天津中医药2026，Vol.43Issue(9)：1099-1108,10.DOI:10.11656/j.issn.1672-1519.2026.09.03
2型糖尿病合并内脏脂肪型肥胖患者的临床特征及中医证素研究
Clinical characteristics and traditional Chinese medicine syndrome elements in patients with type 2 diabetes mellitus with visceral obesity
摘要
Abstract
[Objective]To explore the clinical characteristics and traditional chinese medicine(TCM)symptom distribution patterns of type 2 diabetes mellitus(T2DM)patients with visceral obesity(VO),and provide evidence for integrated traditional and Western medicine intervention.[Methods]A total of 451 T2DM patients from Beijing University of Chinese Medicine Fangshan Hospital between February 2023 and February 2025 were enrolled and divided into non-VO and VO groups based on visceral fat area(VFA).Clinical data and TCM data were collected.Differences between groups were compared,with multivariate Logistic regression,syndrome element clustering,and correlation analysis used to investigate the association of VO with diabetic kidney disease(DKD)and TCM syndrome elements.[Results]The VO group accounted for 60.9%,among whom 59.6%did not meet the body mass index(BMI)criteria for obesity.Compared with the non-VO group,the VO group had higher levels of male proportion,obesity proportion,insulin usage rate,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),brachial ankle pulse wave velocity(baPWV),fasting plasma glucose(FPG),fasting insulin(FINS),fasting C-peptide(FCP),insulin resistance index(HOMA-IR),triglycerides(TG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),uric acid(UA),urine albumin-creatinine ratio(UACR),and free triiodothyronine(FT3),while high-density lipoprotein cholesterol(HDL-C)was decreased,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis indicated that VO was an influencing factor for DKD[OR=1.717,95%CI(1.100,2.687),P=0.018].TCM syndrome elements analysis revealed that the frequencies of dampness,phlegm,blood stasis,and spleen and heart were significantly higher in the VO group than in the non-VO group(P<0.05).Cluster analysis based on syndrome elements identified the common TCM syndrome patterns in T2DM patients with VO as:phlegm-dampness encumbering spleen pattern,stomach heat injuring fluid pattern,qi stagnation and blood stasis pattern,and yin-yang deficiency pattern.VFA was positively correlated with multiple metabolic indicators(P<0.05),and VFA levels in patients with dampness,phlegm,or blood stasis syndrome elements were significantly higher than those in patients without these elements(P<0.05).[Conclusion]T2DM patients with VO are predominantly male.Increased visceral fat is closely associated with metabolic disorders and the risk of DKD.The key TCM disease locations in VO patients are the spleen and heart,with dampness,phlegm,and blood stasis being important pathogenesis.This provides a diagnostic and treatment rationale for applying integrated TCM and Western medicine approaches,such as strengthening the spleen and resolving dampness,resolving phlegm and dispelling stasis,to improve visceral obesity and metabolic abnormalities.关键词
2型糖尿病/内脏脂肪型肥胖/中医证素/临床特征/糖尿病肾脏病Key words
type 2 diabetes mellitus/visceral obesity/traditional chinese medicine syndrome element/clinical characteristic/diabetic kidney disease分类
医药卫生引用本文复制引用
王悦,尚唱,王泽厚,张正姗,王娅辉,孙鲁英..2型糖尿病合并内脏脂肪型肥胖患者的临床特征及中医证素研究[J].天津中医药,2026,43(9):1099-1108,10.基金项目
中国中医药科技发展中心中西医协同慢病管理研究项目(CXZH2024097). （CXZH2024097）
