2型糖尿病及其并发症患者中医证候规律研究
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摘要
目的:探讨2型糖尿病及其并发症患者的中医证候规律。方法:查阅2003年1月至2014年12月广东省中医院住院病案系统第一诊断为2型糖尿病及相关并发症的患者11,421例,运用SPSS17.0统计软件进行频数分析和对应分析,找寻2型糖尿病及其并发症的中医病名、证型分布、证素规律、辨证方法及相关因素。结果:2型糖尿病对应的中医病名为消渴,2型糖尿病伴神经并发症对应的中医病名为消渴筋痹,2型糖尿病足病对应的中医病名为消渴脱疽,2型糖尿病肾病对应的中医病名为消渴肾病,2型糖尿病足病和2型糖尿病肾病对应的中医病名为水肿,2型糖尿病伴眼并发症对应的中医病名为视瞻昏渺;主要证型为气阴两虚血瘀和气阴两虚证;湿热瘀阻,气阴两虚为基本病机;病性证素主要为气虚、阴虚、湿、热、痰、浊、血瘀;病位证素主要为脾、胃、肾;辨证方法以八纲辨证和气血辨证为主,以脏腑辨证和病因辨证为辅。结论:2型糖尿病及其并发症患者基本病机为气阴两虚,病位证素主要为脾、胃、肾,病性证素主要为湿、热、痰、浊、瘀等。
Objective: To investigate the rule of TCM syndromes in type 2 diabetes mellitus and its complications. Methods: We searched the hospital records database of Guangdong hospital of TCM, to screen out 11,421 patients whose first diagnosis is type 2 diabetes mellitus and related complications from January 2003 to December 2014. Using frequency analysis and correspondence analysis with SPSS17.0 statistical software. The TCM disease name, syndrome distribution, syndrome element rule, syndrome differentiation method and related factors of type 2 diabetes mellitus and its complications were investigated. Result: The TCM disease name of Type 2 diabetes is corresponding to "Xiaoke", the TCM disease name of Type 2 diabetes with neurological complications is corresponding to "Xiaoke Jinbi", the TCM disease name of Type 2 diabetes with Type 2 diabetic foot disease is corresponding to "Xiaoke Tuoju", the TCM disease name of Type 2 diabetes with Type 2 nephropathy is corresponding to "Xiaoke kidney disease", the TCM disease name of Type 2 diabetic foot disease and type 2 diabetic nephropathy is corresponding to "edema", the TCM disease name of Type 2 diabetes with ocular complications is corresponding to "Shizhan Hunmiao". The main syndrome are Qi and Yin deficiency and blood stasis, Qi and Yin deficiency. The basic pathogenesis are damp heat and blood stasis, deficiency of Qi and Yin. The main syndrome elements of disease are Qi deficiency, Yin deficiency, dampness, heat, phlegm,turbidity and blood stasis. The main location elements of the disease are spleen, stomach and kidney. The method of syndrome differentiation is mainly composed of eight-principle pattern identification and Qi-blood pattern identificationand, bowel and visceral pattern identification and disease cause pattern identification are auxiliary. Conclusion: The basic pathogenesis of type 2 diabetes and its complications are deficiency of Qi and Yin,and the main location elements of the disease are spleen, stomach and kidney. The main syndrome elements of the disease are damp, heat, phlegm, turbidity and stasis.
Objective: To investigate the rule of TCM syndromes in type 2 diabetes mellitus and its complications. Methods: We searched the hospital records database of Guangdong hospital of TCM, to screen out 11,421 patients whose first diagnosis is type 2 diabetes mellitus and related complications from January 2003 to December 2014. Using frequency analysis and correspondence analysis with SPSS17.0 statistical software. The TCM disease name, syndrome distribution, syndrome element rule, syndrome differentiation method and related factors of type 2 diabetes mellitus and its complications were investigated. Result: The TCM disease name of Type 2 diabetes is corresponding to "Xiaoke", the TCM disease name of Type 2 diabetes with neurological complications is corresponding to "Xiaoke Jinbi", the TCM disease name of Type 2 diabetes with Type 2 diabetic foot disease is corresponding to "Xiaoke Tuoju", the TCM disease name of Type 2 diabetes with Type 2 nephropathy is corresponding to "Xiaoke kidney disease", the TCM disease name of Type 2 diabetic foot disease and type 2 diabetic nephropathy is corresponding to "edema", the TCM disease name of Type 2 diabetes with ocular complications is corresponding to "Shizhan Hunmiao". The main syndrome are Qi and Yin deficiency and blood stasis, Qi and Yin deficiency. The basic pathogenesis are damp heat and blood stasis, deficiency of Qi and Yin. The main syndrome elements of disease are Qi deficiency, Yin deficiency, dampness, heat, phlegm,turbidity and blood stasis. The main location elements of the disease are spleen, stomach and kidney. The method of syndrome differentiation is mainly composed of eight-principle pattern identification and Qi-blood pattern identificationand, bowel and visceral pattern identification and disease cause pattern identification are auxiliary. Conclusion: The basic pathogenesis of type 2 diabetes and its complications are deficiency of Qi and Yin,and the main location elements of the disease are spleen, stomach and kidney. The main syndrome elements of the disease are damp, heat, phlegm, turbidity and stasis.
引文
[1]《中国2型糖尿病防治指南》编写组.中国2型糖尿病防治指南[M].北京:北京大学医学出版社,2013:1-2.
[2]庞博,赵进喜,王世东,等.施今墨诊疗糖尿病学术思想与临证经验[J].世界中医药杂志,2013,8(1):60-61.
[3]庞博,赵进喜,王世东,等.祝谌予诊疗糖尿病学术思想与临证经验[J].世界中医药杂志,2013,8(2):174-175.
[4]肖永华.吕仁和教授治疗糖尿病学术思想及其传承方法的研究[D].北京:北京中医药大学,2007.
[5]龙艳,邹冬吟,沈歆,等,范冠杰教授以“动—定序贯八法”辨治消渴病经验[J].广州中医药大学学报,2013,30(2):255-257.
[6]魏军平.林兰教授糖尿病三型辨证学术思想渊源与临床经验整理研究[D].北京:中国中医科学研究院,2012.
[7]赵进喜,丁英钧,王颖辉,等.辨体质、辨病、辨证“三位一体”诊疗模式与糖尿病临床实践[J].中华中医药杂志,2009,24(8):994-998.
[8]肖永华,王世东,李靖,等.吕仁和教授辨治糖尿病医案数据挖掘分析[J].北京中医药大学学报(中医临床版),2009,16(3):1-4.
[9]陈艳,龚婕宁.王灿晖教授论糖尿病病机与治则[J].吉林中医药杂志,2011,31(6):515-517.
[10]高华,胡晓灵.试述痰浊瘀毒在糖尿病病机演变过程中的作用[J].世界中西医结合杂志,2008,3(7):425-426.
[11]李静.糖尿病的中医病机研究进展[J].辽宁中医药大学学报,2010,12(6):147-148.
[12]黄国庆.浅论中医脾脏与糖尿病[J].江苏中医药杂志,2016,48(5):10-11.
[13]杨彬,张兰.从脾胃论治糖尿病[J].长春中医药大学学报,2008,24(5):510-511.
[14]刘振杰,熊莉华,范冠杰.浅谈糖尿病从脾胃论治[J].新中医,2006,38(8):84-85.
[15]赵丹丹,高思华,穆倩倩,等.肝脾肾同调辨治2型糖尿病的理论依据与特色[J].中医杂志,2014,55(3):205-207.
[2]庞博,赵进喜,王世东,等.施今墨诊疗糖尿病学术思想与临证经验[J].世界中医药杂志,2013,8(1):60-61.
[3]庞博,赵进喜,王世东,等.祝谌予诊疗糖尿病学术思想与临证经验[J].世界中医药杂志,2013,8(2):174-175.
[4]肖永华.吕仁和教授治疗糖尿病学术思想及其传承方法的研究[D].北京:北京中医药大学,2007.
[5]龙艳,邹冬吟,沈歆,等,范冠杰教授以“动—定序贯八法”辨治消渴病经验[J].广州中医药大学学报,2013,30(2):255-257.
[6]魏军平.林兰教授糖尿病三型辨证学术思想渊源与临床经验整理研究[D].北京:中国中医科学研究院,2012.
[7]赵进喜,丁英钧,王颖辉,等.辨体质、辨病、辨证“三位一体”诊疗模式与糖尿病临床实践[J].中华中医药杂志,2009,24(8):994-998.
[8]肖永华,王世东,李靖,等.吕仁和教授辨治糖尿病医案数据挖掘分析[J].北京中医药大学学报(中医临床版),2009,16(3):1-4.
[9]陈艳,龚婕宁.王灿晖教授论糖尿病病机与治则[J].吉林中医药杂志,2011,31(6):515-517.
[10]高华,胡晓灵.试述痰浊瘀毒在糖尿病病机演变过程中的作用[J].世界中西医结合杂志,2008,3(7):425-426.
[11]李静.糖尿病的中医病机研究进展[J].辽宁中医药大学学报,2010,12(6):147-148.
[12]黄国庆.浅论中医脾脏与糖尿病[J].江苏中医药杂志,2016,48(5):10-11.
[13]杨彬,张兰.从脾胃论治糖尿病[J].长春中医药大学学报,2008,24(5):510-511.
[14]刘振杰,熊莉华,范冠杰.浅谈糖尿病从脾胃论治[J].新中医,2006,38(8):84-85.
[15]赵丹丹,高思华,穆倩倩,等.肝脾肾同调辨治2型糖尿病的理论依据与特色[J].中医杂志,2014,55(3):205-207.
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