CAJ | 학술논문

目的：探讨2型糖尿病患者中医证型与血糖波动的相关性。方法选取苏州市中医医院内分泌科住院患者52例，辨证确立其中医证型诊断，并应用动态血糖监测系统（CGMS）评估其血糖波动情况，分析糖尿病中医证型与血糖波动的内在联系。结果糖尿病中医证型分为阴虚热盛，痰湿困脾，气阴两虚，阴阳两虚4种，血瘀脉络作为兼夹证单独列出。按照阴虚热盛证、痰湿困脾证、气阴两虚证、阴阳两虚证的顺序：年龄逐步增大，病程逐步延长，其中阴阳两虚证及有血瘀脉络者年龄最大、病程最长（P<0.05）；糖化血红蛋白、空腹及餐后血糖、血糖波动水平逐步增高，其中气阴两虚证、阴阳两虚证及有血瘀脉络者平均血糖波动幅度（MAGE）较大（P<0.05）。痰湿困脾证患者的体质指数（BMI）最大（P<0.05）。结论糖尿病中医证型发展（按阴虚热盛证、痰湿困脾证、气阴两虚证、阴阳两虚证的顺序）与年龄、病程、血糖波动相关：年龄越大，病程越长，血糖波动大者一般表现为气阴两虚证渐进至阴阳两虚证，阴阳两虚往往是糖尿病发展至后期严重阶段的中医证型、病机。
목적：탐토2형당뇨병환자중의증형여혈당파동적상관성。방법선취소주시중의의원내분비과주원환자52례，변증학립기중의증형진단，병응용동태혈당감측계통（CGMS）평고기혈당파동정황，분석당뇨병중의증형여혈당파동적내재련계。결과당뇨병중의증형분위음허열성，담습곤비，기음량허，음양량허4충，혈어맥락작위겸협증단독렬출。안조음허열성증、담습곤비증、기음량허증、음양량허증적순서：년령축보증대，병정축보연장，기중음양량허증급유혈어맥락자년령최대、병정최장（P<0.05）；당화혈홍단백、공복급찬후혈당、혈당파동수평축보증고，기중기음량허증、음양량허증급유혈어맥락자평균혈당파동폭도（MAGE）교대（P<0.05）。담습곤비증환자적체질지수（BMI）최대（P<0.05）。결론당뇨병중의증형발전（안음허열성증、담습곤비증、기음량허증、음양량허증적순서）여년령、병정、혈당파동상관：년령월대，병정월장，혈당파동대자일반표현위기음량허증점진지음양량허증，음양량허왕왕시당뇨병발전지후기엄중계단적중의증형、병궤。
Objective To explore the correlation between TCM syndromes and blood glucose fluctuation in patients with type 2 diabetes mellitus. Methods 52 cases of Endocrinology patients were selected from the Suzhou Hospital , dialectically established their diagnoses of TCM syndromes, applied the CGMS to assess their blood glucose fluctuations, analyzed the intrin-sic link between TCM syndromes and blood glucose fluctuations. Results We dialectically divided these patients into 4 TCM syndromes, including Yin Deficiency and Dry Heat Syndrome, Damp Retention Syndrome, Qi and Yin Deficiency Syndrome, Yin and Yang Deficiency Syndrome. Blood Stasis was listed separately as a combining syndrome. Age and diabetes duration were roughly incremental from Yin Deficiency and Dry Heat Syndrome, to Damp Retention Syndrome, Qi and Yin Deficiency Syn-drome, Yin and Yang Deficiency Syndrome sequentially. Patients who belonged to Yin and Yang Deficiency Syndrome, com-bining with Blood Stasis Syndrome were the oldest, and had the longest diabetes duration (P<0.05). HbA1c, FPG, 2hPG, blood glucose fluctuation indicators were roughly incremental from the syndrome evolution above. Patients who belonged to Qi and Yin Deficiency Syndrome, Yin and Yang Deficiency Syndrome, combining with Blood Stasis Syndrome had higher MAGE (P<0.05). Patients who belonged to Damp Retention Syndrome had the largest BMI (P<0.05). Conclusion Development of diabetes syndromes (by Yin Deficiency and Dry Heat, Damp Retention, Qi and Yin Deficiency, Yin and Yang Deficiency in the order) is related to age, disease duration and blood glucose fluctuation. Patients with increasing age, duration, blood glu-cose fluctuations often belong to Qi and Yin Deficiency Syndrome gradual to Yin and Yang Deficiency Syndrome. Yin and Yang deficiency is the TCM syndrome and pathogenesis of the late stages of the disease.