發(fā)布時(shí)間：2018-03-23 05:31

  本文選題：2型糖尿病　切入點(diǎn)：中醫(yī)證候　出處：《廣西中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過收集2型糖尿病痰濕質(zhì)患者基本情況、中醫(yī)證候、生存質(zhì)量等資料,運(yùn)用統(tǒng)計(jì)學(xué)方法對(duì)痰濕質(zhì)的2型糖尿病患者在病程、并發(fā)癥、生化指標(biāo)、中醫(yī)證候進(jìn)行相關(guān)性分析,探討2型糖尿病痰濕質(zhì)患者發(fā)病的傾向性和易伴發(fā)疾患。方法:采用臨床問卷調(diào)查的方式,收集2015年6月至12月在內(nèi)分泌科住院的2型糖尿病的痰濕質(zhì)患者的基本情況、生化指標(biāo)、中醫(yī)證候、并發(fā)癥、生存質(zhì)量等資料,然后運(yùn)用統(tǒng)計(jì)學(xué)方法,進(jìn)行數(shù)據(jù)分析。結(jié)果:1一般情況:2型糖尿病痰濕質(zhì)患者青年人比例為零,全部患者年齡均處于45-80歲。男女比例分別占50.6%、49.4%。體重過低的患者的比例為零;正常的體重有3例,占3.7%;超重的有41例,比例占50.6%;肥胖的有37例,占45.7%。在病程上,按5年以下、5-10年、10年以上的病程進(jìn)行分層,患者的比例分別是35.8%、24.7%、39.5%。在飲食偏好上,患者嗜好油膩食物最多,有26例,占21%;有吸煙史者24例,占30%;飲酒史者32例,占40%。生存質(zhì)量方面,痰濕質(zhì)患者在心理健康維度和治療維度評(píng)分明顯較優(yōu)。慢性并發(fā)癥方面,痰濕質(zhì)組出現(xiàn)糖尿病視網(wǎng)膜病變和高血壓的比例分別為85.4%、24%,兩者呈正相關(guān)。2生化指標(biāo):痰濕質(zhì)的空腹血糖控制在4.4-7.0 mmol/L比例占59.3%。餐后2h血糖維持在10 mmol/L以上的比例占74.1%;總膽固醇控制在4.5 mmol/L以下的比例占74.1%,甘油三酯控制在1.5 mmol/L以上的比例占66.7%;LDL-C、HDL-L小于1 mmol/L的66例,占81.5%;在糖化血紅蛋白方面,控制在8~9%和大于9%的分別占33.3%、34.6%。3中醫(yī)癥狀和證候:痰濕質(zhì)組多有易饑多食、形體肥胖、口干喜冷飲、溲赤便秘、舌苔黃膩、脈弦滑等中醫(yī)癥狀。3類聚類分析時(shí),覆蓋率最高的中醫(yī)癥狀分別是形體肥胖、口干喜冷飲、腹部脹大、脈弦滑。與痰濕質(zhì)相關(guān)的有形體肥胖、肢體麻木、脈弦滑三個(gè)中醫(yī)癥狀。在證候方面,痰濕質(zhì)患者比較容易出現(xiàn)痰熱互結(jié)證,而出現(xiàn)肝腎陰虛證、陰陽(yáng)兩虛證的比率最低。痰濕質(zhì)與痰熱互結(jié)證呈正相關(guān);肝腎陰虛證與痰濕組呈明顯的負(fù)相關(guān)。而且在證候虛實(shí)上,痰濕質(zhì)患者兩者比例相近。結(jié)論:1.2型糖尿病痰濕質(zhì)以中、老年患者多見;以超重和肥胖的患者為主;痰濕質(zhì)貫穿整個(gè)糖尿病全程;患者偏好油膩食物,有嗜煙酒傾向。2.患者餐后血糖較高,甘油三酯水平偏高,糖化血紅蛋白控制不理想或很差,病情上不容樂觀,較易出現(xiàn)糖尿病視網(wǎng)膜病變和高血壓等并發(fā)癥,需要積極予糖尿病宣教和早期的干預(yù)。3.2型糖尿病痰濕質(zhì)患者最常見的中醫(yī)癥狀是形體肥胖、口干喜冷飲、腹部脹大、脈弦滑。臨床上,痰濕質(zhì)患者較易出現(xiàn)痰熱互結(jié)證。
[Abstract]:Objective: to collect the data of phlegm dampness, TCM syndromes and quality of life in type 2 diabetes mellitus, and to analyze the course, complications and biochemical indexes of type 2 diabetes patients with phlegm dampness by statistical method. The relationship between TCM syndrome and phlegm dampness in type 2 diabetes mellitus was studied. Methods: clinical questionnaire was used to investigate the tendency of phlegm dampness in type 2 diabetes mellitus. To collect the basic information, biochemical indexes, TCM syndromes, complications, quality of life and other data of type 2 diabetes mellitus patients hospitalized in the Endocrinology Department from June to December 2015, and then use statistical methods. Results in the general situation of 1: 1, the proportion of young people with phlegm dampness in type 2 diabetes mellitus was zero, and all the patients were aged 45-80. The ratio of male to female was 50.6% and 49.49.4cm, respectively. The proportion of patients with low body weight was zero; there were 3 cases of normal weight. Accounting for 3.7%; there were 41 cases of overweight, accounting for 50.6%; 37 cases were obese, accounting for 45.70.In the course of disease, according to the course of disease of less than 5 years or 10 years and more than 10 years, the proportion of patients was 35.8and 24.77.The proportion of patients with fatty food was the most in diet preference, there were 26 cases. There were 24 cases (30%) with a history of smoking, 32 cases (40%) with a history of drinking alcohol. In terms of quality of life, the scores of phlegm and dampness were significantly better in mental health dimension and treatment dimension. The rates of diabetic retinopathy and hypertension in phlegm wet substance group were 85.4% and 24%, respectively. 2 positive correlation was found between the two biochemical indexes: the proportion of fasting blood glucose of phlegm wet substance was controlled at 4.4-7.0 mmol/L (59.3%), and the proportion of 2 h postprandial blood glucose remained above 10 mmol/L. The proportion of total cholesterol under 4.5 mmol/L was 74.1%, the proportion of triglyceride was more than 1.5 mmol/L, the proportion of 66.7% LDL-CU HDL-L was less than 1 mmol/L, In saccharified hemoglobin, 33.3% and more than 9% of them had symptoms and syndromes of traditional Chinese medicine: phlegm dampness group was prone to hunger and eating, obesity, dry mouth, cold drink, Deutzia constipation, yellow and greasy tongue coating, In the cluster analysis of TCM symptoms such as pulse-string slippage and other TCM symptoms, the symptoms with the highest coverage were obesity in form, cold drink in dry mouth, flatulence in abdomen and slippery pulse in abdomen. There was body obesity and numbness of limbs associated with phlegm and dampness. In the syndromes, phlegm dampness syndrome is more likely to appear phlegm heat mutual knot syndrome, while liver and kidney yin deficiency syndrome, yin and yang deficiency syndrome has the lowest ratio. Phlegm dampness and phlegm heat mutual junction syndrome are positively correlated; There was a significant negative correlation between liver and kidney yin deficiency syndrome and phlegm dampness group, and the proportion of phlegm and dampness was similar in syndrome deficiency group. Conclusion in type 1.2 diabetes mellitus, phlegm dampness is more common in elderly patients, overweight and obese patients are the main ones. Phlegm and dampness ran through the whole course of diabetes; patients preferred greasy food and tended to be addicted to tobacco and alcohol .2.The patients' postprandial blood sugar was higher, triglyceride level was on the high side, glycosylated hemoglobin control was not ideal or poor, and the condition was not optimistic. Complications such as diabetic retinopathy and hypertension are more likely to occur. The most common symptoms of type 3.2 diabetes patients with phlegm and dampness are obesity, dry mouth and cold drink, abdominal distension, and so on, which need to be actively treated with diabetes education and early intervention. In clinic, phlegm dampness patients are more prone to phlegm heat syndromes.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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