2型糖尿病心身相关的临床特点及代谢内分泌功能的变化

Clinical character and function of metabolic endocrine of psychosomatic disorders in patients with type 2 diabetes

关键词:  中医证候学  2型糖尿病  危险因素  临床研究

Key words:  TCM symptomatology  type 2 diabetes  risk factors  clinical research

摘要:

[目的] 探讨2型糖尿病心理因素相关的中医证候学特征以及神经内分泌功能与心理健康状况的变化。[方法] 调查192例2型糖尿病患者,根据四诊资料进行心身相关辨证,结果分为单纯糖尿病组和糖尿病并心身相关组,对两组患者进行一般资料、状态特质焦虑问卷(STAI)、简明心境量表(BPOMS)和代谢内分泌相关指标进行比较,采用logisitic回归分析探讨糖尿病并心身相关的危险因素。[结果] 192例2型糖尿病患者合并心身相关证候的暴露水平为81/192(42.19%).糖尿病心身相关组的焦虑状态、焦虑习性因子评分高于糖尿病组和正常对照组,反映心境状态的BPOMS各纬度因子得分高于单纯糖尿病组和正常对照组,差异具有统计学意义(P<0.05或P<0.01),心身相关组糖尿病患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗(IR)、皮质醇(COR)、促肾上腺皮质激素(ACTH)、胰高血糖素(GLU)均高于单纯糖尿病组(P<0.05或P<0.01),logisitic回归分析显示、FPG、GLU、HbA1c、COR是2型糖尿病心身相关的主要危险因素。[结论] 糖尿病患者情绪障碍患病率较高,对血糖控制不佳HbA1c高水平的患者应重视心身并重的综合治疗。

Abstract:

[Objective] To explore the characteristics of psychosomatic disorder-related TCM syndrome in patients with type 2 diabetes and the changes of neuroendocrine function and the mental health. [Methods] The 192 patients with type 2 diabetes were investigated. According to the materials obtained from four diagnostic methods the psychosomatic symptom differentiation was performed and the patients were divided into diabetes group and diabetes and psychosomatic disorder groups. The general information, State-Trait Anxiety Inventory (STAI), the mood Scale (BPOMS) and metabolic endocrine-related indicators were compared between these two groups. Using logistic regression analysis the diabetes and psychosomatic disorde-related risk factors were explored. [Results] The exposure level of patients with type 2 diabetes complicated with psychosomatic disorder-related syndromes in the 192 patients was 81/192 (42.19%). The anxiety state and anxiety habits factor were higher than that in diabetes group and control group. Each latitude factor of BPOMS reflecting mood was higher than that in diabetes group and normal group. All of them were statistically different (P<0.05 or P<0.01). The value of FPG, HbA1c, IR, COR, ACTH and GLU of the diabetes psychosomatic disorder-related group were higher than that in the diabetes group (P<0.05 or P<0.01). The logistic regression analysis showed that FPG, GLU, HbA1c, COR were the major risk factors for the psychosomatic disorder-related patients with type 2 diabetes. [Conclusion] The mood disorders in the patients with diabetes are of prevalence. The patients with poor control of blood sugar and high level of HbA1c should pay attention to the comprehensive treatment for psychosomatic disorders.