本文選題：2型糖尿病 + 骨質(zhì)疏松癥��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的研究2型糖尿病合并骨質(zhì)疏松癥患者的體質(zhì)分布,分析其流行病學(xué)特征,探討不同中醫(yī)體質(zhì)患者的異同。從而為臨床中辨中醫(yī)體質(zhì)論治提供有效數(shù)據(jù)和客觀依據(jù),為2型糖尿病合并骨質(zhì)疏松癥預(yù)防和治療的研究提供新的思路和方案。方法選擇2015年1月至2016年12月在深圳市寶安中醫(yī)院門診、住院部及體檢中心就醫(yī)并確診為2型糖尿病合并骨質(zhì)疏松癥的患者,應(yīng)用調(diào)查問卷(包括調(diào)查人協(xié)助填寫和被調(diào)查人自填)的方法,使用王琦《中醫(yī)體質(zhì)分類與判定表》作為標(biāo)準(zhǔn),按照納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn)收集病例212份,患者同意后進(jìn)行體質(zhì)判定,記錄患者一般信息及疾病相關(guān)信息(年齡、性別、職業(yè)、教育、婚姻、飲食、運動、病程、BMD、VAS等),記錄數(shù)據(jù),運用SPSS 22.0進(jìn)行數(shù)據(jù)處理和分析。對深圳市寶安中醫(yī)院2型糖尿病合并骨質(zhì)疏松癥患者進(jìn)行中醫(yī)體質(zhì)的相關(guān)調(diào)查。結(jié)果本研究共收集T2DM合并OP病例212份,陰虛質(zhì)54例(26%)、瘀血質(zhì)38例(18%)、陽虛質(zhì)32例(15%)、痰濕質(zhì)28例(13%)、其他體質(zhì)歸為一組共60例(28%);以P0.05,為檢驗的結(jié)果有統(tǒng)計學(xué)意義。T2DM合并OP患者中無職業(yè)者(44.3%)和體力勞動者(37.7%),腦力勞動者最少(18%),無職業(yè)者中較多是陰虛質(zhì)(28.7%)、陽虛質(zhì)(22.3%),體力勞動患者中瘀血質(zhì)(23.8%)和其他體質(zhì)(36.3%)較多;T2DM合并OP患者中喜清淡飲食患者共(68.4%)較多,喜食高熱量患者(31.6%)較少,喜食高熱量患者中痰濕質(zhì)(23.9%)最多;本病中無(48%)或每周1-2次運動習(xí)慣(33%)患者較多,每周3次或以上運動患者(18.4%)較少,其中無(31.4%)或每周1-2次運動習(xí)慣患者陰虛質(zhì)較多(22.5%),每周1-2次運動習(xí)慣患者中瘀血質(zhì)(28.2%)較多;不同性別、婚姻狀況和受教育程度的T2DM合并OP患者中的中醫(yī)體質(zhì)分布的無顯著差異(P0.05);所有患者平均年齡為63.68±4.98歲,陰虛質(zhì)的患者(64.13±5.26)歲普遍較瘀血質(zhì)患者(61.92±4.97)年齡要大,陽虛質(zhì)患者(65.94±5.00)較陰虛質(zhì)患者(64.13±5.26)以外所有體質(zhì)患者年齡大;患者病程多為5-10年(51%),病程短于5年或長于10年的少(21%,28%),陰虛質(zhì)和陽虛質(zhì)患者病程大于10年及以上的比例明顯更大(43%,500%),而瘀血質(zhì)患者大于10年病程的明顯更少(13%),痰濕質(zhì)和其他體質(zhì)患者大于10年病程的比例相對也偏小(21%,15%);所有患者骨密度為0.64±0.10g/m2,陰虛質(zhì)患者0.61±0.11g/m2的骨量較瘀血質(zhì)0.68±0.09g/m2和痰濕質(zhì)患者0.68±0.11g/m2更低,瘀血質(zhì)患者0.68±0.09g/m2骨量較陰虛質(zhì)0.61 ±0.11g/m2、陽虛質(zhì)0.59±0.10g/m2及其他體質(zhì)患者0.64±0.09g/m2都要高,陽虛質(zhì)患者0.59±0.10g/m2骨量較除陰虛質(zhì)以外所有體質(zhì)患者更低;所有患者VAS評分為5.03± 1.49,相比起其他任何體質(zhì),瘀血質(zhì)患者6.08±1.38疼痛程度更高。結(jié)論1、絕大部分T2DM合并OP患者是偏頗體質(zhì),最多是陰虛質(zhì),其次依次為瘀血、陽虛、痰濕以及其他體質(zhì)。2、不同職業(yè)、飲食偏好、運動習(xí)慣與T2DM合并OP患者不同的體質(zhì)有關(guān)系,大部分患者無工作、飲食清淡、運動少,無工作者多虛弱者,體力勞動者體質(zhì)多實多瘀,喜高熱量飲食患者更多痰濕,運動多的患者更多瘀血質(zhì),運動少的患者更多為虛弱者,不同性別、婚姻情況和教育情況與中醫(yī)體質(zhì)無明顯關(guān)系。3、不同中醫(yī)體質(zhì)的T2DM合并OP病人年齡、病程、骨量、疼痛有差異,虛弱體質(zhì)患者年齡更高、病程更長、骨量更低,體質(zhì)實者年齡更低、病程更短、骨量更高,瘀血質(zhì)的患者明顯更痛。
[Abstract]:Objective to study the physical distribution of patients with type 2 diabetes and osteoporosis, to analyze the epidemiological characteristics and to explore the similarities and differences of patients with different physique of traditional Chinese medicine, so as to provide effective data and objective basis for the clinical treatment of TCM Constitution, and to provide new ideas and plans for the study of pre prevention and treatment of type 2 diabetes with osteoporosis. Methods from January 2015 to December 2016, the patients with type 2 diabetes combined with osteoporosis were hospitalized in the outpatient department of the Baoan traditional Chinese Medicine Hospital of Shenzhen City, the hospitalization department and the medical examination center. The questionnaire (including the investigators assisting in filling out and the self filled) was used, and Wang Qi was used as the standard for the classification and decision table of Chinese medicine. Inclusion criteria, excluding 212 cases of standard collection cases, the patient's consent after the constitution, records of general information and disease related information (age, sex, occupation, education, marriage, diet, exercise, course of disease, BMD, VAS, etc.), record data, use SPSS 22 for data processing and analysis of type 2 diabetes combined with bone in Baoan Hospital of Shenzhen A total of 212 cases of T2DM combined with OP, 54 cases of yin deficiency (26%), 38 cases of blood stasis (18%), 32 cases of Yang deficiency (15%), 28 cases of phlegm dampness (13%), and a group of 60 cases (28%), and the results of P0.05 were statistically significant in.T2DM combined with no occupations in OP patients. 44.3%) and manual labourers (37.7%), the mental labourers were least (18%), and most of the non occupations were Yin deficiency (28.7%), Yang deficiency (22.3%), blood stasis (23.8%) and other physique (36.3%) in physical labor patients. The patients with T2DM combined with OP were more happy with light diet (68.4%), and more calorie patients (31.6%) were happy to eat high calorie patients. Medium phlegm and wet quality (23.9%) was the most; there were no (48%) or 1-2 exercise habits (33%) per week, and 3 or more exercise patients (18.4%) per week (18.4%), of which there was no (31.4%) or 1-2 exercise weekly patients with more yin deficiency (22.5%), and 1-2 times per week of 1-2 exercise habits (28.2%); different sex, marital status and education. There was no significant difference in the physical distribution of Chinese medicine in patients with T2DM combined with OP (P0.05); the average age of all patients was 63.68 + 4.98 years old, and the patients with Yin deficiency (64.13 + 5.26) years were generally older than those of blood stasis (61.92 + 4.97), and the patients with Yang deficiency (65.94 + 5) were older than those of the yin deficiency patients (64.13 + 5.26). The course of disease was 5-10 years (51%), the course of disease was shorter than 5 years or less than 10 years (21%, 28%). The proportion of patients with Yin deficiency and yang deficiency was greater than 10 years and above (43%, 500%), while the patients with blood stasis were significantly less than 10 years (13%), and the proportion of phlegm and other constitution patients was smaller than that of 10 years (21%, 15%); The bone density of the patients was 0.64 + 0.10g/m2, and the bone mass of the patients with Yin deficiency 0.61 + 0.11g/m2 was 0.68 + 0.09g/m2 and 0.68 + 0.11g/m2 in the phlegm dampness. The 0.68 + 0.09g/m2 bone quantity of the blood stasis patients was 0.61 + 0.11g/m2, the 0.59 + 0.10g/m2 of Yang deficiency and the 0.64 + 0.09g/m2 of the other constitution patients were higher, and the patients of Yang deficiency were 0.59 + 0.10g/m2 The bone mass was lower than that of all physical patients except Yin deficiency; the VAS score of all patients was 5.03 + 1.49. Compared with any other constitution, the pain degree of the patients with blood stasis was 6.08 + 1.38. Conclusion 1, most of the T2DM patients with OP were biased constitution, most of which were Yin deficiency, followed by blood stasis, Yang deficiency, phlegm dampness and other physique.2, different positions. Industry, diet preference and exercise habits are related to the different physique of patients with T2DM combined with OP. Most patients have no work, light diet, less exercise, less workers, more physical and more blood stasis, more patients with high calorie diet, more phlegm in the patients with high calorie diet, more blood stasis in the patients with more exercise, and more debilitating and different in the patients with less exercise. There is no obvious relationship between the marital status and education situation and the constitution of Chinese medicine.3. The T2DM of different Chinese medicine constitution combined with the age of the OP patients, the course of the disease, the bone mass and the pain, the age of the debilitating body is higher, the course of the disease is longer, the bone mass is lower, the age of the body is lower, the course is shorter, the bone mass is higher, and the patients with blood stasis are obviously more painful.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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