中西医结合防治干预对社区糖尿病患者中医体质的影响

蒋良华 翁哲芳 胡小英 诸光花 尉敏琦

摘要：目的 分析中西醫结合防治干预对社区糖尿病患者中医体质及相关指标的改善效果，为社区糖尿病综合防治提供参考。方法 采用整群抽样法，随机抽取上海市闵行区江川社区卫生服务中心45～65岁糖尿病患者700例，分为干预组和对照组各350例。对照组采用信息化平台实施常规社区糖尿病规范化管理及治疗，干预组在此基础上，每月辨识1次中医体质，制定个性化社区糖尿病中医药防治规范，予养生防病指导建议和干预，连续1年。观察2组中医体质，评定糖尿病症状分级量表及焦虑自评量表、抑郁自评量表，观察并发症情况。结果 干预前患者中医体质分布为平和质（51.43%）>阴虚质（18.29%）>气虚质（11.71%）>阳虚质（9.71%）>湿热质（1.57%），干预后为平和质（63.71%）>阴虚质（8.71%）>气虚质（6.57%）>阳虚质（6.29%）>湿热质（1.71%）。平和质、阳虚质、湿热质干预前后、分组交互作用差异有统计学意义（P<0.05）。2组糖尿病症状疗效差异有统计学意义（P=0.021）；眼底镜干预前后、干预与分组交互作用差异有统计学意义（P=0.002）。结论 中西医结合防治干预可改善社区糖尿病患者中医体质及糖尿病相关症状。

关键词：中西医结合；糖尿病；中医体质

DOI：10.3969/j.issn.1005-5304.2018.02.005

中图分类号：R259.871 文献标识码：A 文章编号：1005-5304（2018）02-0020-06

Effects of Prevention and Treatment by Integrated Traditional Chinese and Western Medicine on TCM Constitutions of Community Diabetic Patients

JIANG Liang-hua1， WENG Zhe-fang1， HU Xiao-ying1， ZHU Guang-hua1， WEI Min-qi2

1. Jiangchuan Community Healthcare Service Center， Minhang District， Shanghai 200240， China；

2. Minhang Center for Disease Control and Prevention， Shanghai 201101， China

Abstract： Objective To analyze the improved the effects of prevention and treatment by integrated tradition Chinese and Western medicine on TCM constitutions and relevant indexes of community diabetic patients； To provide a reference for the comprehensive prevention and treatment of community diabetes. Methods By using cluster sampling method， 700 patients with diabetes aged 45 to 65 in healthcare service center in Minhang District in Shanghai were chosen randomly and divided into intervention group and control group， with 350 cases in each group. The control group used information platform， and was treated with standardized management and treatment of diabetes. On the basis of the treatment of the control group， the intervention group was identified TCM constitutions once a month， developed personalized community diabetes prevention and treatment of TCM norms， and gave guidance and intervention for health preserving and disease prevention for a year. The TCM constitution improvement was observed. Diabetic symptoms grading scale and anxiety self-rating scale， depression self-rating scale were assessed， and the complications were observed. Results Before intervention： TCM constitution of yin-yang harmony （51.43%） > yin asthenia （18.29%） > qi asthenia （11.71%） > yang asthenia （9.71%） > damp-heat （1.57%）. After intervention： TCM constitution of yin-yang harmony （63.71%） > yin asthenia （8.71%） > qi asthenia （6.57%）， yang asthenia （6.29%） > damp-heat （1.71%）. There was difference in constitutions of yin-yang harmony， yang asthenia， and damp-heat before and after and through intervention and group interaction （P<0.05）. There was statistical significance in diabetes symptoms curative effect index between the two groups （P=0.021）. There was statistical significance in ophthalmoscopy results before and after and through intervention and group interaction （P=0.002）. Conclusion The

基金项目：上海市卫生和计划生育委员会科研课题（201540004）

通讯作者：翁哲芳，E-mail：jcywk11111@163.com

prevention and treatment by intervention of integrated traditional Chinese and Western medicine can improve the TCM constitutions of diabetic patients in community and influence the symptoms of diabetes.

Keywords： integrated traditional Chinese and Western medicine； diabetes； TCM constitutions

中医体质学说认为，体质的特异性可导致个体对某些致病因子存在易感性或对某些疾病存在易患性和倾向性[1-2]。目前对糖尿病患者中医体质的分布及其与糖尿病的相关性研究较多[3-4]，中西医结合治疗糖尿病的临床疗效显著，安全性更高[5-7]。本研究以社区糖尿病健康管理为基础，分析中西医结合干预对糖尿病患者中医体质改善及疗效，为社区糖尿病综合防治提供参考。