维生素D 缺乏腹型肥胖患者中医证型探讨及其生活习惯特点研究
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R589.2

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国家重点研发计划(2018YFC2002503)


Discussion of Traditional Chinese Medicine Syndrome Types of Patients with Abdominal Obesity Complicated with Vitamin D Deficiency and Study on Characteristics of Their Living Habits
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    摘要:

    目的:探讨维生素D(VD) 缺乏腹型肥胖患者的中医证型分布规律及其生活习惯特点。方法:收 集529例腹型肥胖患者为研究对象,采取面对面调查方式,归纳总结腹型肥胖伴维生素D缺乏者的中医证型分 布规律及其生活习惯特点,分析生活习惯中的危险因素。结果:529例腹型肥胖患者中,VD缺乏组79例(占 14.9%),VD不缺乏组450例(占85.1%)。VD缺乏组老年占49.4% (39/79),中年占24.1% (19/79),青年占 26.6% (21/79);各年龄段例数比较,差异有统计学意义(P<0.05)。VD不缺乏组老年占53.1% (239/450), 中年占33.8%(152/450),青年占13.1%(59/450);各年龄段例数比较,差异有统计学意义(P<0.05)。VD缺 乏腹型肥胖患者中出现频率由高到低前5 位的中医证型分别为瘀血证(65.8%)、脾虚证(50.6%)、气虚 证(46.8%)、湿热证(32.9%)、肾虚证(24.1%),其中VD缺乏的腹型肥胖患者肾虚证占比(24.1%) 高于VD 不缺乏者(14.9%)(P<0.05)。生活习惯方面,VD缺乏的腹型肥胖患者喜生冷、辛辣、重油饮食,喜饮冷饮, 常有久坐的比例比VD不缺乏者更高(P<0.05),而常食白肉的比例比VD不缺乏者更低(P<0.05)。而对饮酒 情况进行两两比较,有且未戒酒的腹型肥胖患者比无饮酒习惯者的VD缺乏比例更低(P<0.05)。久坐行为、 喜生冷的饮食偏好均为VD缺乏的危险因素(P<0.05);有饮酒史是保护因素(P<0.05)。在部分尚无明确临 界指标的生活习惯中,腹型肥胖患者血清25(OH) D水平与吃早餐频率、饮用乳制品频率、饮酒频率、主动 日光暴露时长呈正相关(P<0.05),与饮用含糖饮料频率、每日持续坐立的最长时长呈负相关(P<0.05)。结 论:VD缺乏的腹型肥胖患者较常出现瘀血、脾虚、气虚、湿热、肾虚等中医证型,且相比于VD不缺乏的腹型 肥胖患者,肾虚证患者明显增多。生活习惯方面,建议腹型肥胖患者避免长时间持续坐立、积极参加户外活 动、多晒太阳,并保持规律早餐习惯、增加乳制品,减少生冷饮食。本研究中饮酒是VD缺乏的保护因素,但 不建议为改善VD缺乏而保持饮酒习惯。

    Abstract:

    Abstract:Objective:To discuss the distribution rules of traditional Chinese medicine (TCM) syndrome types of patients with abdominal obesity complicated with vitamin D (VD) deficiency and the characteristics of their living habits. Methods: A total of 529 patients with abdominal obesity were selected as the study objects. The distribution rules of TCM syndrome types of patients with abdominal obesity complicated with VD deficiency and the characteristics of their living habits were summarized by face-to-face investigation, and the risk factors in living habits were analyzed. Results:Among the 529 patients with abdominal obesity, 79 cases(14.9%) were in the VD deficiency group and 450 cases (85.1%) in the VD non-deficiency group. In the VD deficiency group, the elderly accounted for 49.4% (39/79), the middle-aged 24.1% (19/79), and the young 26.6% (21/79); there were significant differences in the comparison of cases among different age groups (P<0.05). In the VD non-deficiency group, the elderly accounted for 53.1% (239/450), the middle-aged 33.8% (152/450), and the young 13.1% (59/450); there were significant differences in the comparison of cases among different age groups (P<0.05). The top five TCM syndrome types of patients with abdominal obesity complicated with VD deficiency were in sequence the blood stasis syndrome (65.8%), spleen deficiency syndrome (50.6%), qi deficiency syndrome (46.8%), damp-heat syndrome (32.9%) and kidney deficiency syndrome (24.1%). The proportion of kidney deficiency syndrome of patients with abdominal obesity complicated with VD deficiency was 24.1%,higher than that of 14.9% of patients without VD deficiency (P<0.05). In terms of living habits,patients with abdominal obesity complicated with VD deficiency preferred cold, spicy, and excessive oil food and cold drinks, and often had a higher proportion of sedentary lifestyle than that of patients without VD deficiency, and the proportion of eating white meat was lower than that of patients without VD deficency (P<0.05). After pairwise comparison of alcohol intake, the proportion of VD deficiency in patients with abdominal obesity with drinking habit and without quitting alcohol was lower than that in those without drinking habit (P<0.05). Sedentary lifestyle and dietary preference for cold food were risk factors for VD deficiency (P<0.05); drinking history was a protection factor (P<0.05). Among some living habits without specific critical indicators, the levels of serum 25 (OH) D of patients with abdominal obesity were positively correlated with the frequency of eating breakfast,drinking dairy products and alcohol intake,and the duration of active exposure to sunlight (P< 0.05), and negatively correlated with the frequency of drinking sugary drinks and the longest duration of daily continuous sitting (P<0.05). Conclusion: Patients with abdominal obesity complicated with VD deficiency often have TCM syndrome types such as blood stasis,spleen deficiency,qi deficiency,dampheat and kidney deficiency. Compared with patients with abdominal obesity and without VD deficiency, patients with kidney deficiency syndrome are significantly more. In terms of living habits, it is recommended that patients with abdominal obesity avoid sitting for a long time, and instead do more outdoor sports, bask more, maintain regular habit of eating breakfast, eat more dairy products, and reduce raw and cold diets. In this study, drinking is a protection factor for VD deficiency, but it is not recommended to maintain drinking habits to improve VD deficiency.

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何英骁,刘振杰,指导:熊莉华.维生素D 缺乏腹型肥胖患者中医证型探讨及其生活习惯特点研究[J].新中医,2024,56(22):68-74

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  • 在线发布日期: 2024-11-28
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