目的:分析1 480 例2 型糖尿病患者病程与中医证候分布的相关性.方法:收集1 480 例2 型糖尿病患者的一般资料、病史资料及中医证候资料等,根据糖尿病病程(病程≤5 年、5 年＜病程≤10 年、病程＞10 年)分组,并进行统计学分析.结果:(1)随着糖尿病病程进展,本虚证中医证型总体分布为:阴虚证(592 例)＞气虚证(440 例)＞阳虚证(252 例)＞血虚证(90例);标实证中医证型总体分布为:内热证(940 例)＞血瘀证(318 例)＞痰湿证(265 例)＞气郁证(190 例).本虚证中,阴虚证、气虚证是最多的两个基本证型,3 组间的气虚证构成比比较,差异有统计学意义(χ2=13.765,P＜0.01);标实证中,内热证、血瘀证是出现最多的两个基本证型,3 组间的痰湿证构成比比较,差异有统计学意义(χ2=4.778,P＜0.05).(2)各组间虚实夹杂证候分布中,以阴虚内热证(524 例)、气虚内热证(229 例)、阳虚内热证(216 例)为多见,随着病程进展,夹血瘀证、夹痰湿证呈上升趋势.其中,在气虚证组中,3 组间气虚夹内热证构成比比较,差异有统计学意义(χ2=14.496,P＜0.01).在血虚证组中,3 组间血虚夹气郁证构成比比较,差异有统计学意义(χ2=4.547,P＜0.05).在阴虚证组中,3 组间阴虚夹血瘀证(χ2=4.052,P＜0.05)、阴虚夹气郁证(χ2=6.131,P＜0.05)构成比比较,差异有统计学意义.结论:2 型糖尿病患者中医证候分布早期以实证为主,中晚期以虚实夹杂多见,其中阴虚证、气虚证、内热证、血瘀证在病程发展过程中始终存在;虚实夹杂中,夹内热证更为多见.
Objective:To analyze the correlation between the course of 1480 patients with type 2 diabetes and the distribution of TCM syndromes.Methods:1480 cases of type 2 diabetes were collected with general data,medical history data and TCM syndrome data.They were grouped according to the course of diabetes(course of disease≤5 years,5 years＜course of disease≤10 years,course of disease＞10 years)and statistically analyzed.Results:(1)With the progression of diabetes,the general distribution of TCM syndrome types of this deficiency syndrome is:Yin deficiency syndrome(592 cases)＞Qi deficiency syndrome(440 cases)＞Yang deficiency syndrome(252 cases)＞blood deficiency syndrome(90 cases);The overall distribution of traditional Chinese medicine syndrome types based on standard evidence is as follows:internal Heat syndrome(940 cases)＞blood stasis syndrome(318 cases)＞Phlegm and Dampness syn-drome(265 cases)＞Qi stagnation syndrome(190 cases).In this deficiency syndrome,Yin deficiency syndrome and Qi deficiency syn-drome are the two most common basic syndrome types.The difference in the composition ratio of Qi deficiency syndrome among the three groups was statistically significant(χ2=13.765,P＜0.01);In standard empirical studies,internal Heat syndrome and blood sta-sis syndrome are the two most common basic syndrome types,and there is a statistically significant difference in the composition ratio of Phlegm and Dampness syndrome among the three groups(χ2=4.778,P＜0.05).(2)In the distribution of mixed syndromes of defi-ciency and excess among each group,the most common ones are Yin deficiency and internal Heat syndrome(524 cases),Qi deficiency and internal Heat syndrome(229 cases),and Yang deficiency and internal Heat syndrome(216 cases).As the disease progresses,the blood stasis syndrome and phlegm dampness syndrome show an upward trend.Among them,in the Qi deficiency syndrome group,there was a statistically significant difference in the proportion of Qi deficiency with internal Heat syndrome among the three groups(χ2= 14.496,P＜0.01).In the blood deficiency syndrome group,there was a statistically significant difference in the proportion of blood de-ficiency with Qi stagnation syndrome among the three groups(χ2=4.547,P＜0.05).In the Yin deficiency syndrome group,there was a statistically significant difference in the proportion of Yin deficiency with blood stasis syndrome(χ2=4.052,P＜0.05)and Yin defi-ciency with Qi stagnation syndrome(χ2=6.131,P＜0.05)among the three groups.Conclusion:The distribution of TCM syndromes of type 2 diabetes patients is mainly empirical in the early stage,and mixed with deficiency and excess in the middle and late stages.Yin deficiency syndrome,Qi deficiency syndrome,internal Heat syndrome and blood stasis syndrome always exist in the course of disease de-velopment.In the mixture of deficiency and excess,the syndrome of Heat inside is more common.
张佳乐;薛哲哲;侠晨辉;吴巧茹;魏蜀吴;姜伟民;王文娜;李春瑶;孙卫卫
北京中医药大学东直门医院,北京 100700西安市第一医院,陕西 西安 710001
中医学
2型糖尿病;病程;中医证候;阴虚证;气虚证;内热证;血瘀证
type 2 diabetes;course of disease;Traditional Chinese medicine syndrome;Yin deficiency syndrome;Qi deficiency syn-drome;internal Heat syndrome;blood stasis syndrome
《中医学报》 2024 (001)
200-204 / 5
中医药行业科研专项基金资助项目(201207012)
10.16368/j.issn.1674-8999.2024.01.033
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