2型糖尿病合并非酒精性脂肪肝主要危险因素及中医证型探析

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1、授予单位代码10089学号或申请号16032中国图书分类号R2-031HebeiMedicalUniversity硕士学位论文学术学位2型糖尿病合并非酒精性脂肪肝主要危险因素及中医证型探析研究生：张忠勇导师：李晶教授专业：中西医结合基础二级学院：第四医院2018年3月目录中文摘要··············································································1英文摘要·····································································

2、·········3英文缩写··············································································5研究论文2型糖尿病合并非酒精性脂肪肝主要危险因素及中医证型探析前言··············································································6资料与方法····································································7结果···········

3、··································································11附图·············································································13附表·············································································14讨论····························································

4、·················17结论·············································································29参考文献·······································································29综述2型糖尿病合并非酒精性脂肪肝中医证型及主要危险因素研究进展··········································································34致谢······

5、·············································································40个人简历·············································································412型糖尿病合并非酒精性脂肪肝主要危险因素及中医证型探析摘要目的：探讨2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）主要危险因素及中医证型特征，研究肥胖、血糖、胰岛素抵抗、血脂以及肝功能同T2DM合并NAFLD之间的关系，为其患者的诊疗提供一定的依据。方

6、法：选取2016年3月至2017年9月河北医科大学附属沧州中西医结合医院内分泌糖尿病科收诊的338名T2DM患者，通过回顾性分析研究这些患者的临床资料，分为两组，观察组为T2DM合并NAFLD患者共140例，对照组为2型糖尿病不合并脂肪肝患者共198例。观察记录两组患者年龄、体重指数（BMI）、糖尿病的病程、血压、腰围（WC）、血脂、肝功能、血糖相关指标等危险因素，依据中医辨证分型标准，对患者的中医证候做出分析。结果：1.观察组和对照组患者性别构成比分别为50.0%和55.0%，两组差异无统计学意义（P>0.05）。2.观察组患者的BMI及WC均明显大于对照组，有统计学意义（P

7、<0.05）；观察组和对照组的年龄、病程、舒张压和收缩压的差异无统计学意义（P>0.05）。3.观察组患者的空腹血糖（FPG）、空腹C肽（FCP）、糖负荷后2小时C肽（2hCP）、C肽改良稳态模型胰岛素抵抗指数（Homa-IR（CP））、谷丙转氨酶（ALT）、谷草转氨酶（AST）、谷氨酰基转肽酶（GGT）、甘油三酯（TG）水平均明显高于对照组，有统计学意义（P<0.05）；观察组和对照组患者的血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖负荷后2