2型糖尿病患者中医证素和糖化血红蛋白水平关系的研究
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摘要
目的:分析2型糖尿病患者中医证素和不同糖化血红蛋白(HbA1c)水平的相关性,探讨HbA1c水平与中医证素的关系。方法:采用中医证素判定表,对320例2型糖尿病患者进行15个中医证素的判定和评分,同时采集患者一般情况并检测其HbA1c值。根据HbA1c水平分为血糖控制不良组(HbA1c>6.5%)和血糖控制良好组(HbA1c≤6.5%),运用SPSS 21.0统计软件,分别分析两组中HbA1c值和中医证素积分的相关性。结果:血糖控制不良组中,热盛证和HbA1c呈正相关(P<0.01);血糖控制良好组中,15个证素和HbA1c的相关性均无统计学意义。结论:当HbA1c>6.5%时,热盛证和HbA1c相关,提示清热治疗的降糖效果更为显著,印证了"糖高不离火,降糖不远寒"。
Objective: To analyze the correlation of the TCM syndromes and different hemoglobin A1 c(HbA1 c) levels in type 2 diabetes patients, and to find the relationship between them. Methods: Three hundred and twenty patients with type 2 diabetes were evaluated by using TCM syndromes determination table that was passed the Delphi method and scored on fifteen TCM syndrome elements. Meanwhile, the patients were collected general information and their HbA1 c values were detected. They were distributed into two groups: glycemic uncontrolled group(HbA1 c>6.5%) and glycemic controlled group(HbA1 c≤6.5%). The correlation of the TCM syndromes and different HbA1 c levels were compered by SPSS 21.0, respectively. Results: In the glycemic uncontrolled group, a positive correlation between heat syndrome and HbA1 c had statistical significance(P<0.01). In the glycemic controlled group, no correlation between fifteen syndromes and HbA1 c had statistical significance. Conclusion: When HbA1 c>6.5%,the heat exuberance syndrome and HbA1 c are related, meaning that the effect of dispelling heat is more significant for treating blood sugar, and it is confirmed that ‘high sugar due to evil-heat, and cold-natured medicines are good to return to normal'.
Objective: To analyze the correlation of the TCM syndromes and different hemoglobin A1 c(HbA1 c) levels in type 2 diabetes patients, and to find the relationship between them. Methods: Three hundred and twenty patients with type 2 diabetes were evaluated by using TCM syndromes determination table that was passed the Delphi method and scored on fifteen TCM syndrome elements. Meanwhile, the patients were collected general information and their HbA1 c values were detected. They were distributed into two groups: glycemic uncontrolled group(HbA1 c>6.5%) and glycemic controlled group(HbA1 c≤6.5%). The correlation of the TCM syndromes and different HbA1 c levels were compered by SPSS 21.0, respectively. Results: In the glycemic uncontrolled group, a positive correlation between heat syndrome and HbA1 c had statistical significance(P<0.01). In the glycemic controlled group, no correlation between fifteen syndromes and HbA1 c had statistical significance. Conclusion: When HbA1 c>6.5%,the heat exuberance syndrome and HbA1 c are related, meaning that the effect of dispelling heat is more significant for treating blood sugar, and it is confirmed that ‘high sugar due to evil-heat, and cold-natured medicines are good to return to normal'.
引文
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[15]Wainstein J,Landau Z,Bar D Y,et al.Purslane extract and glucose homeostasis in adults with type 2 diabetes:A double-blind,placebocontrolled clinical trial of efficacy and safety.Journal of Medicinal Food,2016,19(2):133
[16]姜旻,张先慧,张艳红,等.辛开苦降方对初发2型糖尿病KKAy小鼠胰腺In R和Bax表达的影响.世界中西医结合杂志,2015,10(7):991-994,998
[17]Liu D,Zhang Y,Liu Y,et al.Berberine modulates gut microbiota and reduces insulin resistance via the TLR4 signaling pathway.Experimental and Clinical Endocrinology&Diabetes:Official Journal,German Society of Endocrinology and German Diabetes Association,2018
[18]Chen D L,Yang K Y.Berberine alleviates oxidative stress in islets of diabetic mice by inhibiting miR-106b expression and up-regulating SIRT1.Journal of Cellular Biochemistry,2017,118(12):4349-4357
[19]Krol E,Jeszka-Skowron M,Krejpcio Z,et al.The effects of supplementary mulberry leaf(Morus alba)extracts on the trace element status(Fe,Zn and Cu)in relation to diabetes management and antioxidant indices in diabetic rats.Biological Trace Element Research,2016,174(1):158
[20]Bai Y,Zang X,Ma J,et al.Anti-diabetic effect of Portulaca oleracea L.Polysaccharide and its mechanism in diabetic rats.International Journal of Molecular Sciences,2016,17(8):1201
[21]许军峰,石学敏,李军,等.醒脑开窍针法对脑卒中合并糖尿病及不同血糖水平患者干预效果.中国临床康复,2004,8(22):4526-4527
[2]刘芳芳.388例消渴病(2型糖尿病)的证型分布及其相关因素研究.中医临床研究,2015,7(10):9-11
[3]牛华芬.中医证型与2型糖尿病糖化血红表达水平相关性研究.陕西中医,2013,34(6):709-710
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版).中国实用内科杂志,2018,38(4):292-344
[5]吕仁和,张洁荣,高彦彬.消渴病(糖尿病)中医分期辨证与疗效评定标准.中国医药学报,1993,8(3):54-56
[6]CFDA.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002
[7]仝小林,刘喜明,魏军平,等.糖尿病中医防治指南.中国中医药现代远程教育,2011,9(4):148-151
[8]国家中医药管理局医政司.22个专业95个病种中医诊疗方案.北京:国家中医药管理局医政司,2010
[9]朱文锋.证素辨证学.北京:人民卫生出版社,2008
[10]中华医学会内分泌学分会.中国成人2型糖尿病HbA1c控制目标的专家共识.中国医学前沿杂志(电子版),2011,3(4):73-77
[11]Stefano Del Prato.糖尿病血糖正常的探索:控制餐后血糖.国外医学:内分泌学分册,2003,23(3):155-156
[12]孙水平.黄连素对2型糖尿病患者血清IL-10、IL-6及CRP水平的影响.长春中医药大学学报,2017,33(3):431-433
[13]陈秀芳,雷康福,董敏,等.葛根素对2型糖尿病大鼠胰腺β细胞损伤的影响.温州医科大学学报,2017,47(12):859-863
[14]Riche D M,Riche K D,East H E,et al.Impact of mulberry leaf extract on type 2 diabetes(Mul-DM):A randomized,placebo-controlled pilot study.Complementary Therapies in Medicine,2017,32:105-108
[15]Wainstein J,Landau Z,Bar D Y,et al.Purslane extract and glucose homeostasis in adults with type 2 diabetes:A double-blind,placebocontrolled clinical trial of efficacy and safety.Journal of Medicinal Food,2016,19(2):133
[16]姜旻,张先慧,张艳红,等.辛开苦降方对初发2型糖尿病KKAy小鼠胰腺In R和Bax表达的影响.世界中西医结合杂志,2015,10(7):991-994,998
[17]Liu D,Zhang Y,Liu Y,et al.Berberine modulates gut microbiota and reduces insulin resistance via the TLR4 signaling pathway.Experimental and Clinical Endocrinology&Diabetes:Official Journal,German Society of Endocrinology and German Diabetes Association,2018
[18]Chen D L,Yang K Y.Berberine alleviates oxidative stress in islets of diabetic mice by inhibiting miR-106b expression and up-regulating SIRT1.Journal of Cellular Biochemistry,2017,118(12):4349-4357
[19]Krol E,Jeszka-Skowron M,Krejpcio Z,et al.The effects of supplementary mulberry leaf(Morus alba)extracts on the trace element status(Fe,Zn and Cu)in relation to diabetes management and antioxidant indices in diabetic rats.Biological Trace Element Research,2016,174(1):158
[20]Bai Y,Zang X,Ma J,et al.Anti-diabetic effect of Portulaca oleracea L.Polysaccharide and its mechanism in diabetic rats.International Journal of Molecular Sciences,2016,17(8):1201
[21]许军峰,石学敏,李军,等.醒脑开窍针法对脑卒中合并糖尿病及不同血糖水平患者干预效果.中国临床康复,2004,8(22):4526-4527