临床与病理杂志
臨床與病理雜誌
림상여병리잡지
International Journal of Pathology and Clinical Medicine
2015年
10期
1816-1820
,共5页
中医证型%2型糖尿病%胰岛素抵抗%B细胞功能
中醫證型%2型糖尿病%胰島素牴抗%B細胞功能
중의증형%2형당뇨병%이도소저항%B세포공능
TCM syndromes%type 2 Diabetes%insulin resistance%the function of pancreatic islet
目的：观察中医证型与2型糖尿病患者胰岛素抵抗、B细胞功能的关系。方法：选取2012年至2014年7月苏州市中医医院内分泌科确诊的2型糖尿病住院病人98例，分析其胰岛素抵抗、B细胞功能和中医证型：阴虚热盛证、痰湿困脾证、气阴两虚证、阴阳两虚证的关系。结果：四种证型的空腹胰岛素、空腹C肽在各组间无统计学差异(P>0.05)。但空腹胰岛素值以痰湿困脾证最高，气阴两虚证次之，阴阳两虚证最低；空腹C肽以气阴两虚证最高，阴虚热盛证次之，阴阳两虚证最低。四种证型的HOMA-IR、ISI、HOMA-β在各组间无统计学差异(P>0.05)。但HOMA-IR在痰湿困脾证最大，其余按阴虚热盛证→气阴两虚证→阴阳两虚证的顺序逐渐增大；按阴虚热盛证→痰湿困脾证→气阴两虚证→阴阳两虚证顺序的ISI依次减低；HOMA-β值在痰湿困脾证最大，其余按阴虚热盛证→气阴两虚证→阴阳两虚证排序逐渐减小。结论：2型糖尿病患者的中医证型及病机与胰岛素抵抗、胰岛β细胞分泌功能的损害程度相关。阴虚热盛证、痰湿困脾证以胰岛素抵抗为主；气阴两虚证、阴阳两虚证以胰岛β细胞功能降低为主。苏州地区2型糖尿病患者的中医证型以痰湿困脾证为主，并贯穿病程始终。提示：痰湿困脾可能是苏州地区糖尿病的重要病因病机。
目的：觀察中醫證型與2型糖尿病患者胰島素牴抗、B細胞功能的關繫。方法：選取2012年至2014年7月囌州市中醫醫院內分泌科確診的2型糖尿病住院病人98例，分析其胰島素牴抗、B細胞功能和中醫證型：陰虛熱盛證、痰濕睏脾證、氣陰兩虛證、陰暘兩虛證的關繫。結果：四種證型的空腹胰島素、空腹C肽在各組間無統計學差異(P>0.05)。但空腹胰島素值以痰濕睏脾證最高，氣陰兩虛證次之，陰暘兩虛證最低；空腹C肽以氣陰兩虛證最高，陰虛熱盛證次之，陰暘兩虛證最低。四種證型的HOMA-IR、ISI、HOMA-β在各組間無統計學差異(P>0.05)。但HOMA-IR在痰濕睏脾證最大，其餘按陰虛熱盛證→氣陰兩虛證→陰暘兩虛證的順序逐漸增大；按陰虛熱盛證→痰濕睏脾證→氣陰兩虛證→陰暘兩虛證順序的ISI依次減低；HOMA-β值在痰濕睏脾證最大，其餘按陰虛熱盛證→氣陰兩虛證→陰暘兩虛證排序逐漸減小。結論：2型糖尿病患者的中醫證型及病機與胰島素牴抗、胰島β細胞分泌功能的損害程度相關。陰虛熱盛證、痰濕睏脾證以胰島素牴抗為主；氣陰兩虛證、陰暘兩虛證以胰島β細胞功能降低為主。囌州地區2型糖尿病患者的中醫證型以痰濕睏脾證為主，併貫穿病程始終。提示：痰濕睏脾可能是囌州地區糖尿病的重要病因病機。
목적：관찰중의증형여2형당뇨병환자이도소저항、B세포공능적관계。방법：선취2012년지2014년7월소주시중의의원내분비과학진적2형당뇨병주원병인98례，분석기이도소저항、B세포공능화중의증형：음허열성증、담습곤비증、기음량허증、음양량허증적관계。결과：사충증형적공복이도소、공복C태재각조간무통계학차이(P>0.05)。단공복이도소치이담습곤비증최고，기음량허증차지，음양량허증최저；공복C태이기음량허증최고，음허열성증차지，음양량허증최저。사충증형적HOMA-IR、ISI、HOMA-β재각조간무통계학차이(P>0.05)。단HOMA-IR재담습곤비증최대，기여안음허열성증→기음량허증→음양량허증적순서축점증대；안음허열성증→담습곤비증→기음량허증→음양량허증순서적ISI의차감저；HOMA-β치재담습곤비증최대，기여안음허열성증→기음량허증→음양량허증배서축점감소。결론：2형당뇨병환자적중의증형급병궤여이도소저항、이도β세포분비공능적손해정도상관。음허열성증、담습곤비증이이도소저항위주；기음량허증、음양량허증이이도β세포공능강저위주。소주지구2형당뇨병환자적중의증형이담습곤비증위주，병관천병정시종。제시：담습곤비가능시소주지구당뇨병적중요병인병궤。
Objective: Analyze the corresponding relationship of insulin resistance, injury of islet β-cell function and evolution of Traditional Chinese Medicine (TCM) syndromes in patients with type 2 diabetes mellitus (T2DM). Methods: We studied 98 cases of Endocrinology inpatients from the Suzhou Hospital of TCM for the diagnosis and treatment of diabetes, divided into Yin deifciency and heat syndrome, syndrome of phlegm-damp invading the spleen, Qi and Yin deifciency syndrome, and Yang and Yin deifciency syndrome. Analyzed the corresponding relationship of insulin resistance, injury of islet β-cell function and evolution of TCM syndromes in patients with T2DM.Results: Four types of syndrome and Fins, CPS have no significance (P>0.05). Fins with syndrome of phlegm-damp invading the spleen was highest, and then Qi and Yin deficiency syndrome, Yang and Yin deifciency syndrome was lowest. CPS with Qi and Yin deifciency syndrome was highest, and then Yin deifciency and heat syndrome, Yang and Yin deficiency syndrome was lowest. Four types of syndrome and HOMA-IR, ISI, HMOA-β have no significance (P>0.05). HOMA-IR with syndrome of phlegm-damp invading the spleen was highest, and according to Qi and Yin deifciency syndrome, Yin deifciency and heat syndrome, Yang and Yin deifciency syndrome gradually increased. According to Yin deifciency and heat syndrome, syndrome of phlegm-damp invading the spleen, Qi and Yin deifciency syndrome, and Yang and Yin deifciency syndrome, ISI gradually decreased. HOMA-β with syndrome of phlegm-damp invading the spleen was highest, and according to Yin deficiency and heat syndrome, Qi and Yin deficiency syndrome, Yang and Yin deficiency syndrome gradually decreased. Four types of syndrome and HbA1c, FPG, 2hPG have no signiifcance (P>0.05).Conclusion: 1) Yin deficiency and heat syndrome, syndrome of phlegm-damp invading the spleen were mainly to IR. Qi and Yin deficiency syndrome, Yang and Yin deficiency syndrome were mainly to function of βcells reduced. 2) TCM syndromes were mainly to syndrome of phlegm-damp invading the spleen throughout the disease always. Point out: Damp Retention may be more important diabetes pathogenesis in Suzhou.
