基于动态血糖Hurst 指数与气血流注规律探讨2 型糖尿病血糖的变化特点

目的：基于由CGMS所采集的动态血糖的Hurst指数与气血流注规律探讨2型糖尿病血糖的变化特点。方法：选取上海中医药大学附属龙华医院T2DM患者156例，使用CGMS对其进行连续3天（72 h）的动态血糖监测后，根据第1个完整的从寅时（凌晨3-5点，对应于肺经）至丑时（次晨1-3点，对应于肝经）的24小时动态血糖分时辰段计算Hurst指数。计量资料以每个时辰为一组，组间比较采用多组相关样本检验（Friedman）非参数检验方法，统计显著性层级设定为P < 0.05。结果：各时辰段的Hurst指数均大于0.5。最大的3个Hurst指数依次为：胃Hurst（0.960）> 心Hurst（0.946）> 脾Hurst（0.945），最小的3 个Hurst 指数依次为：肺Hurst（0.886）< 肝Hurst（0.893）< 大肠Hurst（0.905）。大肠Hurst的标准差最大，达0.088，胃Hurst的标准差最小，为0.058。个体患者各时辰的Hurst指数的分布图像与整体样本所得结果类似，但具体到某个时辰，则存在涨落。各时辰组间Hurst指数两两之间存在统计学差异的对数为29对，占总对数的44%，与其他时辰存在差异数较多的脏腑经络依次为胃、肺、肝、肾、脾、心。结论：据气血流注规律所计算的动态血糖Hurst指数可以反映2型糖尿病不同时辰中血糖变化的差异性。

Exploration about Characteristics of Blood Glucose Changes of Type 2 Diabetes Based on Dynamic Blood Glucose Hurst Index and Qi and Blood Flow Rule

This paper aimed at discussing the characteristics of blood glucose changes of type 2 diabetes according to theflow rule of Qi and Blood as well as the Hurst index of dynamic blood glucose collected by CGMS. A total of 156 T2DMpatients were selected from the Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. After continuous monitoring of dynamic blood glucose for 3 consecutive days (72 hours) with CGMS, the first complete 24hour dynamic glucose, which start at 3 to 5 am(corresponding to Lung) and end at 1 to 3 am next morning(correspondingto Liver), are used for calculating each two-hours?? Hurst index. The measurement data was set at each two-hours, andmultiple groups of related sample tests (Friedman) non- parametric test methods were used for comparison betweengroups. The statistical significance level was set to P < 0.05. The results showed that the Hurst indices of each two-hourare all greater than 0.5. The three highest Hurst indices were: Stomach Hurst (0.960) > Heart Hurst (0.946) > SpleenHurst (0.945), and the three lowest Hurst indices were: Lung Hurst (0.886) < Liver Hurst (0.893) < Large intestine Hurst(0.905). The standard deviation of the large intestine Hurst was the largest, reaching 0.088, and the standard deviation ofthe gastric Hurst was the smallest, 0.058. The distribution image of the Hurst index of individual patients at each twohourswas similar to that obtained by the whole sample, but the specific time to a certain two-hours had fluctuations. Thenumber of pairs with statistical difference between each two groups in two-hours is 29, accounting for 44% of the totalnumber of pairs. The organs and meridians that have more differences with other two-hours are successively stomach,lung, liver, kidney, spleen and heart. The differences of the blood glucose changes at different times in patients with type2 diabetes can be indicated by the dynamic blood glucose Hurst indices, which are calculated according to the rule of Qiand blood flow.