2型糖尿病伴高尿酸血症患者临床特点及证候分析

目的:探讨2型糖尿病合并高尿酸血症患者的临床和中医证候特点。方法:选取2013年6月至2015年6月于北京中医药大学东方医院内分泌科住院的2型糖尿病患者142例,据患者血尿酸水平分为高尿酸组69例,尿酸正常组73例,比较分析2组的临床及中医证候特点。结果:高尿酸组饮酒比例、体质量指数(BMI)、舒张压、脂代谢指标、胰岛素抵抗指数(HOMA-IR)、尿白蛋白排泄率(UAE)、肌酐、尿素氮、合并冠心病、下肢血管病变、脂肪肝、泌尿系结石及并发肾病、视网膜病变等高于尿酸正常组,差异有统计学意义(P0.05);主要证候气阴两虚、阴虚火旺、肝胃郁热及兼痰证、瘀证、浊证人数及构成比升高,差异有统计学意义(P0.05)。结论:2型糖尿病合并高尿酸血症患者合并症并发症情况严重;中医证候以气阴两虚、阴虚火旺、肝胃郁热为主,多兼痰、瘀、浊等。

Clinical Characteristics and Traditional Chinese Medicine Syndrome Analysis of Type 2 Diabetes Mellitus with Hyperuricemia

To investigate the clinical features and traditional Chinese medicine (TCM) syndromes of patients with type 2 diabetes mellitus (T2DM) complicated with hyperuricemia. Methods:A total of 142 patients with T2DM who were hospitalized in endocrinology department of Dongfang Hospital of Beijing University of Chinese Medicine from June 2013 to June 2015 were divided into high uric acid group (69 cases) and normal urinary acid group (73 cases) according to the level of uric acid. And then the clinical characteristics and TCM syndromes of the 2 groups were compared and analyzed. Results:The drinking proportion, body measure index (BMI), diastolic blood pressure, lipid metabolism, homeostasis model assessment of insulin resistance (HOMA-IR), urinary albumin excretion rate (UAE), creatinine, combined with coronary heart disease, lower extremity vascular lesions, fatty liver, urinary stones and concurrent nephropathy, retinopathy etc. in high uric acid group were higher than uric acid normal group, and the difference was statistically significant (P<0.05); The main symptoms of qi and yin deficiency, yin-deficiency and fire-hyperactivity syndrome, heat in liver and stomach syndrome, phlegm, blood stasis, turbidity and the proportion of the composition ratio increased, and the difference was statistically significant (P<0.05). Conclusion:Complications of the patient with T2DM complicated with hyperuricemia are serious. The main features of TCM syndrome are qi and yin deficiency, yin-deficiency and fire-hyperactivity syndrome, heat in liver and stomach syndrome, with phlegm, blood stasis and turbidity.