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基于多中心的2029例代谢综合征患者中医体质横断面临床分析

Cross sectional clinical analysis of traditional Chinese medicine constitution in 2 029 patients with metabolic syndrome from multiple centers

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【作者】 李安香卢绮韵梁庆顺陶一鸣戴芳芳胡晓灵王洪霞冯凌一刘昀玮范冠杰刘振杰

【Author】 LI Anxiang;LU Qiyun;LIANG Qingshun;TAO Yiming;DAI Fangfang;HU Xiaoling;WANG Hongxia;FENG Lingyi;LIU Yunwei;FAN Guanjie;LIU Zhenjie;Guangdong Provincial Hospital of Chinese Medicine;Second Clinical Medical College of Guangzhou University of Chinese Medicine;Affiliated Hospital of Nanjing University of Chinese Medicine;Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine;

【通讯作者】 刘振杰;

【机构】 广东省中医院广州中医药大学第二临床医学院南京中医药大学附属医院新疆维吾尔自治区中医医院

【摘要】 目的:探讨代谢综合征(MS)中医体质临床特征。方法:采用横断面研究方法,收集2020年6月至2021年12月广东省中医院、南京中医药大学附属医院、新疆维吾尔自治区中医医院符合标准的正常组、MS前期组、MS组受试者理化指标及中医体质资料,进行组间差异比较、典型相关性及Logistics回归等统计学分析。结果:理化指标中身体质量指数(BMI)、体脂率、内脏脂肪数、腰臀比、胰岛素(INS)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、尿酸(UA)在3组间表现为正常组<MS前期组<MS组(P<0.05);正常组所占比例较大的体质是平和质、气虚质、阳虚质,MS前期组是平和质、气虚质、血瘀质、阳虚质,MS组是平和质、气虚质、血瘀质、阴虚质、痰湿质。对MS组进行体质与理化指标典型相关分析,其中2对综合变量呈现较强的正相关,第1对典型相关系数为0.53,第2对为0.47。多元Logistics回归分析校正混杂因素后发现,平和质、阴虚质、痰湿质、血瘀质患有MS的OR值分别为0.63、2.17、1.77、2.20(P<0.05)。结论:在MS研究人群中,体质与理化指标具有较好典型相关性;气虚质可能与MS发病有关,平和质可视为MS的保护性体质,而痰湿质、血瘀质、阴虚质则为MS的危险性体质。

【Abstract】 Objective: To explore the clinical characteristics of traditional Chinese medicine(TCM) constitution in metabolic syndrome(MS). Methods: The physical and chemical indexes and TCM constitution data of subjects in normal group,pre MS group and MS group that meet the research standards from Guangdong Provincial Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine and Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine were collected by cross-sectional study method from June 2020 to December 2021, and statistical analysis was carried out for differences among groups, canonical correlation and Logistics regression. Results: Among the physical and chemical indicators, body mass index(BMI), body fat rate, visceral fat count, waist to hip ratio, insulin(INS), glycosylated hemoglobin(HbA1c), insulin resistance index(HOMA-IR), uric acid(UA) showed a stepwise pattern among the three groups, which was expressed as normal group<pre-MS group<MS group(P<0.05). There was a larger proportion of constitutions in normal group:Pinghezhi, Qixuzhi and Yangxuzhi, and the pre-MS group had Pinghezhi, Qixuzhi, Xueyuzhi, Yangxuzhi, and the MS group had Pinghezhi, Qixuzhi, Xueyuzhi, Yinxuzhi, Tanshizhi. The canonical correlation analysis of TCM constitution and physical and chemical indexes was carried out in the MS group, and two pairs of comprehensive variables showed a strong positive correlation.The canonical correlation coefficient of the first pair was 0.53, and the second pair was 0.47. After adjusting for confounding factors by multivariate Logistic regression analysis, it was found that the OR values of MS patients with Pinghezhi, Yinxuzhi,Tanshizhi, and Xueyuzhi were 0.63, 2.17, 1.77, and 2.20, respectively(P<0.05). Conclusion: In the MS research population, there is a good canonical correlation between TCM constitution and physical and chemical indicators, Qixuzhi may be related to the pathogenesis of MS, Tanshizhi, Xueyuzhi and Yinxuzhi are high-risk constitutions of MS.

【基金】 国家重点研发计划(No.2018YFC2002500);广州市民政局科技计划项目(No.2020MZK24);广东省中医院中医药科学技术研究专项(No.YN2020QN12);广东省中医药信息化重点实验室开放基金项目(No.2021B1212040007)
  • 【文献出处】 中华中医药杂志 ,China Journal of Traditional Chinese Medicine and Pharmacy , 编辑部邮箱 ,2023年09期
  • 【分类号】R259
  • 【下载频次】11
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