Study On TCM Syndrome Differentiation And Its Correlation With Clinical Diagnostic Parameters Of Metabolic Syndrome

Objective:To establish and standardize the TCM syndrome differentiation classification of metabolic syndrome(MS),and explore the correlation between every TCM syndromes and its clinical diagnostic parameters of MS.Methods:The study is based on the definition about Metabolic Syndrome(2005) stated by the International Diabetes Federation,IDF.TCM syndrome is based on diagnosis standard stated in Chinese Medical Terminology on Clinical Diagnosis and Treat-Syndrome complex(GB/T16751.2-1997).323 MS patients are selected as the studied objects,with 30 healthy people as a normal control group.The study is to survey and quantify scores of 67 symptoms,signs,tongue pictures and pulse conditions and healthy control group,in the meantime to examined several clinical diagnostic parameters.Used the SPSS13.0 statistics software package to carry out the input,the checking with the investigation materials to establish relevant database,and have the database analyzed by means of the description analysis,classify analysis,and principal components analysis methods carrying out the statistical analysis to summarize the TCM syndrome classification and their standards of MS.by means of Analysis of Variance it can be found the correlation between the TCM syndromes and the clinical diagnostic parameters such as waist circumference,W/H ratio,BMI, FPG,TG,TC,LDL-C,HDL-C,SBP,DBP,FINS,HOMA-IR,hs-CRP,PAI-1, adiponectin.Results:According to the results of the cluster analysis,principal component analysis and analysis of variance combined TCM specialized knowledge,the TCM syndromes of MS and their standards are summarized,and their correlation with clinical diagnostic parameters of MS are as fellows:(1) accumulation of phlegm and blood stasis syndrome clinical manifestations:including 24 symptoms and signs:obesity,dizziness, heaviness of head as enwrapping,numbness of limbs,heaviness of limbs,headache, vomiting sputum and saliva,loose stool,dim complexion,dark purple lips,distending full pain in chest and hypochondrium,pink tongue,enlarged tongue,teeth marked tongue,dark purple tongue,ecchymosis on tongue,purple tortuosity in subglossal collateral vessel,thick fur,greasy fur,watery slippery fur,stringy pulse,slippery pulse, sunken pulse or unsmooth pulse.The standards of accumulation of phlegm and blood stasis syndrome: major symptoms and signs:heaviness of head as enwrapping,dizziness,headache, dim complexion,dark purple lips,(?)reasy fur,ecchymosis on tongue,smooth or unsmooth pulse.minor symptoms and signs:obesity,distending full pain in chest and hypochondrium, numbness of limbs,loose stool,thick fur,purple tortuosity in subglossal collateral vessel or stingy pulse.The level of serum TG,TC and plasma PAI-1 in every MS group is significantly higher than those in the normal group(P＜0.01).The level of serum TG,TC and plasma PAI-1 in the phlegm and blood stasis group is significantly higher than the other two groups,the spleen and kidney qi deficiency group or the extreme heat with yin deficiency group(P＜0.05).(2) syndrome of extreme heat with yin deficiency clinical manifestations:including 19 symptoms and signs:flushed face,conjunctival congestion,bitter taste of mouth,halitosis,dry mouth and drink preference, polyphagia,dark urine,constipation,irritability,thin tongue,splitting tongue,pricky tongue,reddish tongue,yellowish fur,little fluid fur,little fur,thin fur,thready pulse or rapid pulse.The standards of syndrome of extreme heat with yin deficiency: major symptoms and signs:flushed face,dry mouth and drink preference,reddish tongue,thin tongue,little fur or yellowish fur.minor symptoms and signs:bitter taste of mouth,polyphagia,dark urine,thin fur or pricky tongue.The level of serum FPG,HOMA-IR,hs-CRP in every MS group is significantly higher than those in the normal group(P＜0.01).The level of serum FPG,HOMA-IR,hs-CRP in the extreme heat with yin deficiency group is significantly higher than the other two groups,the accumulation of phlegm and blood stasis group or the spleen and kidney qi deficiency group(P＜0.05).(3) syndrome of spleen and kidney qi deficiency clinical manifestations:including 20 symptoms and signs:mental fatigue and weakness,shortness of breath with disinclination to talk,spontaneous perspiration, abdominal distension,dysgeusia,poor appetite,insomnia,intolerance of cold and cold limbs,pain of limbs,chest distress,twinge in the chest,pain and lassitude of the loins and legs,tinnitus,palpitation,five feverish centers,frequent and profuse urination, amnesia,pale tongue,whitish fur or weak pulse.The standards of syndrome of spleen and kidney qi deficiency: major symptoms and signs:mental fatigue and weakness,shortness of breath with disinclination to talk,dysgeusia,palpitation,amnesia or weak pulse.minor symptoms and signs:intolerance of cold and cold limbs,tinnitus,frequent and profuse urination,poor appetite,abdominal distension or pale tongue. The level of serum adiponectin in the MS group is significantly lower than it in the normal group(P＜0.01),The level of serum adiponectin from top to bottom is the normal group,the accumulation phlegm and blood stasis group,the yin deficiency with heat excess group,the spleen and kidney qi deficiency group.It is the lowest in the spleen and kidney qi difficiency group and is significantly lower than that of the other two groups(P＜0.05).Conclusion:the TCM syndromes of MS are classified as three types:accumulation of phlegm and stagnated blood,spleen and kidney qi deficiency and extreme heat with yin deficiency.The syndrome of phlegm and stagnated blood is the most frequent syndrome in MS,and it is closely related with the high level of serum TC,TG and plasma PAI-1.The syndrome of spleen and kidney qi deficiency is closely related with the low level of serum adiponectin and the syndrome of extreme heat with yin deficiency is closely related with high level serum FPG,hs-CRP and HOMA-IR.