糖尿病湿热困脾证患者饮食结构调查
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摘要
目的:调查糖尿病湿热困脾证患者膳食结构及食物摄入频率情况,寻找导致湿热困脾证的影响因素,为针对性个体化糖尿病饮食指导提供依据。方法:采取随机抽样问卷调查方法,对本院门诊成人糖尿病患者进行调查,了解饮食结构、食物摄入频率、中医证候积分等,共计调查139份问卷。结果:(1)糖尿病湿热困脾证患者粮谷类每日平均摄入量(290. 83±223. 34) g,低于推荐量。蔬菜、水果、奶制品、大豆及坚果的摄入量明显低于推荐量,分别为66. 7%、72. 9%、93. 7%、77. 1%。油脂摄入量明显高于推荐量。(2)糖尿病湿热困脾证患者中医证候积分与摄入粮谷类、畜禽肉类的量均有关联(P <0. 05),但关联度均不高,γp分别为0. 351、0. 292。中医证候积分与摄入油脂的量呈正相关,呈中等相关联(γp=0. 634)。(3)糖尿病湿热困脾证患者中医证候积分与油脂、饮酒摄入频率均有关联(P <0. 05),但关联度均不高,γp分别为0. 333、0. 346。中医证候积分与油炸食物摄入频率有关联(P <0. 05),呈中等相关联(γp=0. 551)。结论:高热量、高脂肪的饮食结构、饮酒、嗜甜食等因素均可导致糖尿病患者湿热内蕴症状加重,因此个体化饮食指导可考虑结合中医特色进行更有针对性饮食结构调整,在达到血糖控制的基础上改善患者证候。
Objective: To investigate the dietary structure and food intake frequency of diabetic patients with damp-heat spleen-trapping syndrome in outpatient clinic,and to find out the influencing factors which easily lead to damp-heat spleen-trapping,so as to provide basis for individualized dietary guidance of diabetes with Chinese medicine characteristics. Methods: A total of 139 questionnaires were conducted to investigate the dietary structure,food intake frequency and TCM syndrome scores of adult diabetic patients in outpatient department of our hospital by random sampling questionnaire. Results: The results were as follows:(1)The average daily intake of cereals was(290. 83 ± 223. 34) g,which was lower than the recommended intake. The intakes of vegetables,fruits,dairy products,soybeans and nuts were significantly lower than the recommended intakes,which were 66. 7%,72. 9%,93. 7% and 77. 1% respectively. The oil intake was significantly higher than the recommended amount,89. 6% higher than the recommended amount.(2)The scores of TCM syndromes were correlated with the intake of cereals,livestock and poultry meat(P <0. 05),but the correlation degree was not high,and the γp was 0. 351 and 0. 292 respectively. The score of TCM syndromes was positively correlated with the amount of oil intake,and moderately correlated(γp= 0. 634).(3)The scores of TCM syndromes were correlated with the intake frequency of oil and alcohol(P < 0. 05),but the correlation degree was not high,and the γpwas 0. 333 and 0. 346,respectively. The score of TCM syndromes was correlated with the frequency of frying food intake(P < 0. 05),and moderately correlated with the frequency of frying food intake(gamma P = 0. 551). Conclusion: High calorie,high fat diet structure,drinking wine,sweetness habits and other factors can lead to diabetic patients with damp-heat symptoms aggravated,so individualized dietary guidance can consider more targeted dietary structure adjustment combined with the characteristics of TCM,in order to improve the symptoms of patients on the basis of achieving blood sugar control.
Objective: To investigate the dietary structure and food intake frequency of diabetic patients with damp-heat spleen-trapping syndrome in outpatient clinic,and to find out the influencing factors which easily lead to damp-heat spleen-trapping,so as to provide basis for individualized dietary guidance of diabetes with Chinese medicine characteristics. Methods: A total of 139 questionnaires were conducted to investigate the dietary structure,food intake frequency and TCM syndrome scores of adult diabetic patients in outpatient department of our hospital by random sampling questionnaire. Results: The results were as follows:(1)The average daily intake of cereals was(290. 83 ± 223. 34) g,which was lower than the recommended intake. The intakes of vegetables,fruits,dairy products,soybeans and nuts were significantly lower than the recommended intakes,which were 66. 7%,72. 9%,93. 7% and 77. 1% respectively. The oil intake was significantly higher than the recommended amount,89. 6% higher than the recommended amount.(2)The scores of TCM syndromes were correlated with the intake of cereals,livestock and poultry meat(P <0. 05),but the correlation degree was not high,and the γp was 0. 351 and 0. 292 respectively. The score of TCM syndromes was positively correlated with the amount of oil intake,and moderately correlated(γp= 0. 634).(3)The scores of TCM syndromes were correlated with the intake frequency of oil and alcohol(P < 0. 05),but the correlation degree was not high,and the γpwas 0. 333 and 0. 346,respectively. The score of TCM syndromes was correlated with the frequency of frying food intake(P < 0. 05),and moderately correlated with the frequency of frying food intake(gamma P = 0. 551). Conclusion: High calorie,high fat diet structure,drinking wine,sweetness habits and other factors can lead to diabetic patients with damp-heat symptoms aggravated,so individualized dietary guidance can consider more targeted dietary structure adjustment combined with the characteristics of TCM,in order to improve the symptoms of patients on the basis of achieving blood sugar control.
引文
[1]中华医学会糖尿病学分会.中国动态血糖监测临床应用指南(2012年版)[J].中国医学前沿杂志(电子版),2013,5(1):51-60.
[2]李凌空.湿热、痰瘀体质成因分析[J].中医文献杂志,2004,22(3):36-38.
[3]嵇加佳.2型糖尿病患者自我管理行为及血糖控制现状的研究[J].中华护理杂志,2014,49(5):617-620.
[4]刘红云.个性化综合饮食护理干预对2型糖尿病患者的临床效果研究[J].重庆医学,2015,44(13):1784-1787.
[5]秦红静,侯献兵,韩亚妹,等.阳虚体质的中医调养护理[J].光明中医,2015,36(3):620-621.
[6]周卓宁,刘鹏,庞健丽,等.体质辨识在糖尿病饮食治疗中的应用进展[J].广西中医药,2015,38(3):1-3.
[7]石劢,刘兆兰,许美艳,等.北京城区居家老年人生活习惯与中医体质类型的相关性[J].中国中西医结合杂志,2016,36(5):564-569.
[8]唐迎雪.湿热体质与2型糖尿病相关性研究浅释[J].中医药学刊,2004,23(9):1656-1657.
[9]徐进华,吴小秋,丁萍,等.糖尿病前期患者中医体质分布及其与相关指标关系的研究[J].新中医,2015,33(3):92-94.
[10]朱琳,刘力戈.社区居民中医体质与2型糖尿病相关性研究[J].临床和实验医学杂志,2016,15(12):1169-1174.
[11]钱玲玲,陈晓.2型糖尿病中医证型与胰岛素样生长因子-1、Homa-IR指数关系研究[J].四川中医,2018,36(7):86-89.
[12]师林,柯斌,罗晓莉.从脾虚痰湿角度探讨2型糖尿病胰岛素抵抗的中医研究思路[J].广州中医药大学学报,2015,32(2):336-338.
[13]杨志敏,张锦祥,原嘉民,等.生活方式与中医体质类型相关性研究[J].新中医,2013,45(2):98-100.
[14]张笑梅,朱燕波,邬宁茜,等.腹型肥胖和全身型肥胖与中医体质类型的关系[J].天津中医药,2014,31(10):603-607.
[15]张笑梅,朱燕波,邬宁茜,等.基于不同指标诊断的肥胖与中医体质的相关性分析[J].中医杂志,2015,56(3):212-215.
[16]虞晓含,朱燕波,王琦,等.体重指数与中医体质类型的对应分析[J].中医杂志,2015,56(2):105-107.
[17]高晓津,杨进刚,杨跃进,等.中国急性心肌梗死患者心血管危险因素分析[J].中国循环杂志,2015,30(3):206-210.
[18]陈中倩,刘冬梅.过量饮酒致病的中医病机探讨[J].湖南中医杂志,2016,32(1):135-136.
[19]王瑞萍,姜建,胡亦伟,等.不同医学营养治疗对老年2型糖尿病患者血糖波动性的影响[J].重庆医学,2015,44(28):3921-3924.
[20]唐迎雪.湿热体质与2型糖尿病相关性研究浅释[J].中华中医药学刊,2004,23(9):1656-1657.
[21]范芳,龙洋,陈娇,等.饮酒与2型糖尿病及其常见并发症关系的研究进展[J].中国全科医学,2015,18(30):3644-3647.
[22]车晓礼,万沁.酒精摄入量与糖尿病患病关系的横断面研究[J].重庆医科大学学报,2015,40(7):935-940.
[23]杨水清,谢利梅.中医饮食养生干预社区2型糖尿病痰湿型的研究[J].新中医,2014,46(4):152-154.
[2]李凌空.湿热、痰瘀体质成因分析[J].中医文献杂志,2004,22(3):36-38.
[3]嵇加佳.2型糖尿病患者自我管理行为及血糖控制现状的研究[J].中华护理杂志,2014,49(5):617-620.
[4]刘红云.个性化综合饮食护理干预对2型糖尿病患者的临床效果研究[J].重庆医学,2015,44(13):1784-1787.
[5]秦红静,侯献兵,韩亚妹,等.阳虚体质的中医调养护理[J].光明中医,2015,36(3):620-621.
[6]周卓宁,刘鹏,庞健丽,等.体质辨识在糖尿病饮食治疗中的应用进展[J].广西中医药,2015,38(3):1-3.
[7]石劢,刘兆兰,许美艳,等.北京城区居家老年人生活习惯与中医体质类型的相关性[J].中国中西医结合杂志,2016,36(5):564-569.
[8]唐迎雪.湿热体质与2型糖尿病相关性研究浅释[J].中医药学刊,2004,23(9):1656-1657.
[9]徐进华,吴小秋,丁萍,等.糖尿病前期患者中医体质分布及其与相关指标关系的研究[J].新中医,2015,33(3):92-94.
[10]朱琳,刘力戈.社区居民中医体质与2型糖尿病相关性研究[J].临床和实验医学杂志,2016,15(12):1169-1174.
[11]钱玲玲,陈晓.2型糖尿病中医证型与胰岛素样生长因子-1、Homa-IR指数关系研究[J].四川中医,2018,36(7):86-89.
[12]师林,柯斌,罗晓莉.从脾虚痰湿角度探讨2型糖尿病胰岛素抵抗的中医研究思路[J].广州中医药大学学报,2015,32(2):336-338.
[13]杨志敏,张锦祥,原嘉民,等.生活方式与中医体质类型相关性研究[J].新中医,2013,45(2):98-100.
[14]张笑梅,朱燕波,邬宁茜,等.腹型肥胖和全身型肥胖与中医体质类型的关系[J].天津中医药,2014,31(10):603-607.
[15]张笑梅,朱燕波,邬宁茜,等.基于不同指标诊断的肥胖与中医体质的相关性分析[J].中医杂志,2015,56(3):212-215.
[16]虞晓含,朱燕波,王琦,等.体重指数与中医体质类型的对应分析[J].中医杂志,2015,56(2):105-107.
[17]高晓津,杨进刚,杨跃进,等.中国急性心肌梗死患者心血管危险因素分析[J].中国循环杂志,2015,30(3):206-210.
[18]陈中倩,刘冬梅.过量饮酒致病的中医病机探讨[J].湖南中医杂志,2016,32(1):135-136.
[19]王瑞萍,姜建,胡亦伟,等.不同医学营养治疗对老年2型糖尿病患者血糖波动性的影响[J].重庆医学,2015,44(28):3921-3924.
[20]唐迎雪.湿热体质与2型糖尿病相关性研究浅释[J].中华中医药学刊,2004,23(9):1656-1657.
[21]范芳,龙洋,陈娇,等.饮酒与2型糖尿病及其常见并发症关系的研究进展[J].中国全科医学,2015,18(30):3644-3647.
[22]车晓礼,万沁.酒精摄入量与糖尿病患病关系的横断面研究[J].重庆医科大学学报,2015,40(7):935-940.
[23]杨水清,谢利梅.中医饮食养生干预社区2型糖尿病痰湿型的研究[J].新中医,2014,46(4):152-154.