本文選題：2型糖尿病　切入點(diǎn)：骨質(zhì)疏松　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：1目的:通過對(duì)2型糖尿病患者的臨床指標(biāo)及中醫(yī)證候進(jìn)行回顧性分析,旨在探討2型糖尿病合并骨質(zhì)疏松患者的臨床特征及中醫(yī)證候?qū)W特點(diǎn)、以及中醫(yī)證型與臨床指標(biāo)的相關(guān)性,為中西醫(yī)結(jié)合防治2型糖尿病并骨質(zhì)疏松提供一定的依據(jù)。2方法:本研究以2015年12月至2016年10月廣安門醫(yī)院內(nèi)分泌科住院且符合納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)的156例2型糖尿病患者為研究對(duì)象,根據(jù)骨密度檢測結(jié)果將患者分為骨量正常組(T≥-1),骨量減少組(-2.5＜T-1),骨質(zhì)疏松組(T≤-2.5)。探索三組患者中醫(yī)證型特點(diǎn),并分析三組間的一般資料(如性別、年齡、病程、體重指數(shù))、血糖、骨代謝等相關(guān)指標(biāo),探索它們與2型糖尿病并骨質(zhì)疏松癥的關(guān)系及臨床指標(biāo)與中醫(yī)證型之間的關(guān)系。3結(jié)果:①共收集到2型糖尿病患者156例,其中合并骨質(zhì)疏松癥有46例,骨量減少有54例,骨量正常有56例,占總數(shù)比例分別為29.5%、34.6%、35.9%。在骨質(zhì)疏松組中,氣滯血瘀證明顯多于其他證型,在骨量減少組中,氣滯血瘀證多于其他證型,而在骨量正常組中,肝腎虧損證所占比例最高,在證型分布上,三組證型差異有統(tǒng)計(jì)學(xué)意義(P0.05);②骨質(zhì)疏松組2型糖尿病女性患者所占比例較高;③骨質(zhì)疏松組年齡高于骨量減少組和骨量正常組(P0.05);④骨質(zhì)疏松組BMI低于骨量正常組(P＜0.05);骨質(zhì)疏松組ALP、iPTH、β-CTX、BGP高于骨量正常組(P0.05);骨質(zhì)疏松組UA低于骨量正常組和骨量減少組(P0.05);骨量減少組的24HMA、24h-uTP高于骨量正常組(P0.05);⑤三組證型BMI、HBA1c、FPG、P、VITD-T、Ca、TG、CHO、HDL、ALP、β-CTX、BGP、UA、24h-uTP差異無統(tǒng)計(jì)學(xué)意義(P0.05),氣滯血瘀證24HMA、iPTH水平高于肝腎虧損證(P0.05);氣滯血瘀證全髖BMD小于肝腎虧損證(P0.05)。4結(jié)論:①2型糖尿病合并骨質(zhì)疏松者氣滯血瘀證最多,合并骨量減少者氣滯血瘀證最多,骨量正常者肝腎虧損證最多。氣滯血瘀證全髖BMD較低;②2型糖尿病患者骨量流失與性別及年齡有關(guān),與骨質(zhì)疏松危險(xiǎn)因素報(bào)道相一致;③2型糖尿病合并骨質(zhì)疏松患者BMI較低;④2型糖尿病合并骨質(zhì)疏松患者ALP、iPTH、β-CTX、BGP較高;⑤2型糖尿病合并骨質(zhì)疏松患者血UA較低;⑥2型糖尿病合并骨質(zhì)疏松患者尿蛋白較高。
[Abstract]:1 Objective: retrospective analysis of the clinical indicators and TCM syndromes in patients with type 2 diabetes mellitus, to investigate the clinical characteristics and TCM syndromes in patients with type 2 diabetes complicated with osteoporosis features, and the relationship between TCM syndrome and clinical index, type 2 diabetes and osteoporosis and provide the basis for Chinese and Western.2 methods medicine in the prevention and treatment of this study from December 2015 to October 2016 in Guanganmen hospital in the Department of Endocrinology and in accordance with the inclusion criteria and exclusion criteria, 156 cases of type 2 diabetes patients as the research object, according to the measurement of bone mineral density results were divided into normal bone mass group (T = -1), osteopenia group (-2.5 < T-1), osteoporosis group (T less than -2.5). To explore the TCM syndrome characteristics of three groups of patients, and analyze the general information between the three groups (such as gender, age, duration, body mass index, blood glucose), bone metabolism related indicators, and explore them with type 2 diabetes mellitus The relationship between osteoporosis and clinical indexes and TCM syndrome types of.3 results: We collected 156 cases of patients with type 2 diabetes, of which 46 cases of patients with osteoporosis, osteopenia in 54 cases, normal bone mass in 56 cases, accounting for the proportion of the total number were 29.5%, 34.6%, 35.9%. in osteoporosis group in Qi stagnation and blood stasis were significantly more than the other syndromes, in the osteopenia group, qi stagnation and blood stasis syndrome than other syndromes, and in normal bone mass group, liver and kidney deficiency with the highest proportion in the distribution of syndromes, syndrome of the three groups was statistically significant difference (P0.05); the 2 groups of patients with osteoporosis diabetic women accounted for a higher proportion of osteoporosis; the higher age group osteopenia group and normal group (P0.05); the osteoporosis group BMI was lower than that of normal bone mass group (P < 0.05); osteoporosis group ALP, iPTH, beta -CTX, BGP higher than the normal bone mass group (P0.05); osteoporosis group UA low In normal bone mass group and osteopenia group (P0.05); osteopenia group 24HMA, 24h-uTP higher than the normal bone mass group (P0.05); the three group card type BMI, HBA1c, FPG, P, VITD-T, Ca, TG, CHO, HDL, ALP, BGP, UA, -CTX, 24h-uTP showed no statistically significant difference (P0.05), qi stagnation and blood stasis syndrome 24HMA, iPTH level is higher than that of liver and kidney deficiency syndrome (P0.05); Qi stagnation and blood stasis type total hip BMD less than liver and kidney deficiency syndrome (P0.05).4 conclusion: type 2 diabetes mellitus with osteoporosis complicated with qi stagnation and blood stasis, qi stagnation and blood stasis are the most osteopenia, bone mass in normal liver and kidney deficiency the card up. Qi stagnation and blood stasis type total hip BMD was low; the bone loss in patients with type 2 diabetes and gender and age, consistent with the reported risk factors of osteoporosis; BMI the patients with type 2 diabetes mellitus with osteoporosis is low; the type 2 diabetic patients with osteoporosis in patients with ALP, iPTH, beta -CTX, BGP is higher; the type 2 diabetic patients with bone The blood of the patients with osteoporosis and low UA; type 2 diabetes mellitus with osteoporosis in patients with urinary protein is higher.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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本文編號(hào)：1619623