Research On TCM Constitution Intervention Of "2394" Chronic Disease Management Model In Type 2 Diabetic Patients

BackgroundThe prevalence of type 2 diabetes is increasing year by year,which is one of the four chronic diseases managed by health service agencies,"Community control" have great significance.The "2394" chronic disease management models was come from Professor Luo group and based on the study of "Preventive treatment of diseases"and sub health management and intervention,of which characteristics are the health promotion and physical conditioning.If the "2394" chronic disease management model is used in type 2 diabetes management,that will be an innovation and try in the method of community chronic disease management.In the model,the "four" is four interventions,aimed at correcting bad habits and biased traditional Chinese medicine constitution for the purpose of interventions.By improving the biased physical condition,shows physical intervention has a positive prevention and treatment effect on type 2 diabetic patients.Objective1.To understand the relationship between TCM constitution type and common cardiovascular risk factors in type 2 diabetes patients.2.To clarify the prevention and treatment of biased constitution type 2 diabetes by"2394" chronic disease management mode physical intervention.3.To explore the metabolic mechanism of intervention in qi-deficiency and phlegm-dampness constitution of type 2 diabetes with biased constitution.Methods1.To determine the cardiovascular risk factors and TCM constitution identification in 497 patients with type 2 diabetes patients through free health examination and scale survey.2.One hundred patients with type 2 diabetes were divided into two groups:the intervention group and the control group.The two groups maintained the original hypoglycemic drug treatment.The control group was given the guidance of diabetes lifestyle,the intervention group to correct the biased constitution by the four kinds of physical measures for 6 months.The blood glucose level and TCM physical scale scores were the main efficacy indicators.3.The two most common kinds of biased constitution,Qi-deficiency and Phlegm-dampness constitution were selected from the study subjects,and their serum samples were collected before and after the intervention to carry out metabolomics test.Results:1.497 cases of type 2 diabetes patients with normal constitution are less than with biased one,which is 24.14 percent and 75.86 percent.In biased constitution,Phlegm-dampness,Yin-deficiency and Qi-deficiency constitution are common;Obesity(58.35%),dyslipidemia(54.93%)and high blood pressure(51.91%)are the most common cardiovascular risk factors;Yang-deficiency is more common in old age patients,phlegm-dampness constitution of high rate of overweight or obesity and dyslipidemia,damp-heat constitution of smoking,drinking and overweight or obesity,blood stasis constitution of hypertension,ECG abnormalities and lack of exercise.2.After Clinic intervention,There was a significant difference between the two groups(P<0.05)in TCM physical scale scores.In the blood glucose level,fasting blood glucose and glycosylated hemoglobin value in the intervention group are significantly lower than those in the control group(P<0.05)and before the intervention(P<0.05).In BMI,waist circumference and blood pressure,BMI,systolic and diastolic blood pressure are significantly lower in the intervention group than in the control group(P<0.05).In the quality of life score,the health and physiology scores of the intervention group are significantly higher than those of the control group(P<0.05)and before the intervention(P<0.05).3.After intervened,There are 22 and 15 serum categories that contribute to the larger differential metabolites in Qi-deficiency and phlegm-dampness type 2 diabetes patients,the common metabolites are tyrosine,a-linolenic acid,guanosine,adenosine diphosphate,nicotinamide adenine dinucleotide,inosine.nicotinamide,citrulline,α-glucose.β-glucose.Conclusions:1.Type 2 diabetes patients have more biased constitution,these have a certain relevance and trend with cardiovascular risk factors.2.The four interventions of the "2394" chronic disease management model,with characteristics of Health promotion and physical conditioning,can improve the biased constitution of type 2 diabetes patients,build up the normal constitution,reduce blood sugar levels,promote clinical relevance abnormal indicators and improve the quality of life for patients.3.Intervention measures may play a role through energy metabolism,lipid metabolism,amino acid metabolism,nucleotide metabolism,intestinal flora and so on,which are characterized by health promotion and constitution regulat.And different physical interventions of its metabolic changes have some differences.