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??OBJECTIVE To develop Zaocys dhumnades DNA extraction and detection kit, evaluate the specificity, stability and repeatability of the kit, and investigate the quality of commercial black tip snake products using the kit. METHODS Using the modern DNA fingerprint technology, the pharmacopoeia Zaocys dhumnades DNA detection method was optimized and improved, and Zaocys dhumnades DNA extraction and detection reagent was developed to obtain the tip snake PCR detection kit. The performance parameters of the kit were evaluated. The kit was used on 18 commercial black tip snake products randomly sampled from Beijing, Tianjin, Changchun and Jilin City.The results were compared with those got by using pharmacopoeia method of DNA test. RESULTS Zaocys dhumnades DNA testing kit was still valid after repeated freezing and thawing for 5, 10 and 20 times. Among the 18 commercial black tip snake samples 14 were quality goods, and four were adulterants. Repeated experiments of specificity, stability and repeatability displayed exactly the same results . The test result of the kit method was consistent with the pharmacopoeia method. And the kit method could fulfil the DNA testing task in ordinary laboratories. CONCLUSION Zaocys dhumnades DNA testing kit can identify tip snake products conveniently, accurately and effectively, which can be applied in the rapid detection of Zaocys dhumnades DNA.     

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目的探讨transgelin 2在人乳腺癌紫杉醇耐药细胞(MCF-7/PTX)紫杉醇耐药和侵袭转移中的作用。方法在倒置显微镜下观察细胞的形态;采用MTT法测定细胞活性;运用Western blot和Real-time PCR检测细胞中transgelin 2,E-cadherin,Ncadherin,Vimentin的蛋白和mRNA表达;通过细胞划痕和Transwell侵袭实验分别测定细胞的迁移和侵袭能力;运用小干扰RNA技术降低MCF-7/PTX细胞中transgelin 2的表达。结果 MCF-7/PTX细胞发生EMT过程,并具有较强的耐药和侵袭迁移能力;干扰transgelin 2后,增强MCF-7/PTX细胞对紫杉醇的敏感性,抑制它们的侵袭和迁移能力。结论高表达transgelin 2不仅能够诱导MCF-7/PTX对紫杉醇的耐药,还能促进侵袭转移的发生,提示transgelin 2可望成为乳腺癌新的肿瘤标志物及治疗靶点。     

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??OBJECTIVE To explore whether knockdown serglycin's expression level in MDA-MB-231 cells by transient transfection can improve the sensitivity of breast cancer cells to the doxorubicin.METHODS At first, qRT-PCR,Western-Blot and immunofluorescence were used to examine the expression level in two different cell lines, MDA-MB-231 and MCF-7. Then serglycin's expression level in MDA-MB-231 was knocked down by using transient transfection, qRT-PCR and immunofluorescence were used to test the efficiency of this approach; and then, between the NC group and the Si-SG group, MTS was used to measure the IC₅₀ of doxorubicin and the proliferation curve under the treatment of the doxorubicin. Also the numbers of colony formation in this two groups was observed when treating with different concentration of doxorubicin. RESULTS It was found that in these two cells, the expression of serglycin in MDA-MB-231 is significantly higher than MCF-7. The efficiency of knockdown in MDA-MB-231 is above 70%. In Si-SG group, the IC₅₀ and the growth curve under treatment with doxorubicin is significantly lower than the NC group. Same RESULTS can be found in the colony formation assay, when treating with the doxorubicin, the decreasing rate of colony numbers is significantly quicker in the Si-SG group than NC group. CONCLUSION Knockdown serglycin's expression level in MDA-MB-231 cells by transient transfection can improve the sensitivity to the doxorubicin.     

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??OBJECTIVE To conduct the contrastive studies of universal compression model to pharmaceutical powder compression characteristics effect base on Heckel and Kawakita equation founded.METHODS The uniaxial compression tests were developed with three excipients of lactose, starch, microcrystalline cellulose and four mixture excipients of lactose, starch, microcrystalline cellulose with different mass fraction. The change rules between density and pressure and model error are analyzed of two different compression models respectively.RESULTS The absolute density error value of Heckel and Kawakita compression model is within 4%, when the pressure is greater than 80 MPa,and the variance of Kawakita model is less than Heckel model.The absolute error value of Heckel and Kawakita compression model is within 3.73%, when the pressure is larger than 60 MPa, and the variance of Kawakita compression model less than Heckel model.CONCLUSION During applying two universal compression models to analyze pharmaceutical powder compression characteristics, two models are suitable, when the pressure is between 80 and 240 MPa.     

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??OBJECTIVE To establish a method for the determination of norathyriol in rat plasma by HPLC and to study its characteristics of pharmacokinetics. METHODS Ethyl formic acid(10:1)was used to precipitate protein in the plasma samples after the addition of internal standard, and then the concentration was analyzed by HPLC. All of the separations were carried out on a Platisil ODS(4.6 mm??250 mm,5 ??m) at room temperature. The mobile phase was consisted of formic acid(40:60:0.5, pH 2.74), and was pumped at flow rate of 0.8 mL??min^-1. The UV detection wavelength was set at 312 nm. The rats were given norathriol by intragastric administration with a dosage of 400 mg??kg^-1. The concentration of norathriol in plasma at different time points was determined. RESULTS A good linear relationship was obtained in the concentration range of 0.54-162 ??g??mL^-1(r=0.998). The intra-day and inter-day RSD were less than 7.5% . The main pharmacokinetic parameters measured by Winnonlin 6.1 were showed as follows:t_max,t_1/2, ??_max and AUC_0-t were 0.5 h,(3.46??0.903) h,(26.9??3.17)??g??mL^-1,(52.4??12.0) ??g??h??mL^-1, respectively. CONCLUSION The HPLC method established is rapid and specific, and can be successfully applied in basic pharmacokinetic study in rat plasma.     

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??OBJECTIVE To investigate the mechanism of nucleophosmin (NPM) in the formation of breast cancer drug resistance. METHODS The methotrexate- resistant breast cancer cells (MCF-7/MTX) was established by escalating the concentrations of methotrexate to drug-sensitive MCF-7 cells (MCF-7/S). The cells viability of MCF-7/MTX was detected by MTT test, cell growth curve was drawn and doubling time was calculated. The cell morphology and ultrastructure were observed using optical and transmission electron microscopy. The expression of NPM and factors related to drug resistance were tested by Real-time PCR and Western blot assay. Then the NPM level was attenuated by RNA interfering technology, and the resistance mechanism was explored in MCF-7/MTX cells. RESULTS The MCF-7/MTX cell line was successfully established and resistance factor was 64. The resistant cells has spindle shaped morphology and tended to grow slowly, and the variations appeared in the internal structure of cells. MCF-7/MTX cells possessed cross-resistance to various chemotherapeutic drugs. The expressions of NPM and multidrug-resistant factors P-gp, MRP1, BCRP were up-regulated in the resistant cells. Further, the overexpression of NPM activated PI3K/Akt signaling pathway and inhibited downstream apoptotic factors. Then knockdown of NPM by siRNA significantly decreased the drug resistance of MCF-7/MTX cells, suppressed PI3K/Akt pathway and promoted the downstream cells apoptosis. CONCLUSION The high expression of NPM has an important role in the formation of breast cancer drug resistance, and it is expected to be a novel molecular target for breast cancer treatment in clinical.     

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??OBJECTIVE To identify the secondary metabolites of endophytic fungus C. capsici. METHODS Various column chromatographic methods were used to isolate and purify compounds, such as silica gel, Sephadex LH-20 and semi-prep HPLC. The structures were established on the basis of spectral analysis. RESULTS Thirteen compounds were isolated and identified as GKK1032(1), altertoxin I(2), ergosta-7,22-dien-3??,5??,6??-triol(3), ergosterol(4), 20-hydroxylergosta-4,6,8(14),22-tetraen-3-one(5), ergosta-7,22-diene-3,6-dione(6), isocyathisterol(7), ganodermaside D(8), TCA 3a(9), TCA 3b(10), nicotinamide(11), tyrosol(12) and 4-hydroxybenzaldehyde(13). CONCLUSION All these compounds are isolated from C. capsici for the first time.     

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??OBJECTIVE To prepare Gd-DOTA-E-₂ targeted contrast agent and evaluate its relaxation properties, cytotoxicity and targeting. METHODS E-₂ was synthesized by F-moc solid phase method, covalently bonded with chelating agent DOTA, meanwhile ultilizing chelating ligand Gd³⁺ to prepare MRI contrast agent Gd-DOTA-E-₂. The structure was characterized by ESI-MS and NMR, and the properties were evaluated by relaxation properties, MTT and mouse MRI contrast assay. RESULTS ESI-MS and NMR RESULTS showed that Gd-DOTA-E-₂ was synthesized successfully, and its relaxation efficiency(k=9.551 mmol^-1??L??s^-1) is 1.84 times more efficient than a commercially available contrast agent of Gd-DOTA; MTT RESULTS showed that the toxicity of Gd-DOTA-E-₂ cell is lower than that of Gd-DOTA; the experimental RESULTS in MRI angiography showed that Gd-DOTA-E-₂ is possessing of targeting and can image clearly. CONCLUSION Gd-DOTA-E-₂ is a kind of MRI contrast agent with good stability, low cytotoxicity and targeted properties in vivo,which is valuable in research and application.     

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??OBJECTIVE To observe the neuro-protective effects of harpagide on acute cerebral ischemic injury in mice and its mechanism involving mitochondria. METHODS Acute cerebral ischemia were achieved by operation of MCAO in the left brain, random allocation was taken to divide ICR mice into sham group, model group, nimodipine group and harpagide(5, 10, 15 mg??kg^-1) groups. Mice were intraperitoneal injected harpagide immediately after surgery. Nerve function score, content of brain water, brain index and the common changes of brain pathological structure in HE staining were measured; Ability of mitochondria?? Ca²⁺-Mg²⁺-ATPase and protein expression level of caspase-3 in the MCAO mice?? brains was determined; Ultrastructure change of mitochondria under the TEM was observed. RESULTS Compared with model group, the harpagide groups could decreased the nerve function score, the content of brain water, brain index and the volume of ischemia in mice with different degrees in MCAO mice(P<0.05,P<0.01); 10 mg??kg^-1 of harpagide could increased the activity of Ca²⁺-Mg²⁺-ATPase obviously(P<0.01); And significantly decreased the protein expression level of caspase-3(P<0.01); harpagide groups could protect the pathogeny structure and the ultrastructure of mitochondria with different degrees in MCAO mice, decrease edema of mitochondria obviously. CONCLUSION Harpagide could obviously protect acute cerebral ischemia in mice, its therapeutical effects are approached to protecting the activity of brain mitochondria and decreasing protein expression level of caspase-3.     

合并2型糖尿病的缺血性脑梗死复发危险因素研究

目的分析合并2型糖尿病的急性缺血性脑卒中患者首次发生脑梗死与复发脑梗死的l临床特点。方法采用Logi5tic回归分析,回归模型以脑梗死为因变量,年龄、性别、高血压痛、糖尿病、三酰甘油（TG）、胆固醇、低密度脂蛋白（LDL－C）、高密度脂蛋白、纤维蛋白原、血小板聚集率、尿酸、同型半胱氨酸、颈动脉斑块及吸烟为自变量,分析缺血性脑卒中的危险因素。回顾性分析合并2型糖尿病的缺血性脑卒中首次发生脑梗死100例患者的临床资料,与复发性脑梗死100例患者进行对比分析。结果年龄、糖尿病、LDL－C、颈动脉斑块及吸烟是缺血性脑梗死的独立危险因素。合并糖尿病的缺血性脑卒中首次脑梗组年龄63．26岁±9．93岁,入院时收缩压、舒张压均高于复发脑梗死组,收缩压结果有统计学意义（P〈o．05）;首次脑梗组胆固醇、TG、LDI。一C均高于复发组（P〈O．05）;复发脑梗组年龄66．35岁±9．51岁,纤维蛋白原、血小板聚集率均高于首发组（P〈O．05）。颈动脉斑块性质分析,两组均以硬斑为主,结果无统计学意义。首发组入院及出院时NHISS评分均低于复发组（P〈0．05）。合并糖尿病的急性缺血性脑率中首发组以部分前循环梗死（PICA）比例最多,而复发组以腔隙性脑梗死（LACI）比例最多,结果有统计学意义。结论合并2型糖尿病的缺血性卒中,首次脑梗死组收缩压高,血脂明显异常,而复发脑梗组血液黏度升高;首次脑梗组以部分前循环梗死为主,复发脑梗组以腔隙性脑梗死为主,呈多灶病变;复发脑梗组患者预后差,遗留神经功能缺损较明显,住院时间延长,卒中相关性痴呆发生率高。     

2型糖尿病合并高尿酸血症的危险因素分析

目的 探究2型糖尿病(T2DM)合并高尿酸血症(HUA)的危险因素.方法 选取2017年12月一2019年5月医院收治并确诊为2型糖尿病的患者203例,根据尿检结果,将其分为高尿酸A组及普通2型糖尿病B组,其中HUA(A组)107例,T2DM(B组)96例.比较两组成员的年龄、BMI等资料及血检生物化学指标.结果 ①两...     

2型糖尿病合并肥胖患者的相关危险因素和中医证素分析＊

目的 探讨2型糖尿病合并肥胖患者的相关危险因素及中医证素。方法 采用回顾性病例对照的研究方法，选取120例就诊于杭州市中医院内分泌科（2017年1月-2019年12月）的糖尿病患者，将其按照体重指数分为两组，即肥胖组62例（BMI ≥ 28 kg/m²），正常体重组58例（18.5 kg/m² ≤ BMI < 25 kg/m²），对比两组患者的体重（BW）、体重指数（BMI）、腰臀比（WHR）、糖代谢指标（空腹血糖（FPG）、餐后2 h血糖（PPG）、糖化血红蛋白（HbA1c）、空腹C肽（FCP）、空腹胰岛素（FINS）、Homa2-IR）、脂代谢指标（甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL））。中医方面：以朱文峰教授的证素理论为基础，运用证素辨证的方法探讨消渴病与肥胖之间的关系。结果 肥胖组与正常体重组FPG、HDL无组间差异。肥胖组患者的BW、BMI、WHR高于正常体重组（P < 0.05）；糖代谢方面，肥胖组PPG、HbA1c、FCP、FINS、Homa2-IR水平高于正常体重组（P < 0.05）；脂代谢方面，肥胖组TC、TG、LDL水平均高于正常体重组（P < 0.05）。中医证素：脏腑病位证素方面，肥胖组脾、胃、肝证素高与正常体重组（P < 0.05）；病性证素方面，气虚、气郁、痰、湿、热、瘀证素高与正常体重组（P < 0.05）。根据性别及腰臀比对肥胖2型糖尿病患者进行分层比较，在脏腑病位证素方面，肥胖男性中腰臀比 ≥ 0.90者脾、肝证素出现频次更高（P < 0.05）；肥胖女性中腰臀比 ≥ 0.85者脾、胃、肝证素出现频次更高（P < 0.05）；在病性证素方面，腰臀比 ≥ 0.90的肥胖男性及腰臀比 ≥ 0.85的肥胖女性中气郁、湿、热、瘀证素出现频次较高（P < 0.05）。结论 肥胖2型糖尿病患者多存在较高的胰岛素抵抗水平及更显著的糖脂代谢紊乱。治疗肥胖2型糖尿病患者，除了传统的“阴虚燥热”和“脾虚痰湿”等常见病机外，可以从调整肝、脾、胃脏腑功能，改善气郁、气虚、痰、湿、热、瘀的方向着手进行辨证 论治。     

玉泉丸合桃红四物汤加减对气阴两虚证2型糖尿病心血管主要危险因素的影响

目的:观察玉泉丸合桃红四物汤加减对气阴两虚证2型糖尿病(T2DM)心血管主要危险因素的影响及对炎症因子和血管内皮功能的作用。方法:将160例患者随机分为对照组和观察组各80例。两组均口服拜阿司匹林肠溶片,0.1 g/次,1次/d;注射用胰岛素或口服降糖药;口服辛伐他汀片,20 mg/次,1次/d;厄贝沙坦片,150 mg/次,1次/d。对照组加用天芪降糖胶囊,5粒/次,3次/d。观察组内服玉泉丸合桃红四物汤加减,1剂/d。两组患者均连续治疗24周,再进行48周随访。监测血糖、血脂和血压,空腹血糖(FPG),餐后2 h血糖(2 h PG),糖化血红蛋白(HbA1c),观察组收缩压(SBP),舒张压(DBP),每8周评价1次,记录治疗后8,16,24周的FPG,HbA1c,LDL-C,SBP和DBP的达标情况及三者联合达标情况,并比较不同时点血糖、血脂和血压水平;记录治疗期间和随访期间共72周内心血管事件、脑卒中事件、周围血管事件和微血管并发症的发生情况;检测治疗前后肿瘤坏死因子-α(TNF-α),同型半胱氨酸(Hcy),白细胞介素-6(IL-6),超敏C反应蛋白(hs-CRP),内皮素(ET-1)和一氧化氮(NO);记录治疗后8,16,24周体质量指数(BMI)达标率。结果:在治疗后24周,观察组HbA1c达标率为81.16%(56/69),高于对照组的64.71%(44/68)(χ2=4.701,P0.05),观察组SBP达标率为94.2%(65/69),高于对照组的82.36%(56/68)(χ2=4.662,P0.05);在治疗后16,24周观察组LDL-C达标率分别为79.71%(55/69),88.41%(61/69),高于同期对照组的63.24%(43/68),70.59%(48/68)(χ2=4.5642,χ2=5.108,P0.05);在16周时,观察组综合达标率(血糖、血压、血脂)为59.42%,高于对照组的41.18%(28/68)(χ2=4.559,P0.05);在24周时,观察组综合达标率69.57%(48/69),高于对照组的51.47%(35/68)(χ2=4.695,P0.05);在16周时,观察组BMI达标率为60.87%(42/69),高于对照组的39.71%(27/68)(χ2=6.136,P0.05);在24周时,观察组BMI达标率为72.46%(56/69),高于对照组的52.94%(36/68)(χ2=5.585,P0.05);在治疗后16周,观察组2 h PG和HbA1c水平低于对照组(P0.05);在治疗后24周,观察组FPG,2 h PG,HbA1c,SBP和DBP水平均低于对照组(P0.05);观察组TNF-α,Hcy,IL-6和hs-CRP水平均低于对照组(P0.01);观察组NO高于对照组(P0.01),ET-1均低于对照组(P0.01);在72周的观察期间,观察组不良血管事件的发生为13.04%(9/69),低于对照组的30.88%(21/68)(χ2=5.957,P0.05)。结论:在常规西医治疗的基础上,玉泉丸合桃红四物汤内服可进一步控制T2DM患者心血管主要危险因素,改善T2DM患者血管内皮功能,抑制促炎因子的表达,降低不良血管事件的发生。     

2型糖尿病患者中医体质类型分布特点及与相关危险因素的关系研究

目的:通过对2型糖尿病患者进行中医体质类型的辨识,调查分析2型糖尿病患者中医体质类型分布特点,探索2型糖尿病患者常见体质类型,并对其与相关危险因素的关系进行初步研究,为建立2型糖尿病发病的中医病因学理论提供科学依据,也为临床防治提供依据。方法:选取2014年6月至2015年12月来自4家社区卫生服务中心的门诊或体检患者947例,其中2型糖尿病患者461例,非糖尿病对照组人群486例,参照中华中医药学会《中医体质分类判定》标准进行中医体质辨识,并记录糖尿病患者的性别、年龄、身高、体重、BMI、吸烟史、饮酒史、高血压病史、心脑血管疾病史、血脂异常病史等,进行统计学分析。结果:2型糖尿病患者9种体质按分布频率由高到底依次为:阴虚质、痰湿质、血瘀质、气虚质、阳虚质、湿热质、平和质、气郁质、特禀质;2型观察组平和质所占比例低于非观察组,阴虚质所占比例高于非观察组,差异有统计学意义(P0.01);logistic回归分析筛选出阴虚质为2型糖尿病的主要危险体质,差异有统计学意义(P0.01,OR=1.887)。平和质为2型糖尿病的主要保护体质,差异有统计学意义(P0.01,OR=0.239)。2型糖尿病人群中主要体质人群中不同性别、年龄、体重指数、高血压病史、冠心病、脑梗及血脂异常患病率比较,差异有统计学意义(P0.01~0.05)。结论:阴虚质为2型糖尿病的主要危险体质,平和质为其主要保护体质,为其防治提供了理论依据;2型糖尿病各主要体质间心脑血管危险因素发生率表现各异,因此预后可能不同,应全面关注其各项指标及相关疾病患病率,制定个性化防治方案。     

2型糖尿病并发非酒精性脂肪肝患者证素分析

目的 探讨2型糖尿病合并非酒精性脂肪肝的主要危险因素及中医的主要证型和病机。 方法采用病例对照研究的方法观察180例2型糖尿病并发脂肪肝和无脂肪肝患者的年龄、身高、体重、体重指数、空腹血糖、C肽、糖化血红蛋白（HbA1c）、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白(LDL-C)、餐后2 h C肽等指标。根据2型糖尿病中医证素分型,统计合并脂肪肝患者所占类型比例。 结果 2型糖尿病并发脂肪肝组与无脂肪肝组年龄、身高、空腹血糖、HbA1c、TC、LDL-C比较,差异无统计学意义（P>0.05）;脂肪肝组体重〔（73.4±11.7）kg〕、BMI(26.0±3.67)、空腹C肽〔(4.09±2.40)μg/L〕和餐后2 h C肽〔(6.38±5.46)μg/L〕、TG〔（2.81±2.33）mmol/L〕、HDL-C〔（1.07±0.06）mmol/L〕与无脂肪肝组体重〔（61.4±10.1）kg〕、BMI(22.8±3.23)、空腹C肽〔(2.47±1.74)μg/L〕和餐后2 h C肽〔(4.35±2.92)μg/L〕、TG〔（1.93±1.92）mmol/L〕、HDL-C〔（1.19±0.32）mmol/L〕比较,差异均有统计学意义（P<0.01,P<0.05）;合并脂肪肝组患者更易出现痰湿证。     

胰岛素原与2型糖尿病合并高尿酸血症中医证型及相关危险因素分析

目的:探讨胰岛素原(PI)与2型糖尿病(T2DM)合并高尿酸血症(HUA)中医证型及其影响因素的关系。方法:选取T2DM住院患者80例,按照其是否合并HUA分为两组进行对照研究,每组患者40例。其中将T2DM合并HUA者按中医辨证分型分为风寒湿热、痰瘀痹阻、气阴两虚、阴阳两虚4个证型,同时收集两组临床资料进行组间比较;并根据PI水平采用四分位数法将所有患者分为P1(246.78pmmol/L)、P2(246.78~483.72 pmmol/L)、P3(483.72~720.66pmmol/L和P4(≥720.66 pmmol/L)4个亚组。结果:PI水平在T2DM合并HUA的4种证型中有显著性差异(P0.05),其中阴阳两虚型的PI水平最高,同时PI与BMI、腹围、TG、UA、HDL-C相关(P0.05);除P4亚组外,各亚组UA水平和HUA发病率随着PI水平逐渐升高。结论:T2DM合并HUA不同中医证型间PI水平存在差异,且PI与体型及脂代谢异常相关,同时为T2DM患者发生HUA的独立危险因素。     

糖尿病中医瘀血证的相关因素探讨

目的：通过对糖尿病瘀血和非瘀血2种状态的研究，为中医糖尿病辨证分型和活血化瘀治疗提供依据；方法：将310例住院2型糖尿病患者分为瘀血组和非瘀血组，在体重指数、血压无差异的状态下，对其采血测定血常规、血糖各项、血脂各项、血流变等项目，并对数据进行统计学处理；结果：瘀血组的高血压发生率高于非瘀血组；在全血黏度（高切，中切）、血浆黏度、红细胞数、红细胞压积等项目比较中，瘀血组均高于非瘀血组，差异有显著性（全部P〈0．01），但瘀血组的纤维蛋白原和血小板数则低于非瘀血组（均P〈0．01）；结论：2型糖尿病患者，高血压、全血黏度、血浆黏度、红细胞数、红细胞压积异常是造成瘀血的主要因素。     

214例2型糖尿病患者的舌苔特点及相关因素

目的:探讨2型糖尿病患者舌苔特点及其与西医实验室指标的相关性,尝试从舌苔角度为糖尿病临床辨证论治与判断预后转归提供更多的参考依据。方法:选取2018年12月至2019年10月于北京中医药大学东直门医院收治的2型糖尿病患者214例作为研究对象,应用固定光源的舌象采集设备统一采集患者舌象资料。将舌象舌苔特点从苔色、苔质两部分细化为剥苔、水滑苔、黄苔、厚苔、腻苔、燥苔6个维度,参考疼痛程度的数字等级评分法,由2位高年资专家对214张舌象照片中舌苔特点的6个维度分别进行程度量化评分,并取其平均值录入Excel表格。同时收集患者舌象采集前后两周内的单次空腹静脉血糖、空腹指尖血糖、早餐后2 h指尖血糖、糖化血红蛋白、血常规、血脂、同型半胱氨酸和尿微量清蛋白/尿肌酐比值等实验室指标。研究2型糖尿病患者舌苔特点并分析以上实验室指标与舌苔的相关性。结果:214例2型糖尿病患者中,男117例,女97例,90.60%呈现腻苔的特点,其赋值结果为4.165±1.72;84.11%呈现厚苔的特点,厚苔值为3.371±1.621,其余出现频率由高到低依次为黄苔(51.40%)、剥苔(33.18%)、水滑苔(21.03%)、燥苔(11.68%),且腻苔的程度与总胆固醇、三酰甘油正相关(均P<0.05);厚苔的程度与血尿酸值正相关(P<0.01);剥苔的程度与糖化血红蛋白、空腹指尖血糖、空腹静脉血糖均正相关(均P<0.05)。结论:糖尿病患者舌苔的显著特点为腻、厚,其中腻苔程度较厚苔更深;通过判断舌苔腻、厚、剥等特点,除提供辨证论治的基本依据外,也一定程度有助于医师更直观、便捷地评价糖尿病患者的代谢功能,有助于患者临床血脂、血糖、血尿酸等的自我控制。     

2型糖尿病患者阴虚证危险因素分析

目的:探讨2型糖尿病阴虚证主要危险因素,为2型糖尿病中医辨证提供客观依据。方法:在流行病学横断面调查基础上,得到147例合格2型糖尿病病例,分为阴虚证组和非阴虚证组,运用单因素和多因素非条件Logistic回归方法分析阴虚证的相关危险因素。结果:年龄、糖化血红蛋白与2型糖尿病阴虚证呈正相关,性别呈负相关。结论:糖化血红蛋白与年龄是2型糖尿病阴虚证出现的主要危险因素,对中医辨证客观化具有参考价值。