上海社区中老年糖调节受损人群中医证素研究

摘要

目的:分析社区中老年糖调节受损(Impaired Glucose Regulation,IGR)人群的中医证素分布特征以及与代谢、炎性反应指标之间的相关性,为该人群的个性化中医药治疗与评价提供依据.方法:以上海3家社区604例中老年体检者为研究对象,收集身高、体重、血压等6项体检指标以及中医症状体征与舌、脉象信息,检测血糖、糖化血红蛋白(Glycosylated Hemoglobin,HbA1c)、空腹胰岛素(Fasting Insulin,FINS)等11项生化指标,将收集资料运用SPSS 17.0进行统计分析.结果:调查的糖调节受损人群体重指数(Body Mass Index,BMI)、收缩压(Systolic Blood Pressure,SBP)、心率(Heart Rate,HR)值均高于非糖调节受损人群(P<0.05);糖调节受损人群中以阴虚证为主(>50%).IFG+IGT组与重度胰岛素抵抗组人群中占比相对较高的证素分别为气虚证(占40.26%)与热证(占10.23%).气虚、阴虚、热、瘀4组比较,其中空腹血糖(Fasting Plasma Glucose,FPG)、餐后2 h血糖(2-hour Postprandial Plasma Glucose,2hPPG)、HbA1c、总胆固醇(Total Cholesterol,TC)、低密度脂蛋白(Low Density Lipoprotein,LDL)值差异有统计学意义,热证组中2hPPG 、TC、LDL值均较高.结论:调查的糖调节受损人群主要证素表现为气虚、阴虚,夹杂热、瘀等证素,糖脂代谢紊乱较为严重的为热证型,原因可能与胰岛素抵抗程度有关.%Objective:To analyze the distribution of TCM syndromes and their correlation with metabolism indicator and inflammation indicator among middle-aged and elderly population with impaired glucose regulation (IGR) in Shanghai communities, thus providing experimental basis on traditional Chinese medicine treatment and evaluating its effect.Methods:A total of 604 cases with IGR from three communities of Shanghai were enrolled, and 6 physical examination indicators such as height, weight, blood pressure were collected.Meanwhile, 11 biochemical indicators such as blood glucose, glycosylated hemoglobin (HbA1c), fasting insulin (FINS) were tested.Also, objective tongue indicators were recorded.The data were then analyzed by SPSS 17.0 software.Results:1) The BMI, SBP, HR value in IGR population were higher than those of the non-IGR population (P<0.05).2) Yin deficiency syndrome in the IGR population accounted for the major proportion (>50%);qi deficiency syndrome and heat syndrome in the (IFG+IGT) group and severe HOMA-IR index group took a higher proportion (40.26%, 10.23%).3) Significant statistical differences were found in FPG, 2hPPG, HbA1c, TC, LDL indexes among the four syndrome factors, moreover, the value of 2hPPG, TC, LDL in heat syndrome group increased.Conclusion:The main syndromes of IGR population are qi deficiency syndrome and yin deficiency syndrome, mixed with heat syndrome and stagnation syndrome.People with heat syndrome have heavier glucose and lipid metabolism disorder, which might be related to the insulin resistance.