摘要
目的:探讨新诊断2型糖尿病常见中医证型与合并非酒精性脂肪肝及其相关危险因素的关系,揭示两病中西医病因病机的相关性。方法:选取本院内分泌科住院的新诊断2型糖尿病患者222例,按其是否合并非酒精性脂肪肝分为两组。同时测定身高H、体重W、腰围WC、空腹血糖(FPG),餐后2h血糖(2hPBG),各项血脂指标:甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C),肝功(ALT、AST),空腹C-肽(FCP),2,C-肽(2hCP)、糖基化血红蛋白(HbA1c)、病毒性肝炎检测,并进行空腹肝脏彩超检查。计算体重指数(BMI)及胰岛素抵抗指数(HOMA-IR),用空腹C-肽代替胰岛素改良HOMA公式评价胰岛素抵抗。结果:(1)新诊断2型糖尿病合并非酒精性脂肪肝患者中医证型以虚实夹杂为主,以湿热困脾证、气阴两虚证多见,其次为阴虚热盛证、血瘀脉络证,阴阳两虚,血瘀水停证。(2)新诊断2型糖尿病合并脂肪肝组与无脂肪肝组各理化指标相比较,T2DM伴NAFLD组的BMI、WC、HOMA-IR(CP)、FCP、TG、TC明显高于单纯T2DM组(P<0.05)。T2DM伴NAFLD组的2hCP、HbA1c、FBG、2hPBG、ALT、AST、HDL-C、LDL-C与单纯T2DM组相比无显著性差异(P>0.05)。(3)通过非条件Logistic回归分析,BMI、TG、CP是NAFLD发生的主要危险因素。结论:(1)新诊断2型糖尿病合并非酒精性脂肪肝的中医证型特点为虚实夹杂为主,湿热困脾证为最常见证型。(2)肥胖、胰岛素抵抗及脂质代谢紊乱是2型糖尿病并发非酒精性脂肪肝的主要危险因素。
Objective：To study the relationship between newly diagnosed type 2 diabetes mellitus of syndrome types of TCM,patients with non-alcoholic fatty liver disease and associated risk factors.Reveals the announce of two TCM etiology and pathogenesis.Methods：According to Inclusion criteria and Exclusion criteria,According to whether patients with non-alcoholic fatty liver disease were divided into two groups,the newly diagnosed type 2 diabetic cases were from endocrine Dept.of our hospital,Simultaneous determination of Height（H）、Weight（W）、Waist Circle（WC）、Fasting Plasma Glucose（FPG）、2-hour Postprandial Blood Glucose（2hPG）、The lopid index（Triglyceride、Total Cholesterol、High Density Lipoprotein、Low-density Lipoprotein）、Liver Function（Alanine Aminotransferase、Aspartate Aminotransferase）、Fasting C-peptide、2-hour C-peptide、Glycohemoglobin 、Detection of Viral Hepatitis 、Fasting liver color Doppler ultrasound examination 、Body Mass Index（BMI）、Insulin resistance index（HOMA-IR）,Fasting C-peptide instead of insulin with improved formula for evaluation of insulin resistance HOMA.Results：（1）Newly diagnosed type 2 diabetic patients with non-alcoholic fatty liver disease are mixed,to prevalent spleen deficiency and damp-heat syndrome and deficiency of qi and yin syndrome,followed with yin deficiency and heat intensive syndrome blood stasis syndrome and deficiency of yin and yang syndrome.（2） Compared with the physical and chemical index,T2DM with NAFLD group of BMI,WC,HOMA-IR（CP）,FCP,TG,TC significantly higher than that in T2DM group（P〈0.05）,was no significant difference when making the comparison of HbA1C,FBG,2hPBG,ALT,AST,HDL,LDL between them（P〉0.05）.（3） Through non-conditional Logistic regression analysis,BMI,TG,CP is the major risk factor for NAFLD occurs.Conclusion：（1） Newly diagnosed type 2 diabetic patients with non-alcoholic fatty liver disease are mixed,Spleen Damp-heat storm was the most syndrome.（2） Obesity,insulin resistance and lipid metabolism disorder is the major risk factors of type 2 diabetes with non-alcoholic fatty liver disease.
出处
《辽宁中医杂志》
CAS
北大核心
2011年第2期200-202,共3页
Liaoning Journal of Traditional Chinese Medicine
基金
国家中医药管理局优秀中医临床人才研修项目
关键词
2型糖尿病
新诊断
证型
脂肪肝
危险因素
Newly Diagnosed Type 2 Diabetes
Differentiation Syndrome
Fatty liver disease
Risk factors
