2型糖尿病常见慢性并发症的中医辨证特点

目的探讨2型糖尿病常见慢性并发症的中医辨证特点。方法采用5 级记分法对124 例2 型糖尿病伴常见慢性并发症患者进行临床症状评分,按气虚、阴虚、阳虚、血瘀、痰湿5个证候类型判定证型归属。结果各证候频次顺序为阴虚证>血瘀证>气虚证>阳虚证>痰湿证,其中阴虚、血瘀>50%。辨证分型以虚实夹杂证居多(80.5%),位于前3 位的证型是阴阳两虚血瘀(17.7%)、气阴两虚血瘀(16.9%)、阴虚血瘀(16.9%)。不同病程组间辨证分型构成有显著性差异( P <0.05)。病程<5年以下组以典型症状起病者明显减少(39.1%),但高血压、血脂异常的患病率增高(分别为63.0%和87.0%)。结论现阶段2型糖尿病常见慢性并发症的辨证分型以虚实夹杂证为主,阴虚、血瘀证候贯穿于病程始终。

Characteristics of TCM syndrome differentiation in chronic complications of type 2 diabetes mellitus

ObjectiveTo explore the characteristics of traditional Chinese medicine (TCM) syndrome differentiation in chronic complications of type 2 diabetes mellitus (DM).Methods124 patients with chronic complications of type 2 DM were scored by 5 grades according as the severities of their symptoms. There were 5 kinds of patterns such as deficiency of Qi, deficiency of Yin, deficiency of Yang, blood stasis and retention of phlegm and fluid by which the TCM syndrome differentiation was generalized.ResultsThe sequence of TCM patterns was deficiency of Yin, blood stasis, deficiency of Qi, deficiency of Yang and retention of phlegm and fluid, and the syndrome of the two formers were greater than 50%. The proportion of unity of deficient and excessive pattern was 80.5%. Three larger syndrome types were deficiency of both Yin and Yang combined with blood stasis (17.7%), Qi-Yin deficiency with blood stasis ( 16.9 %) and Yin deficiency with blood stasis (16.9%). There was a statistically significant difference in TCM syndromes which were divided into different groups by course of diseases ( P<0.05). At onset of DM, the typical symptoms were less observed in the group whose course of disease was less than 5 years, and only 39.1% of patients had the typical symptoms. But at the same time, the prevalences of hypertension and hyperlipidemia were higher in this group than in the others, respectively 63.0% and 87.0%.ConclusionThe primary syndrome is unity of deficient and excessive pattern in chronic complications of type 2 DM and deficiency of Qi and blood stasis are the commonest patterns in course of DM.