点和演变规律。方法选择符合标准的2型糖尿病合并MS患者295例，采用中华中医药学会糖尿病（消渴病）专业委员会制定的辨证标准进行辨证，对不同病程患者的临床症状、体征和证候分布进行统计分析和比较。结果以形体肥胖、唇舌瘀暗、头身困重、脉滑数等症状及体征为多见。以湿热、血瘀证候最为多见。病程小于5年者，主要表现为湿热、血瘀、胃肠结热证候；5-10年病程的患者则表现为邪实与正虚同时并见；病程超过10年者，主要表现为正虚。结论2型糖尿病合并MS早期以邪实为主，随着病程的延长，呈现出虚实错杂之证。邪实主要包括气郁、血瘀、湿浊、热结等，而以湿浊血瘀最为常见。

Development laws of TCM syndromes of type 2 diabetes accompanied by metabolic syndrome

Objective To sum up and study the distribution characteristics and development laws of TCM syndrome in the patients with type 2 diabetes accompanied by metabolic syndrome. Methods The patients accorded with the diagnostic standard of type 2 diabetes accompanied by metabolic syndrome （n=295） were chosen and given the syndrome differentiation according to the criteria of syndrome differentiation established by the Expert Committee of Diabetes Mellitus of China Association of Chinese Medicine. The clinical symptoms,signs and syndrome distribution in different processes of diabetes were analysed and compared statistically. Results Most of patients had the symptoms and signs of obesity, darkness in lips and tongue, heaviness of head and body, slippery and rapid pulse. The most common syndromes were dampness-heat syndrome and blood-stasis syndrome. The patients with the process of diabetes less than 5 years had mostly dampness-heat syndrome, blood-stasis syndrome and syndrome of heat accumulation in stomach and intestines, those with the process of diabetes for 5 to 10 years had the syndromes of pathogen excess and healthy qi deficiency at the same time, and those with the process of diabetes for more than 10 years had the syndrome of healthy qi deficiency mainly. Conclusion The patients with type 2 diabetes accompanied by metabolic syndrome have the syndrome of pathogen excess mainly at early stage, and then will have syndrome of deficiency complicated with excessiveness along with the development of diabetes. The syndrome of pathogen excess includes qi stagnation, blood stasis, dampness turbid and heat accumulation, among which the most common syndromes are dampness turbid and blood stasis.