基于社区的2型糖尿病周围神经病变中医证候特征及发病因素调查分析

张丽霞

[摘要] 目的 调查分析基于社区的2型糖尿病周围神经病变中医证候特征及发病因素。 方法 于2018年10月—2019年10月选择该院117例2型糖尿病患者作为调查分析对象，以中医证候量表为依据，分析患者周围神经病变的中医证候特征以及发病因素。结果 按照多伦多量表评价患者病情等级，其中轻度比例为24.79%、中度比例为49.57%、重度比例为25.64%;从中医单证发生率的角度来看，除阴虚证与气虚证之间的比例差异无统计学意义（P>0.05），其余证型之间均差异有统计学意义（P<0.05）。轻度患者中医单证的发生率偏高，中度患者则发生中医复合证的比例较高，而重度患者则全部发生中医复合证。 结论 从中医证候的角度来看，气虚证以及阴虚证的发病率最高，随着疾病的发展，患者的中医证候从原本的气阴两虚转化向阴阳两虚夹痰淤症是2型糖尿病发病的主要因素。

[关键词] 2型糖尿病;周围神经病变;中医证候特征;发病因素

[中图分类号] R587.1          [文献标识码] A          [文章编号] 1672-4062（2020）08（b）-0183-03

[Abstract] Objective To investigate and analyze the characteristics and morbidity factors of TCM syndromes of type 2 diabetic peripheral neuropathy based on community. Methods 117 patients with type 2 diabetes in the hospital were selected as the objects of investigation and analysis. Based on the TCM syndrome scale， the characteristics of TCM syndromes and the onset factors of patients with peripheral neuropathy were analyzed. Results The patient's condition was evaluated according to the Toronto scale. Among them， the mild proportion was 24.79%， the moderate proportion was 49.57%， and the severe proportion was 25.64%. There was no statistically significant difference between the ratio of deficiency syndrome and QI deficiency syndrome（P>0.05）， and there were statistically significant differences among other syndrome types（P<0.05）. The incidence of mild TCM documents was higher， moderate patients have a higher proportion of TCM syndromes， and severe patients all had TCM syndromes. Conclusion From the perspective of TCM syndromes， the incidence of QI deficiency syndrome and YIN deficiency syndrome was the highest. With the development of the disease， the TCM syndrome of the patient changes from the original QI and YIN deficiency to YIN and YANG deficiency and phlegm stasis is the main factors for the onset of type 2 diabetes.

[Key words] Type 2 diabetes; Peripheral neuropathy; TCM syndrome characteristics; Pathogenic factors

周圍神经病变是2型糖尿病患者常见的慢性并发症之一，在临床上主要表现为感觉缺失和感觉过敏等症状，具体为患者有发凉、麻木、针刺样疼痛以及蚁行感等，其发病率较高，一旦发生病变，将难以逆转，而且在没有高效的治疗方法的情况下，患者可能面临截肢的风险，甚至危及到患者的生命安全。而且，糖尿病周围神经病变会累及到患者全身的神经系统，早期的临床症状主要表现为疼痛、麻木等症状，在病情的不断进展下，患者的感觉神经、运动神经、自主神经等均会受到不同程度的影响，影响到患者的生活质量。在该次的调查分析中，于2018年10月—2019年10月以该院的117例2型糖尿病患者为研究对象，从中医辨证的角度分析其周围神经病变的特点以及发病因素，在这个基础上对2型糖尿病周围神经病变提供可靠的预防和治疗依据，现报道如下。