单纯性肥胖患者中医辨证分型与胰岛素抵抗相关性研究
9页1、单纯性肥胖患者中医辨证分型与胰岛素抵抗相关性研究 作者:陈维铭,钱涯邻,王馨然【摘要】 目的 探讨单纯性肥胖患者胰岛素抵抗与中医辨证分型之间的关系。方法 按照中医辨证分型标准将180例单纯性肥胖患者分为脾虚湿阻型、胃热湿阻型、肝郁气滞型、脾肾阳虚型、阴虚内热型,并与健康对照组作胰岛素敏感性比较。结果 单纯性肥胖各证型与健康对照组比较均存在明显的胰岛素抵抗(P<0.05),且脾虚湿阻型、胃热湿阻型较肝郁气滞型、脾肾阳虚型、阴虚内热型明显(P<0.05)。前两型间无显著性差异(P>0.05),合并称为湿阻型,后三型间亦无显著性差异(P>0.05),合并称为非湿阻型。通过Logistic回归分折,在排除年龄、性别、血压、血脂、血糖的影响后,仅胰岛素敏感性与中医分型密切相关(P<0.05),湿阻型的胰岛素抵抗较非湿阻型显著。结论 胰岛素抵抗是单纯性肥胖中医辨证分型的病理基础和客观依据之一。 【关键词】 单纯性肥胖症;胰岛素抵抗;中医辨证分型 Abstract:Objective To find the relationship between insulin-re
2、sistance (IR) and TCM syndrome differentiation typing (SDT) in exclusive obese patients. Methods According to SDT, 180 exclusive obese patients were selected and classified into 5 types, the Spleen-Deficiency and Dampness-Stagnation type (A), the Gastric-Fever and Dampness-Stagnation type (B), the Liver-Qi Stagnation type (C), the Spleen-Kidney Yang Deficiency type (D) and the Yin-Deficiency and Calor-Internus type (E). Their insulin sensitivity was examined and compared with that of healthy con
3、trol group. Results Compared with healthy subjects, all the exclusive obese patients had apparent insulin resistance (P<0.05) and patients of type A and type B had insulin resistance more apparently than those of type C, D and E (P<0.05). Type A and B showed no significant difference in insulin resistance (P>0.05), therefore they were grouped into the Dampness- Stagnation type. The other three types also had no significant difference (P>0.05), so they were called the non-Dampness-Sta
4、gnation type. After adjusting age, sex, blood pressure, blood fat and blood glucose, Logistic regression analysis demonstrated that insulin sensitivity was closely correlated with SDT (P<0.05). Conclusion Insulin resistance is one of the pathological basis for SDT in exclusive obesity. Key words:exclusive obesity;insulin resistance;TCM syndrome differentiation typing 单纯性肥胖患者存在胰岛素抵抗(IR)现象已被大量的临床研究和流行病学调查所证实1-2。IR作为一种病理生理状态,和高胰岛素血症一起被视为2型糖尿病、高血压病、肥胖和脂代谢紊乱等一系列代谢综合征的共同病理基础3。本课题以肥胖症辨证分型为指导,研究IR在单纯
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