【摘要】：目的:旨在觀察2型糖尿病合并阻塞性睡眠呼吸暫停綜合征痰濕證患者的人口生物學(xué)指標(biāo)、代謝相關(guān)指標(biāo)、凝血功能指標(biāo)、呼吸障礙指標(biāo)、糖尿病并發(fā)癥及合并癥等方面的特征,初步歸納2型糖尿病合并阻塞性睡眠呼吸暫停綜合征痰濕證患者的表征特點,以期為2型糖尿病合并阻塞性睡眠呼吸暫停綜合征痰濕證的中醫(yī)辨證論治提供參考。方法:選自2015年9月至2017年1月廈門大學(xué)附屬第一醫(yī)院內(nèi)分泌糖尿病科住院及門診的2型糖尿病合并阻塞性睡眠呼吸暫停綜合癥患者197例。根據(jù)證素辨證診斷標(biāo)準(zhǔn),將其分為痰濕證組(98例)與非痰濕證組(99例)。分別記錄人口生物學(xué)指標(biāo)、代謝相關(guān)指標(biāo)、凝血功能指標(biāo)、呼吸障礙指標(biāo)、糖尿病并發(fā)癥及合并癥等。收集資料后進(jìn)行整理分析,并分別比較痰濕證組與非痰濕證組相關(guān)指標(biāo)的差異。采用SPSS 20.0統(tǒng)計軟件進(jìn)行分析、檢驗。計量資料服從正態(tài)分布者以均數(shù)±標(biāo)準(zhǔn)差(x±S)表示,采用兩獨立樣本t檢驗,不服從正態(tài)分布者以中位數(shù)(25%-75%)M(25%-75%)表示,采用Mann-Whitney檢驗。計數(shù)資料用率(%)表示,采用x2檢驗。以P0.05為時認(rèn)為差異有統(tǒng)計學(xué)意義。結(jié)果:1.人口生物學(xué)指標(biāo):與非痰濕證組相比,痰濕證組的體重、身體質(zhì)量指數(shù)、腰圍、臀圍、頸圍較大(P0.05)。2.痰濕證組合并輕度OSAS有29例(29.59%)、中度OSAS有30例(30.61%)、重度OSAS有39例(39.80%);非痰濕證組合并輕度OSAS有54例(54.55%)、中度OSAS有23例(23.23%)、重度OSAS有22例(22.22%),兩組間OSAS嚴(yán)重程度構(gòu)成比有統(tǒng)計學(xué)差異(P0.05)。3.實驗室檢查指標(biāo):與非痰濕證組相比,痰濕證組的高密度脂蛋白膽固醇較低、血漿纖維蛋白原較高(P0.05)。4.合并癥情況:與非痰濕證組相比,痰濕證組的動脈斑塊患病率較高(65.31%vs50.51%,P=0.035)、冠心病患病率較高(21.43%vs10.1%,P=0.029)、腦卒中患病率較高(10.2%vs3.0%,P=0.043)。5.呼吸障礙相關(guān)指標(biāo):與非痰濕證組相比,痰濕證組的呼吸暫停指數(shù)、ESS評分較高(P0.05)。結(jié)論:1.在T2DM合并OSAS痰濕證患者中,中重度OSAS患者占70.41%。2.在T2DM合并OSAS痰濕證患者中,痰濕證表征表現(xiàn)在BMI、頸圍、HDL-C、FIB、AHI、ESS評分以及合并動脈斑塊、冠心病、腦卒中的患病率上,與非痰濕證T2DM合并OSAS患者相比具有可比性。3.T2DM合并OSAS痰濕證患者合并心腦血管疾病的風(fēng)險可能比非痰濕證的風(fēng)險更高,在中醫(yī)藥治療T2DM合并OSAS應(yīng)注重祛濕化痰。
[Abstract]:Objective: to observe the biological index, metabolism index, coagulation function index, respiratory disorder index of type 2 diabetes mellitus complicated with obstructive sleep apnea syndrome with phlegm dampness syndrome. The characteristics of type 2 diabetes mellitus with obstructive sleep apnea syndrome and phlegm dampness syndrome were summarized. In order to provide reference for type 2 diabetes mellitus with obstructive sleep apnea syndrome phlegm dampness syndrome differentiation of TCM treatment. Methods: 197 patients with type 2 diabetes complicated with obstructive sleep apnea syndrome were selected from September 2015 to January 2017 in Department of Endocrine Diabetes, first affiliated Hospital of Xiamen University. According to the diagnostic criteria of syndrome element differentiation, it was divided into phlegm dampness syndrome group (98 cases) and non phlegm dampness syndrome group (99 cases). The indexes of population biology, metabolism, coagulation function, respiratory disorders, diabetic complications and complications were recorded. The data were collected and analyzed, and the differences between phlegm dampness syndrome group and non-phlegm dampness syndrome group were compared. SPSS 20.0 statistical software was used to analyze and test. The measured data were expressed as mean 鹵standard deviation (x 鹵S) in normal distribution, t test in two independent samples, and Mann-Whitney test in median (25-75%) M (25-75%) in those who did not accept normal distribution. The count data rate (%) was expressed by x 2 test. The difference was statistically significant in terms of P05. Results: 1. Demographic indicators: compared with the non-phlegm dampness syndrome group, the phlegm dampness syndrome group's body weight, body mass index, waist circumference, hip circumference, neck circumference was larger (P0.05). There were 29 cases (29.59%) with mild OSAS, 30 cases (30.61%) with moderate OSAS and 39 cases (39.80%) with severe OSAS. There were 54 cases (54.55%) with mild OSAS, 23 cases (23.23%) with moderate OSAS and 22 cases (22.22%) with severe OSAS. Laboratory indicators: compared with the non-phlegm dampness syndrome group, the phlegm dampness syndrome group had lower HDL cholesterol and higher plasma fibrinogen (P0.05). Complications: compared with the non-phlegm dampness syndrome group, the prevalence of arterial plaque in phlegm dampness syndrome group was higher (65.31 vs 50.51P = 0.035), and the prevalence rate of coronary heart disease was higher (21.43 vs 10.1% P0.029). The incidence of stroke was higher (10.2% vs 3.0% P 0.043). Respiratory disorders related indicators: compared with the non-phlegm dampness syndrome group, phlegm dampness syndrome group apnea index, ESS score was higher (P0.05). Conclusion: 1. In T2DM patients with OSAS phlegm dampness syndrome, moderate and severe OSAS patients accounted for 70.41cm. 2. In T2DM patients with OSAS phlegm dampness syndrome, the characteristics of phlegm dampness syndrome were BMI, neck circumference, HDL-C,FIB,AHI,ESS score and the prevalence of artery plaque, coronary heart disease and stroke. Compared with non-phlegm dampness syndrome T2DM combined with OSAS patients, 3.T2DM combined with OSAS phlegm dampness syndrome patients with cardio-cerebrovascular disease risk may be higher than non-phlegm dampness syndrome risk, in Chinese medicine treatment of T2DM with OSAS should pay attention to remove dampness phlegm.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259;R276.1

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