糖尿病坏疽危险因素及中医常见证型的临床研究.pdfVIP

提 要 目的：探讨糖尿病坏疽危险因素在常见中医辨证分型——湿热下注型与血瘀型中 的联系和差异，从而为临床辨证施治、改善患者预后、预防护理提供依据。方法：采 用回顾性住院病历资料调查统计方法，共收集辨证分型为湿热下注型和血瘀型的糖尿 病坏疽患者病历104例。结合糖尿病坏疽的危险因素，登记各患者的基本情况和相关 2 的实验室指标，通过SPSS13.0统计学软件，运用χ 检验、t检验、Logistic回归分 析、判别分析等统计学方法，初步探讨了糖尿病坏疽危险因素在两证型中的相关性。 结果：统计分析表明两证型在外伤史、血糖(FBS)、糖化血红蛋白(HbA1c)、纤维蛋白 原(Fib)、内皮素-1(ET-1)、血栓素B2 (TXB2)、踝肱比值(ABI)、股动脉内径方面具有 显著差异,P0.05；经 Logistic 回归分析,筛选出与该病常见辨证分型密切相关的 5 项危险因素：外伤史、Fib、ET-1、ABI、股动脉内径,并建立了本病辨证分型的判别 方程式，其证型判别正确率达90%以上。结论：糖尿病坏疽危险因素在湿热下注和血 瘀两证型中存在着相关性，特定危险因素的差异可指导临床筛查糖尿病足的高危人 群，并为临床辨证论治提供客观依据。 关键词 糖尿病足危险因素；湿热下注证；血瘀证；临床研究 Clinical research on the relation between the risk factors for diabetic gangrene and familiar syndrome differentiation of TCM Speciality:Peripheral Vascular Diseases,Surgery of TCM Author:Qin Shanshan Tutor:Prof.Hou Yufen Abstract Objective: To explore the relation and difference between the risk factors for diabetic gangrene(DM) and familiar syndrome differention of TCM. In order to offer gist for dialectic and precaution. The familiar syndrome differention of TCM was devided into 2 type that one was attributed to pathogenic dampness-heat attacking the lower limb and the other was attributed to the syndrome of blood stasis. Methods:Using retrospective case investigation study method,104 medical records were collected in the past two years. Considering the risk factors for diabetic gangrene, we retrospect the basic state of the illness and clinical index in patients with diabetic gangrene.we apply statistics which include X2 Test ，T Test，Logistic regression and Discriminant to explore the relativity between the risk factors for diabetic gangrene and familiar syndrome differention of TCM.Result:statistics s