摘要
【目的】探究2型糖尿病伴视网膜病变患者不同中医证型与发生心律失常风险的关系。【方法】选取137例2型糖尿病伴视网膜病变患者的临床资料,根据中医证型分为气阴两虚证38例、肝肾亏虚证47例和阴阳两虚证52例。回顾性分析不同中医证型患者的血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]、心率变异性时域参数[全部窦性心搏N-N间期标准差(SDNN)、全程记录中每5 min N-N间期平均值的标准差(SDANN)、全程相邻N-N间期差值的均方根(RMSSD)、相邻R-R间期相差≥50 ms占总窦性心律的百分数(PNN50)]及心律失常类型[室上性心律失常、室性心律失常、传导阻滞、ST-T改变]的差异。【结果】(1)血脂方面:在糖尿病伴视网膜病变患者的中医证型中,阴阳两虚证的TC和LDL-C水平高于其他2组证型(P<0.01),而3组证型的HDL-C和TG比较,差异无统计学意义(P>0.05)。(2)心率变异性方面:阴阳两虚证的PNN50、SDANN、SDNN低于其他2组证型(P<0.05或P<0.01),而肝肾亏虚证组的PNN50和SDNN低于气阴两虚证组(P<0.05或P<0.01),气阴两虚证的RMSSD低于其他2组证型(P<0.01),其余各组两两比较差异无统计学意义(P>0.05)。(3)心律失常方面:阴阳两虚证的心律失常发生率明显高于气阴两虚证和肝肾亏虚证,差异均有统计学意义(P<0.01);而气阴两虚证与肝肾亏虚证比较,差异无统计学意义(P>0.05)。【结论】糖尿病伴视网膜病变患者发生心律失常与不同中医证型有一定相关性。
Objective To investigate the correlation of traditional Chinese medicine(TCM)syndrome types with the risk of arrhythmia in patients with type 2 diabetic retinopathy.Methods The clinical data of 137 patients with type2 diabetic retinopathy were collected.The enrolled patients were differentiated as the syndrome of deficiency of both qi and yin(38 cases),syndrome of liver and kidney insufficiency(47 cases),and syndrome of deficiency of both yin and yang(52 cases).Retrospective analysis was carried out for the investigation of the correlation of TCM syndrome types with the blood lipid parameters of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C),heart rate variability time domain parameters of standard deviation of the average normal-to-normal(NN)intervals(SDNN),standard deviation of the average normal-to-normal(NN)intervals in every 5 minutes(SDANN),root mean square of the successive differences(RMSSD),percentage of normal waves differing≥50 ms compared to the preceding wave(PNN50),and arrhythmia parameters of supraventricular arrhythmia,ventricular arrhythmia,conduction block,and ST-T variation.Results(1)In respect of the blood lipids,type 2 diabetic retinopathy patients with the syndrome of deficiency of both yin and yang had higher TC and LDL-C levels than the other two syndrome types(P<0.01),and the differences of the levels of HDL-C and TG among the three syndrome types were insignificant(P>0.05).(2)In respect of the heart rate variability,type 2 diabetic retinopathy patients with the syndrome of deficiency of both yin and yang had lower PNN50,SDANN and SDNN than the other two syndrome types(P<0.05 or P<0.01),patients with the syndrome of liver and kidney insufficiency had lower PNN50 and SDNN than the syndrome of deficiency of both qi and yin(P<0.05 or P<0.01),patients with the syndrome of deficiency of both qi and yin had lower RMSSD than the other two syndrome types(P<0.01).The difference of other intergroup comparison was insignificant(P>0.05).(3)In respect of the arrhythmia parameters,type 2 diabetic retinopathy patients with the syndrome of deficiency of both yin and yang had higher incidence of arrhythmia than the other two syndrome types,and the difference was statistically significant(P<0.01).However,the difference of the incidence of arrhythmia between the syndrome of deficiency of both qi and yin and the syndrome of liver and kidney insufficiency was insignificant(P>0.05).Conclusion The incidence of arrhythmia in patients with type 2 diabetic retinopathy is correlated with the TCM syndromes types.
作者
林清华
谢慧文
LIN Qing-Hua;XIE Hui-Wen(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2020年第12期2292-2297,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
2型糖尿病伴视网膜病变
心率变异性
心律失常
中医证型
气阴两虚
肝肾亏虚
阴阳两虚
type 2 diabetic retinopathy
heart rate variability
arrhythmia
traditional Chinese medicine(TCM)syndromes
deficiency of both qi and yin
liver and kidney insufficiency
deficiency of both yin and yang
