糖尿病周围神经病变中医证型分析及其与交感神经皮肤反应的关系

目的探讨糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)中医证型及其与交感神经皮肤反应(sympatheitc skin response,SSR)的关系。方法记录378名DPN患者的SSR检测结果、血糖、血脂、血压、中医症状及舌脉,按照先辨单一证候,然后将单一证候组合形成证型的辨证方式进行中医辨证。结果 DPN中医证型以阴阳两虚血瘀证最多见。随着年龄增长和病程延长,阴虚或兼痰瘀证、气阴两虚或兼痰瘀证的比例逐渐降低,阴阳两虚或兼痰瘀证的比例逐渐升高。SSR异常率为67.5%,阴阳两虚或兼痰瘀证的SSR异常率与其余各组相比显著升高(P<0.05),该组中的主要证型阴阳两虚血瘀证及阴阳两虚痰瘀互结证与SSR呈显著正相关。结论 SSR异常与阴阳两虚血瘀证及阴阳两虚痰瘀互结证之间具有相关性,为DPN的中医辨证提供了依据。

Clinical study on relationship between syndrome of traditional Chinese medicine and sympathetic skin response in diabetic peripheral neuropathy

Objective To explore the relationship between traditional Chinese medicine（TCM） syndrome and sympathetic skin response（SSR） in patients with diabetic peripheral neuropathy（DPN）.Methods 378 patients with DPN were selected to record SSR test results,blood glucose,blood pressure,serum lipids,TCM symptoms and were classified as TCM syndrome Qi-deficiency,Yin-deficiency,Yang-deficiency,blood-stasis,phlegm-dampness and Qi-depression.Results The main syndrome type was Yin and Yang-deficiency combined with blood-stasis.With age and the course progress,the proportion of Yin-deficiency,Qi and Yin-deficiency decreased,and the proportion of Yin and Yang-deficiency increased.The rate of SSR abnormality was 67.5%,and abnormal SSR rate of Yin and Yang-deficiency group was significantly higher than other groups（P0.05）.In this group,Yin and Yang-deficiency combined with blood-stasis,Yin and Yang-deficiency combined with blood-stasis and phlegm-dampness were significant positive correlated with SSR abnormality.Conclusion SSR abnormality was related with Yin and Yang-deficiency combined with blood-stasis,Yin and Yang-deficiency combined with blood-stasis and phlegm-dampness,to provide the basis for TCM syndrome in patients with DPN.