1型糖尿病中医证型和临床特点分析

目的〓分析1型糖尿病患者的中医证型分布和临床特点。方法 收集169例2012年1月-2019年12月在南京中医药大学附属医院内分泌科病房的1型糖尿病患者，观察患者中医证型分布，比较不同中医证型患者临床特点。结果 169例1型糖尿病患者主证中气阴两虚证患者最多（88.76%），阴虚火旺证者次之（10.06%），阴阳两虚证所占比例最低（1.18%），兼证分布血瘀证最多，痰湿证其次。T1D 主证、兼证与T1D年龄、BMI、病程、FBG、PBG、HbA1c及急性并发症并无明显统计学差异（P>0.05）。慢性并发症方面，阴虚火旺证的糖尿病肾病发生率明显高于其他各组（P<0.05）。比较其余各组中医证型的 DPN、DR、动脉粥样硬化、冠心病、脑梗的发生率，差异均无统计学意义（P>0.05）。结论 气阴两虚证为1型糖尿病的主要证型，1型糖尿病阴虚火旺证更易发生糖尿病肾病。

Syndrome Types of Chinese Medicine and Clinical Characteristicsof Type 1 Diabetes Mellitus

Objective To analyze the distribution and clinical characteristics of TCM syndromes in patients with type 1 diabetes. Methods Totally 169 patients with type 1 diabetes at Department of endocrinology, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine were recruited from January 2012 to December 2019. The distribution of TCM syndrome types of patients and the clinical characteristics of different TCM syndromes were observed. Results 169 patients with type 1 diabetes had the most syndrome of deficiency of both qi and yin (88.76%), followed by deficiency of yin and yang syndrome(10.06%), and the lowest proportion of deficiency of yin and yang(1.18%). The distribution of blood stasis syndrome is the most, followed by phlegm-dampness syndrome. There were no significant differences in age, BMI, course , FBG, PBG, HbA1c and acute complications between the main and concurrent syndrome types of T1D(P>0.05). In terms of chronic complications, the incidence of diabetic nephropathy with Yin deficiency and fire vigour syndrome was significantly higher than that of the other groups(P<0.05). There were no significant differences in the incidence of the other groups of DPN, DR, atherosclerosis, coronary heart disease, and cerebral infarction(P>0.05). Conclusion Deficiency of both Qi and Yin is the main syndrome of type 1 diabetes. Diabetic nephropathy is more likely to occur in type 1 diabetes with Yin deficiency and fire flourishing syndrome.