早期糖尿病肾病证候分布及影响因素的研究

目的：探讨早期糖尿病肾病（DN）患者中医证候与影响因素的相关性，为DN 的防治提供理论依据。方法：选取符合西医诊断标准的早期DN 样本，共236 例，运用单因素和多元Logistic 回归统计分析。结果：气阴两虚证的危险因素主要有体质量指数（BMI）、年龄、病程、冠心病、高血压、脉无力；阴虚燥热证的危险因素主要有吸烟，甘油三酯（TG）、尿微量白蛋白（UMA）升高，舌红、苔黄；脾肾气虚证的危险因素有苔白；瘀证的危险因素有TG、UMA 升高，舌紫暗；痰瘀证的危险因素有苔黄燥、脉弦滑；湿热证的危险因素有运动情况、胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）升高、苔黄厚。结论：早期DN 中医证候之间存在一定的差异，临床辨证诊断及治疗应考虑上述因素的影响。

Research on Traditional Chinese Medicine Syndrome Distribution and Influential Factors of Early-stage Diabetic Nephropathy

This study was aimed to explore the relationship between traditional Chinese medicine (TCM) syndrome distribution characteristics and influential factors of early-stage diabetic nephropathy (DN) patients in order to provide theoretical basis for DN prevention and treatment. A total of 236 early-stage DN cases were selected in consistency with western diagnostic criteria. The single-factor and multivariate logistic regression were used in the statistical analysis. The results showed that the risk factors of qi-yin deficiency syndrome contained body mass index(BMI), age, disease course, coronary heart disease (CHD), hypertension, and weak pulse. Risk factors of yin-deficiency and dryness-heat syndrome contained smoking, TG and UMA elevation, red tongue with yellow coating. Risk factor of qi-deficiency of spleen and kidney syndrome contained white coating. Risk factors of stasis syndrome contained TG and UMA elevation, and dark purplish tongue. Risk factors of phlegm-stasis syndrome contained yellow and dryness coating, wiry and slippery pulse. Risk factors of damp-heat syndrome contained sports, TC, LDL-C elevation, yellow and thick coating. It was concluded that there were some differences among TCM syndromes in the early-stage of DN. Therefore, the clinical syndrome diagnosis and treatment should consider influential factors mentioned above.