2型糖尿病合并脑小血管病临床特点及证候规律研究

李艳杰; 吴善瑛; 吴倩; 倪青

doi:10.3969/j.issn.2095-6606.2023.05.004

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2型糖尿病合并脑小血管病临床特点及证候规律研究

临床研究 | 更新时间：2023-10-12

- 2型糖尿病合并脑小血管病临床特点及证候规律研究
- Clinical characteristics and syndrome regularity of patients with type 2 diabetes mellitus complicated with cerebral small vessel disease
- 现代中医临床 2023年30卷第5期页码：17-23
- 作者机构：
  
  1.北京核工业医院　北京　102400
  2.北京中医药大学
  3.中国中医科学院广安门医院
- 作者简介：
  
  李艳杰，女，硕士，住院医师
  # 倪青，男，博士，教授、主任医师，E-mail：niqing@gamyy.cn
- 基金信息：
  
  国家自然科学基金面上项目(82174354)
- DOI：10.3969/j.issn.2095-6606.2023.05.004
  中图分类号： R256
- 纸质出版日期：2023-09-30，
  
  收稿日期：2022-12-01，
- 稿件说明：
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李艳杰, 吴善瑛, 吴倩, 等. 2型糖尿病合并脑小血管病临床特点及证候规律研究[J]. 现代中医临床, 2023,30(5):17-23.

LI Yanjie, WU Shanying, WU Qian, et al. Clinical characteristics and syndrome regularity of patients with type 2 diabetes mellitus complicated with cerebral small vessel disease[J]. Modern Chinese Clinical Medicine, 2023,30(5):17-23.
李艳杰, 吴善瑛, 吴倩, 等. 2型糖尿病合并脑小血管病临床特点及证候规律研究[J]. 现代中医临床, 2023,30(5):17-23. DOI： 10.3969/j.issn.2095-6606.2023.05.004.

LI Yanjie, WU Shanying, WU Qian, et al. Clinical characteristics and syndrome regularity of patients with type 2 diabetes mellitus complicated with cerebral small vessel disease[J]. Modern Chinese Clinical Medicine, 2023,30(5):17-23. DOI： 10.3969/j.issn.2095-6606.2023.05.004.

摘要

目的

对2型糖尿病合并脑小血管病患者临床特点及中医证候规律进行初步探索与分析。

方法

统计2型糖尿病合并脑小血管病系列调查表，结合电子病历系统和现场调查，采集一般信息及四诊资料，同时进行神经心理状况评估，建立数据库后采用SPSS 26.0进行描述性统计分析临床特点，以聚类分析联合专家意见归纳中医证候，对证候规律进行初步探索。

结果

① 2型糖尿病合并脑小血管病患者以60岁以上人群为主，常伴随多种血管并发症，且存在不同程度的认知功能损害和抑郁症状；②常见中医证候为肝肾阴虚证、脾肾气虚证、心肾阳虚证、痰瘀闭阻证、肝胃郁热证、肾虚髓亏证，其中4种证候均与肾虚相关，可统归为肾虚证，肾虚证患者占比最高。

结论

衰老、多血管损害、神经心理学障碍是2型糖尿病合并脑小血管病重要临床特点，肾虚为关键病机之一。

Abstract

Objective

Preliminary exploration and analysis of the clinical characteristics and TCM syndrome regularity of patients with type 2 diabetes mellitus complicated with cerebral small vessel disease (CSVD).

Methods

A series of questionnaires for type 2 diabetes mellitus complicated with CSVD were designed

which were used to collect general information and TCM four-diagnosis data in combination with electronic medical record system and on-site investigation

and the patients’ neuropsychological status was assessed at the same time. The TCM syndromes were summarized by cluster analysis and expert opinions

and the regularity of syndromes was preliminarily explored.

Results

Type 2 diabetes patients with CSVD were mainly people over 60 years old

often accompanied by a variety of vascular complications

and had different degrees of cognitive impairment and depressive symptoms; ② The common TCM patterns identified in the study were liver-kidney yin deficiency

spleen-kidney qi deficiency

heart-kidney yang deficiency

phlegm and blood stasis obstruction

liver-stomach stagnation-heat

kidney and marrow deficiency syndrome. Four of them were classified as kidney deficiency patterns

and the proportion of patients with kidney deficiency syndrome was the highest.

Conclusion

Aging

polyvascular damage and neuropsychological disorders are important clinical features of type 2 diabetes mellitus complicated with CSVD

and kidney deficiency is one of the key pathological factors.

关键词

脑小血管病2型糖尿病临床特点证候规律肾虚证

Keywords

cerebral small vessel diseasetype 2 diabetes mellitussyndrome regularitykidney deficiency patterns

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