【目的】 研究肥胖型 2 型糖尿病（T2DM）合并幽门螺旋杆菌（Hp）感染患者的中医证型与中性粒细胞与淋巴细胞比值 （NLR）、系统性免疫炎症指数（SII）、系统性炎症反应指数（SIRI）、系统性炎症聚集指数（AISI）的关系。【方法】 选取 2023年 1 月 ~ 2024 年 7 月临海市中医院收治的符合纳入标准的肥胖型 T2DM 合并 Hp 感染患者 200 例及肥胖型 T2DM（Hp 阴性）患者 20例、肥胖者（Hp阴性）20例，观察不同组别肥胖人群与NLR、SII、SIRI、AISI的关系以及肥胖型T2DM合并Hp感染患者不 同中医证型、是否伴发慢性并发症与NLR、SII、SIRI、AISI的关系。【结果】（1）肥胖型T2DM合并Hp感染患者的NLR、SII、 SIRI、AISI水平高于肥胖型T2DM（Hp阴性）、肥胖者（Hp阴性）（P＜0.05）。（2）200例肥胖型T2DM合并Hp感染患者的中医证 型占比从高到低依次为痰浊中阻证（29.50%）＞痰热互结证（21.50%）＞气滞血瘀证（20.00%）＞肝郁脾虚证（19.00%）＞气阴两 虚证（10.00%）。（3）肥胖型T2DM合并Hp感染患者不同中医证型的NLR、SII、SIRI、AISI水平从高到低依次为痰热互结证＞ 气滞血瘀证＞肝郁脾虚证＞痰浊中阻证＞气阴两虚证（P＜0.05）。（4）Logistic回归分析结果显示：NLR、SII、SIRI、AISI是肥 胖型 T2DM 合并 Hp感染伴慢性并发症的危险因素，且均呈正相关（P＜0.05或 P＜0.01）。【结论】 NLR、SII、SIRI、AISI与肥 胖型T2DM合并Hp感染病情程度呈一定相关性，NLR、SII、SIRI、AISI有可能成为肥胖型T2DM合并Hp感染中医辨证及其 慢性并发症的潜在生物学指标。

Objective To investigate the relationship between traditional Chinese medicine （TCM） syndromes and biological indicators of neutrophil-to-lymphocyte ratio （NLR）， systemic immune-inflammatory index （SII）， systemic inflammation response index （SIRI），and aggregate index of systemic inflammation （AISI） in obese type 2 diabetes mellitus （T2DM） patients complicated with Helicobacter pylori （Hp） infection. Methods From January 2023 to July 2024，an investigation was carried out in 200 cases of obese T2DM patients complicated with Hp infection， 20 cases of obese T2DM patients without Hp infection （Hp-negative）， and 20 obese individuals without Hp infection （Hp-negative） who met the inclusion criteria and were treated at Linhai Hospital of Traditional Chinese Medicine. The relationships between different groups of obese individuals and biological indicators of NLR，SII，SIRI，and AISI were observed. And the correlation of TCM syndromes and the presence of chronic complications with biological indicators of NLR， SII， SIRI， and AISI in obese T2DM patients complicated with Hp infection was also explored. Results （1） The levels of NLR，SII，SIRI，and AISI in obese T2DM patients complicated with Hp infection were higher than those in obese T2DM patients （Hp-negative） and obese individuals （Hp-negative）（P＜0.05）.（2） Among the 200 cases of obese T2DM patients with Hp infection， the distribution of TCM syndromes in descending order was as follows： phlegm-turbidity blocking the middle energizer syndrome （29.50%）＞phlegm blended with heat syndrome （21.50%）＞qi stagnation and blood stasis syndrome （20.00%）＞liver depression and spleen deficiency syndrome （19.00%）＞qi and yin deficiency syndrome （10.00%）.（3） The levels of NLR， SII， SIRI， and AISI varied in obese T2DM patients with Hp infection of various TCM syndrome types，and they were in descending order in the following types：phlegm blended with heat syndrome＞qi stagnation and blood stasis syndrome＞liver depression and spleen deficiency syndrome＞phlegmturbidity blocking the middle energizer syndrome＞qi and yin deficiency syndrome（P＜0.05）. （4）Logistic regression analysis showed that NLR，SII，SIRI，and AISI were the risk factors of chronic complications in obese T2DM patients complicated with Hp infection，and all were positively correlated with the chronic complications （P＜0.05 or P＜0.01）. Conclusion NLR，SII，SIRI，and AISI are correlated with the severity of obese T2DM complicated with Hp infection，which may serve as potential biological indicators for TCM syndrome differentiation and identification of chronic complications in obese T2DM patients complicated with Hp infection.

R259.871

浙江省自然科学基金项目（编号：2023J011898）；台州市科技计划项目（编号：20ywb141）