北京市糖耐量异常和糖尿病危险因素及中医证候流行病学调查
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摘要
本文系统概括了近年来关于糖耐量异常和糖尿病的中医研究进展、危险因素的流行病学调查研究进展,并依托北京市中医药重大科技项目——北京社区2型糖尿病中医证候检测点建设与干预的示范研究,在导师魏军平副主任医师的指导下,对北京市的糖耐量异常及糖尿病的基本情况进行了流行病学调查,以明确北京市社区20岁以上居民糖耐量异常(Impaired Glucose Tolerant,IGT)与糖尿病(Diabetes mellitus,DM)的患病率及其危险因素、并发症发生情况以及二者的中医证候分布情况。
于2007年6-9月,采用随机、分层、整群抽样的方法,调查北京市常住居民5 465人IGT与DM的患病情况。结果显示:(1)IGT患病率为8.70%;DM患病率为为11.95%。(2)新发现DM344例,占总糖尿病患者的32.45%。(3)IGT组合并高血压、脂代谢紊乱、肥胖(含超重)分别为32.88%,24.18%和72.79%;DM组合并高血压、脂代谢紊乱、肥胖(含超重)分别为42.35%,34.39%,和72.7%。(4)糖尿病家族史:IGT患者有18.52%的人有家族史;DM患者有33.96%的人有家族史;(5)非条件logistic多元逐步回归分析显示,家族史、体重指数、腰臀比、高血脂病史、高血压病史、年龄和吸烟为IGT患者独立危险因素;家族史、WHR、高血脂病史、高血压病史、年龄、高收缩压、运动频率和饮酒年限为DM患者独立的危险因素;每次饮酒量和单次运动时间为保护因素。(6)IGT人群依据虚实辨证病机出现的频率从大到小依次为:气滞、痰湿、血瘀、实热、阴虚、阳虚、气虚、血虚,肥胖与非肥胖IGT实证皆以气滞、痰湿多见,虚证中肥胖IGT以阴虚、阳虚多见;非肥胖以气虚、血虚多见;T2DM患者中以痰热互结证最多见,其次为气阴两虚、热盛伤津证,肝肾阴虚证和阴阳两虚证少见。
从调查结果可以看出,北京市社区居民IGT和DM的患病率与年龄增长呈正相关;二者均有明显的家族遗传倾向。IGT和DM患者均易合并高血压、肥胖和脂代谢紊乱。防治IGT和DM的关键在于对肥胖,高血压,脂代谢紊乱以及吸烟等危险因素的控制。本调查为深入T2DM的中医理论及治则治法研究奠定坚实基础。中医药干预IGT是预防糖尿病的重要措施,需密切关注无症状IGT的诊治。
The whole essay discusses the cognition and comprehensive of Impaired Glucose Tolerant (IGT) and Diabetes mellitus (DM) by traditional Chinese medicine, we took a Epidemiology survey in Beijing about IGT and DM, which based on the TCM technological article of Beijing—the foundation of syndrome manifestation on type 2 diabetes mellitus in Beijing community and guided by Doctor Wei Junping,in order to detect prevalence and risk factors of IGT and DM in residents over 20 in communities of Beijing.
The stratified random and cluster sampling was applied in this study, which was about the prevalence, risk factors and complication of IGT and DM among the 5465 residents in Beijing. We got the Results following: 1. The prevalence of IGT and DM are 8.70% and 11.95% respectively. 2. 344 residents were diagnosed in this study, the new cases were 33.63% of all diabetics found in this study. 3.Among IGT group, 32.88% was with hypertension, 24.18% with lipid metabolism disorder, and 72.79% with obesity (including overweight). While in DM group, 42.35%, 34.39% and 72.70% respectively. 4.DM family history: Among IGT group, 18.25% got DM family history, while in DM was 33.96%. 5. As is shown in logistic Multi-element Regression Statistics Step By Step, the independent risk factors of IGT contain family history, BMI, WHR, hyperlipidemia, hypertension, age and smoking.
In summary the prevalence of DM and IGT of Beijing has increased obviously compared with which in 1995-1997,it positive correlated with age. IGT and DM both have the genetic predisposition. Most of IGT and DM patients are accompanied with hypertension obesity and lipid metabolism disorder and obesity. It is vital for prevention of IGT and DM to control weight, blood pressure lipid and quit smoking.
于2007年6-9月,采用随机、分层、整群抽样的方法,调查北京市常住居民5 465人IGT与DM的患病情况。结果显示:(1)IGT患病率为8.70%;DM患病率为为11.95%。(2)新发现DM344例,占总糖尿病患者的32.45%。(3)IGT组合并高血压、脂代谢紊乱、肥胖(含超重)分别为32.88%,24.18%和72.79%;DM组合并高血压、脂代谢紊乱、肥胖(含超重)分别为42.35%,34.39%,和72.7%。(4)糖尿病家族史:IGT患者有18.52%的人有家族史;DM患者有33.96%的人有家族史;(5)非条件logistic多元逐步回归分析显示,家族史、体重指数、腰臀比、高血脂病史、高血压病史、年龄和吸烟为IGT患者独立危险因素;家族史、WHR、高血脂病史、高血压病史、年龄、高收缩压、运动频率和饮酒年限为DM患者独立的危险因素;每次饮酒量和单次运动时间为保护因素。(6)IGT人群依据虚实辨证病机出现的频率从大到小依次为:气滞、痰湿、血瘀、实热、阴虚、阳虚、气虚、血虚,肥胖与非肥胖IGT实证皆以气滞、痰湿多见,虚证中肥胖IGT以阴虚、阳虚多见;非肥胖以气虚、血虚多见;T2DM患者中以痰热互结证最多见,其次为气阴两虚、热盛伤津证,肝肾阴虚证和阴阳两虚证少见。
从调查结果可以看出,北京市社区居民IGT和DM的患病率与年龄增长呈正相关;二者均有明显的家族遗传倾向。IGT和DM患者均易合并高血压、肥胖和脂代谢紊乱。防治IGT和DM的关键在于对肥胖,高血压,脂代谢紊乱以及吸烟等危险因素的控制。本调查为深入T2DM的中医理论及治则治法研究奠定坚实基础。中医药干预IGT是预防糖尿病的重要措施,需密切关注无症状IGT的诊治。
The whole essay discusses the cognition and comprehensive of Impaired Glucose Tolerant (IGT) and Diabetes mellitus (DM) by traditional Chinese medicine, we took a Epidemiology survey in Beijing about IGT and DM, which based on the TCM technological article of Beijing—the foundation of syndrome manifestation on type 2 diabetes mellitus in Beijing community and guided by Doctor Wei Junping,in order to detect prevalence and risk factors of IGT and DM in residents over 20 in communities of Beijing.
The stratified random and cluster sampling was applied in this study, which was about the prevalence, risk factors and complication of IGT and DM among the 5465 residents in Beijing. We got the Results following: 1. The prevalence of IGT and DM are 8.70% and 11.95% respectively. 2. 344 residents were diagnosed in this study, the new cases were 33.63% of all diabetics found in this study. 3.Among IGT group, 32.88% was with hypertension, 24.18% with lipid metabolism disorder, and 72.79% with obesity (including overweight). While in DM group, 42.35%, 34.39% and 72.70% respectively. 4.DM family history: Among IGT group, 18.25% got DM family history, while in DM was 33.96%. 5. As is shown in logistic Multi-element Regression Statistics Step By Step, the independent risk factors of IGT contain family history, BMI, WHR, hyperlipidemia, hypertension, age and smoking.
In summary the prevalence of DM and IGT of Beijing has increased obviously compared with which in 1995-1997,it positive correlated with age. IGT and DM both have the genetic predisposition. Most of IGT and DM patients are accompanied with hypertension obesity and lipid metabolism disorder and obesity. It is vital for prevention of IGT and DM to control weight, blood pressure lipid and quit smoking.
引文
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