摘要
目的:探讨胰岛素抵抗在2型糖尿病中医证型分布情况,为2型糖尿病中医辨证提供客观指标。方法:选择2型糖尿病患者180例为研究对象,按中医辨证分为阴虚燥热,湿热困脾和阳虚湿瘀3型。另选60名健康体检者为正常对照组,测定身高、体质量、空腹血糖(FPG)、空腹胰岛素(FINS)、糖基化血红蛋白(HbA1C)、甘油三脂(TG)、胆固醇(TC)等,并计算体质量指数(BMI),胰岛素敏感指数(ISI),将这些客观指标与中医证型对应起来,探讨不同证型的特点和分布规律。结果:湿热困脾型最为多见,阴虚燥热型病程最短。各组ISI均显著低于健康对照组(P<0.01),湿热困脾型最低;2型糖尿病患者的BMI,HbA1C均高于健康对照组,湿热困脾型最高,TC、TG湿热困脾型均高于其它证型。结论:2型糖尿病的中医证型有从阴虚燥热证经湿热困脾证向阳虚湿瘀证发展的趋势,胰岛素抵抗的程度随着病程的发展而呈现出先升高后降低的变化,湿热困脾型在2型糖尿病患者中所占的比例最高,且存在严重的胰岛素抵抗。血脂代谢紊乱在胰岛素抵抗发生过程起着重要的作用。
This paper aims to discuss the distribution status of insulin resistance in TCM syndromes of Type 2 diabetes mellitus and to provide objective indicators for TCM syndrome differentiation of Type 2 diabetes mellitus.The research methods of the paper involve：Select 180 cases of Type 2 diabetes mellitus as subjects to be investigated and divide them into three groups of yin-deficiency dryness-heat, dampness-heat distressing spleen and yang-deficiency dampness-stasis.Another 60 healthy cases are selected as comparison group. Indicators such as height,body mass,asting plasma glucose （FPG）,fasting insulin （FINS）, glycosylated hemoglobin （HbA1C）, three acids glyceride（TG）,cholesterol （TC） etc,are tested and body mass index （BMI） ,insulin sensitivity index （ISI） are calculated.The comparisons are made between such objective indices and TCM syndromes to discuss the features and distribution rules of TCM syndromes.The results show that the dampness-heat distressing spleen type is the most common; the yin-deficiency dryness-heat type has the shortest course of diseases.The ISI in each group is lower than that of the healthy comparison group （P0.01）,of which the dampness-heat distressing spleen type is the lowest.The BMI and HbA1C of Type 2 diabetes mellitus sufferers are higher than that of the healthy comparison group,of which the dampness-heat distressing spleen type is the highest. The TC and TG indicators of dampness-heat distressing spleen type are higher than other TCM syndromes.Therefore conclusions are made that, the TCM syndromes of Type 2 diabetes mellitus is representing a trend from yin- deficiency dryness-heat to dampness-heat distressing spleen and then to yang-deficiency dampness-stasis.The insulin resistance represents a trend of first rising then declining.The proportion of the dampness-heat distressing spleen type is the greatest in the Type 2 diabetes mellitus sufferers with serious insulin resistance.The metabolism disorder of lipid is playing an important role in the course of insulin resistance.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2010年第8期1318-1320,共3页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
福建省卫生厅青年科研基金资助项目(No.2002-1-13)~~
关键词
2型糖尿病
中医辨证
胰岛素抵抗
Type 2 diabetes
TCM syndrome differentiation
Insulin resistance
