【作者】 曾晋阳；

【导师】 周国英；

【作者基本信息】 福建中医学院 ， 中医内科学， 2007， 硕士

【摘要】 背景：2型糖尿病的发生、发展与低度炎症反应密切相关。糖尿病血管病变与高血糖、高血压、高血脂、高血粘等众多因素有关，但在众多因素中脂代谢紊乱起着更为重要的作用。目的：通过观察2型糖尿病中医证型与CRP、血脂等相关指标，探讨它们之间的相互关系，为中医证型的判断提供客观依据，并为2型糖尿病及其并发症的预防及治疗提供临床思路。资料与方法：按WHO诊断标准，选择2型糖尿病患者101例为研究对象，按中医证型分为5组。阴虚热盛证24例，男11例，女13例，年龄54.41±6.32岁；气阴两虚31证例，男14例，女17例，年龄55.32±6.67岁；湿热困脾21证例，男9例，女12例，年龄55.04±7.03岁；血瘀脉络证18例，男11例，女7例，年龄55.72±4.76岁；阴阳两虚，血瘀水停证7例，男3例，女4例，年龄55.85±6.73岁；正常对照组31例，其中男17例，女14例，年龄55.85±6.73岁。CRP采用免疫增强的透射比浊法；血脂（甘油三酯TG、高密度脂蛋白HDL-C、总胆固醇TC）测定采用酶法；HbA₁C采用免疫增强胶乳浊度法；血糖测定采用葡萄糖氧化酶法。并在清晨测量血压。结果：1．在2型糖尿病患者证型之间年龄、血压不具可比的情况下（阴阳两虚，血瘀水停型因例数太少未列入讨论）：（1）．CRP比较结果：CRP与TC、TG、LDL-C呈正相关（P＜0.01），与HDL-C呈负相关（P＜0.05），与HbA₁C不相关。2．（1）①4型之间TC、TG、LDL-C比较趋势：血瘀脉络、湿热困脾＞气阴两虚＞阴虚热盛；②4型之间HDL-C比较结果：阴虚热盛、气阴两虚＞血瘀脉络、湿热困脾。（2）．4型之间HbA₁C比较结果：血瘀脉络＞湿热困脾＞气阴两虚、阴虚热盛。结论：在糖尿病中医证型中湿热、血瘀程度越严重，脂代谢紊乱程度越严重，且与炎症水平是相关的。更多还原

【Abstract】 Background: The occurrence and development of Type 2 diabetes mellitus has closely related to low grade inflammation.The vasculopathy of Type 2 diabetes mellitus was caused by the factor such as high blood sugar、hypertension, high blood lipid、high blood stickness and so on,but lipid metabolic disturbance rose more importance function than other factors.Objective: To provide objective evidence for the judgement of TCM’s syndromes and clinical idea for the precaution and treament for T2DM and its complication by observing the relationship between the TCM syndromes and c-reative protein.Materials and methods: According to WHO diagnosis criteria and TCM differentiation criteria, 101 cases were selected,and they were divided into 5 groups. Yin deficiency and heat excess syndrome （YDHES）:24cases（11male,13 female）, the average age was 54.41±6.32 years old; Qi and Yin deficiency syndrome （QYDS）:31 cases（14 male,17 female）, the average age was 55.32±6.67 years old; Moist Heat deficiency syndrome （MHDS）:21 cases（9 male,12 female）, the average age was 55.04±7.03 years old;Stagnated blood deficiency syndrome（SBDS）: 18 cases （11 male,7 female）, the average age was 55.72±4.67 years old ;Yin and Yang deficiency syndrome （YYDS）:7 cases（3 male,4 female）, the average age was 55.85±6.73 years old. Healthy people （17 male and 14 female） were taken as the control group, the average age was 55.85±6.73 years old. Then detected CRP by Elisa;triglyceride （TG）、high density lipoprotein-cholestcrol （HDL-C） and Total cholesterol（TC） by zymology; glycosylated hemoglobin（HbAiC） by microclumu chromatography ; fasting plasma glucose （FPG） by glucose oxidase.And measure blood presure in morning. Results: 1. Under the premise that keeping the age ,blood pressures of 4 TCM Differention Syndromes with out comparation（YYDS was not in the discussion because its cases is too few）:（1）.The degree of HbA₁C is as follow: SBDS〉MHDS〉QYDS、YDHES; （2）①. The degree of TG、TC、LDL are as follows: SBDS, MHDS〉QYDS〉YDHES;②. The degree of HDL is as follow: YDHES、QYDS〉SBDS、MHDS. 2. The level of CRP is closely positive correlated to TG、TC、LDL and negative correalated to HDL,but not correlated to HbA₁C.Conclusion: The higher of the degree of Type 2 Diabetes’ moist heat and stagnated blood,the more serious of lipid metabolic disturbance and inflamation.更多还原