【摘要】：目的:分析中醫(yī)證型分布規(guī)律,并調查患者相關臨床資料,探討相關指標與各證型間的相關性,以期總結中醫(yī)證型分布規(guī)律,了解各危險成分于各證型中具體表現(xiàn),進而對其發(fā)展變化做深入分析與探索,期于中醫(yī)辨證治療DPN提供理論、臨床基礎。材料與方法:選取2015年2月至2016年1月我院內(nèi)分泌科診治的DPN患者160例為研究對象,據(jù)《糖尿病中醫(yī)防治指南》DPN中醫(yī)辨證以及相關診斷標準明確診斷。且進行辨證分型,具體包含:肝腎虧虛證、痰瘀阻絡證、陰虛血瘀證、氣虛血瘀證。記錄所有患者的年齡,性別,體重指數(shù),糖尿病病程,糖化血紅蛋白,甘油三脂,高、低密度脂蛋白等指標,將之與不同分型做相關性分析。結果:1.所選160例DPN患者中,男性64例,女性96例,分別占比40%、60%。其中肝腎虧虛證52例(32.5%);痰瘀阻絡證32例(20%);氣虛血瘀證28例(17.5%);陰虛血瘀證48例(30%)。不同證型患者的性別比無明顯差異,無統(tǒng)計學意義(P0.05)。2.各組間兩兩比較,肝腎虧虛證年齡與陰虛血瘀證、氣虛血瘀證年齡相比差異顯著有統(tǒng)計學意義(P0.05),表明肝腎虧虛證組年齡較陰虛血瘀證、氣虛血瘀證大。痰瘀阻絡證年齡與氣虛血瘀證年齡相比差異顯著有統(tǒng)計學意義(P0.05);而肝腎虧虛證、痰瘀阻絡證兩組間年齡相比無顯著性差異(P0.05)。氣虛血瘀證與陰虛血瘀證兩組間相比無顯著性差異,不具有統(tǒng)計學意義。(P0.05)。3.各證型患者的體重指數(shù)比較,痰瘀阻絡證氣虛血瘀證陰虛血瘀證肝腎虧虛證;其中兩組間比較提示痰瘀阻絡證組與肝腎虧虛證組相比差異顯著(P0.01),痰瘀阻絡證組與其他各組相比有差異(P0.05),肝腎虧虛證組與氣虛血瘀證組相比差異顯著(P0.05),肝腎虧虛證組與陰虛血瘀證組相比差異顯著(P0.05),而氣虛血瘀證組與陰虛血瘀證組相比無顯著性差異(P0.05)。4.各證型患者病程比較,肝腎虧虛證痰瘀阻絡證陰虛血瘀證氣虛血瘀證。各組間兩兩比較,肝腎虧虛證病程與氣虛血瘀證及陰虛血瘀證相比差異顯著有統(tǒng)計學意義(P0.05);而肝腎虧虛證與痰瘀阻絡證組間病程相比無顯著性差異(P0.05);痰瘀阻絡證與氣虛血瘀證、陰虛血瘀證之間相比有顯著差異(P0.05);氣虛血瘀證組與陰虛血瘀證組間病程相比無明顯差異(P0.05)。5.各證型血糖相關指標如空腹血糖、餐后2小時血糖、糖化血紅蛋白比較,結果顯示陰虛血瘀證患者的空腹血糖、餐后2小時血糖為所有證型中最高,且與肝腎虧虛證組患者比較差異顯著(P0.05);不同證型患者的糖化血紅蛋白水平均高于正常值,陰虛血瘀證患者最高,痰瘀阻絡證次之,肝腎虧虛最低;其中陰虛血瘀證與肝腎虧虛證組患者比較差異顯著(P0.05),其余各組間比較無顯著差異(P0.05)。6.各證型血脂相關指標如TC、TG、HDL-C與LDL-C比較,結果顯示TC方面,陰虛血瘀證組的TC較高,與氣虛血瘀證組和肝腎虧虛證組的比較有顯著性差異具有有統(tǒng)計學意義(P0.05),與痰瘀阻絡證組比較無顯著性差異(P0.05),而氣虛血瘀證組、肝腎虧虛證組與痰瘀阻絡證組三組之間比較差異不顯著(P0.05);LDL-C方面,以陰虛血瘀證組最高,與氣虛血瘀證組比較有顯著性意義(P0.05),其余各組間比較無顯著性差異(P0.05);TG、HDL-C方面,痰瘀阻絡證組的TG、HDL-C值均較高,但各組間兩兩比較差異均不顯著(P0.05)。結論:1.糖尿病周圍神經(jīng)病變中醫(yī)證型分布由多到少依次為肝腎虧虛證,陰虛血瘀證,痰瘀阻絡證,氣虛血瘀證。2.肝腎虧虛型糖尿病周圍神經(jīng)病變病程較長且年齡偏大。3.痰瘀阻絡型患者BMI均值明顯高于其他各組。4.不同證型組間均存在不同程度的血糖、血脂異常。
[Abstract]:Objective: To analyze the distribution of TCM syndromes, investigate the clinical data of patients, and explore the correlation between the relevant indicators and syndromes, so as to summarize the distribution of TCM syndromes, to understand the specific manifestations of various dangerous components in each syndromes, and to make in-depth analysis and exploration of its development and change, so as to provide theory and clinical evidence for the treatment of DPN by TCM syndrome differentiation. Materials and Methods: 160 cases of DPN diagnosed and treated in the Department of Endocrinology of our hospital from February 2015 to January 2016 were selected as the research object, and the diagnosis was made according to the syndrome differentiation of traditional Chinese medicine and relevant diagnostic criteria. The age, sex, body mass index, course of diabetes, glycosylated hemoglobin, triglyceride, high, low density lipoprotein and other indicators of all patients were recorded and correlated with different types. Results: 1. Among 160 DPN patients, 64 were males and 96 were females, accounting for 40% and 60% respectively. There was no significant difference in sex ratio among different syndrome types (P 0.05). 2. There was significant difference between the age of liver and kidney deficiency syndrome and yin deficiency and blood stasis syndrome, and the age of qi deficiency and blood stasis syndrome was significantly different (P 0.05). The age of phlegm-stasis obstructing collateral syndrome was significantly different from that of Qi-deficiency and blood-stasis syndrome (P 0.05), but there was no significant difference between the two groups of liver-kidney deficiency and phlegm-stasis obstructing collateral syndrome (P 0.05). 3. Comparing the body mass index of the patients with different syndrome types, the syndrome of phlegm-stasis obstructing collaterals with Qi deficiency and blood stasis with Yin deficiency and blood stasis with liver and kidney deficiency syndrome is of deficiency of liver and kidney; the comparison between the two groups indicates that there is a significant difference between the syndrome of phlegm-stasis obstructing collaterals and the syndrome of liver and kidney deficiency (P 0.01), the syndrome of phlegm-stasis obstructing collaterals is different from the other groups (P 0.05 Significant (P 0.05), liver and kidney deficiency syndrome group and Yin deficiency and blood stasis syndrome group was significantly different (P 0.05), but Qi deficiency and blood stasis syndrome group and Yin deficiency and blood stasis syndrome group was no significant difference (P 0.05). 4. Comparing the course of disease of each syndrome type, liver and kidney deficiency syndrome of phlegm and blood stasis syndrome of Yin deficiency and blood stasis syndrome. Stasis syndrome and yin deficiency and blood stasis syndrome were significantly different (P 0.05); liver and kidney deficiency syndrome and phlegm stagnation collateral syndrome were not significantly different (P 0.05); phlegm stagnation collateral syndrome and Qi deficiency and blood stasis syndrome, Yin deficiency and blood stasis syndrome were significantly different (P 0.05); Qi deficiency and blood stasis syndrome and yin deficiency and blood stasis syndrome were not significantly different (P 0.05); The results showed that the fasting blood glucose of the patients with Yin deficiency and blood stasis syndrome and the blood glucose of 2 hours after meal were the highest among all the syndrome types, and there was significant difference between the patients with liver and kidney deficiency syndrome and the patients with different syndrome types (P 0.05). Compared with the normal value, the patients with Yin deficiency and blood stasis syndrome were the highest, phlegm and blood stasis obstructing collaterals syndrome was the second, liver and kidney deficiency was the lowest; the difference between the patients with Yin deficiency and blood stasis syndrome and the patients with liver and kidney deficiency syndrome was significant (P 0.05), and there was no significant difference between the other groups (P 0.05). 6. TC in group A was higher than that in group B (P 0.05), but there was no significant difference between group B (P 0.05), group B (P 0.05), group B (P 0.05), and group B (P 0.05). Syndrome group was the highest, compared with Qi deficiency and blood stasis syndrome group, there was significant difference (P 0.05), there was no significant difference between the other groups (P 0.05); TG, HDL-C, the phlegm stasis collateral syndrome group TG, HDL-C values were higher, but there was no significant difference between the two groups (P 0.05). Conclusion: 1. Diabetic peripheral neuropathy of traditional Chinese medicine syndrome distribution from more to less in turn is liver. Kidney deficiency syndrome, Yin deficiency and blood stasis syndrome, phlegm and blood stasis syndrome, Qi deficiency and blood stasis syndrome. 2. Liver and kidney deficiency diabetes mellitus peripheral neuropathy longer course and older. 3. Phlegm and blood stasis collateral type patients BMI was significantly higher than other groups. 4. There were different degrees of blood glucose and blood lipid abnormalities between different syndrome groups.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259;R277.7

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