老年2型糖尿病合并颈动脉粥样硬化斑块中医证型分布特点临床研究

摘要

目的：探讨老年2型糖尿病（T2DM）合并颈动脉粥样硬化斑块（CAS）中医证型分布特点。方法将150例老年2型糖尿病合并颈动脉粥样硬化斑块患者辨证分为湿热困脾、气阴两虚、血瘀阻络3型，观察一般情况及相关指标，研究其与中医证型的关系。结果老年 T2DM 合 CAS 的中医证型以气阴两虚型发生率最高，湿热困脾型最低，证型构成比差异有统计学意义（P ＜0．05）。3种证型在不同年龄段的分布差异无统计学意义（P ＞0．05）；气阴两虚型、湿热困脾型、血瘀阻络型3种证型两两比较，在年龄、病程方面差异有统计学意义（P ＜0．05），气阴两虚型与其他2种证型腰臀比差异有统计学意义（P ＜0．05），各证型体质指数两两比较差异无统计学意义（P ＞0．05）；气阴两虚型纤维蛋白原水平（Fg）最低，血瘀阻络型最高，3种证型两两比较差异有统计学意义（P ＜0．05）；气阴两虚型血清同型半胱氨酸（Hcy）、胆固醇（TC）、甘油三酯（TG）水平最低，与其他2种证型比较差异有统计学意义（P ＜0．05），其他2种证型间无明显差异；3种证型低密度脂蛋白（LDL）和高密度脂蛋白（HDL）差异无统计学意义（P ＞0．05）；老年 T2DM 合并 CAS 时 Fg 水平与 TG、TC、LDL 呈正相关，与 HDL 呈负相关，与糖化血红蛋白（HBALC）、空腹血糖（FPG）无相关性。结论2型糖尿病合并颈动脉粥样硬化斑块中医证型分布差异明显，与年龄、病程以及相关理化指标关系密切，掌握其特点可帮助临床诊疗。%Objective To discuss the elderly patients with type 2 diabetes mellitus (T2DM)with carotid ar-tery atherosclerosis (CAS)characteristics of TCM syndrome type distribution.Methods Elderly patients with syndrome differentiation of 150 cases met the inclusion criteria were divided into yin deficiency,accu-mulation of damp heat in spleen,blood stasis obstructing collaterals type 3,to observe the general condi-tions and the relevant indicators,and to study the relationship between TCM syndrome type.Results TCM Types of senile T2DM CAS to yin deficiency type was the highest,and the lowest in hot and humid spleen,card type structure has statistical significance difference (P <0.05).3 card type no statistically sig-nificant differences in the distribution of different age groups (P >0.05);compared with deficiency of both qi and Yin,accumulation of damp heat in spleen,blood stasis blocking collateral type 3 syndrome type two two in the age,course of disease,there was a significant difference (P <0.05),Qi and yin deficiency type waist hip had statistical significance than respectively with the other two syndromes differences (P < 0. 05),no statistical significance of each syndrome type two two differences between the body mass index (P>0.05);the level of fibrinogen (Fg)in the deficiency of both qi and Yin,blood stasis obstruction mini-mum,maximum,and there was significant difference between the three groups (P <0.05);serum homo-cysteine (HCY),cholesterol (TC),triglyceride (TG)levels in the deficiency of both qi and Yin in the lowest,and the other two groups was statistically significant difference (P <0.05),the other two groups had no significant difference;low density lipoprotein (LDL)and high density lipoprotein (HDL)had no significant difference in the 3 group of syndromes (P >0.05);elderly T2DM with CAS Fg level and TG, TC,LDL positive correlation,negative correlation with HDL;and glycosylated hemoglobin (HBALC), fasting blood glucose (FPG)and no correlation.Conclusion Difference of distribution of TCM syndrome associated with carotid atherosclerosis plaque in type 2 diabetes,and age,course and relevant physico-chemical indexes closely,master its characteristics can help the clinical diagnosis and treatment.