The Investigation Of The Distribution Of TCM Constitution In 302 Metabolic Syndrome Patients

Background:The definition of the metabolic syndrome (MS) is under revision. The International Diabetic Federation has recently proposed that a waist circumference more than 94 cm in men and 80 cm in women should be, considered the primary diagnostic factor in addition to two other criteria selected from an elevated fasting plasma glucose level a low HDL-cholesterol level, an elevated triglyceride level, and a high-normal blood pressure. Other possibilities under consideration are the inclusion of detail edlipoprotein abnormalities, such as factors indicating a proinflammatory or prothrombotic (increased fibrinogen and plasminogen activation inhibitor) state, given their association with an excessive adipose tissue mass and their higher prevalence in individuals with the metabolic syndrome. The incidence of MS is 14%-18% in our country. Many research suggest that MS increase the incidence of cardio- cerebrovascular disease.There is no special discussion about MS in Taditongal Chinese Medicine, and there is no unified and standard TCM syndrome differentiation in MS. The discussion and TCM syndrome differentiation are appear in the "consumptive thirst" ,"vertigo","blood stasis syndrome", "phlegm-turbid syndrome" ect. TCM Constitution is closely correlated with MS. The differents of TCM constitutions decide the incidents to certain disesses. For exampal, the people of Phlegm-dampness constitution are prone to consumptive thirst, stroke and thoracic obstruction. The methods of syndrome differentiation and TCM constitution differentiation are more or less the same. The TCM constitution is more stable than the TCM syndrome, so the differentiation of TCM constitution and the adjustment of biased constitution are more suitable to the patients with MS.Objective :To study the distributed regularity of TCM constitution type in metabolic syndrome. Provide a base for TCM constitution differentiation in practice clinic.Methods: In the basic of the extensive review and recent literatures about MS , combined with the opinions of the experts, we designed the "questionnaire of MS" (Apendix). According to the inclusion criteria,we used the exist clinical data to collect 302 cases of MS. (the cases are mainly from the Departments of Cardiology, Neurology and Endocrinology in our hospital dated from Jan 2006 to Mar 2007. ) Then we make differentiation of TCM Constitution according the information from the TCM four diagnostic methods which are take charged by associate professors or professors . We use SPSS 13^th version statistical software to analysis clinic data. , statistics common clinic type of TCM Constitution, analysis the differents of the general conditions and Laboratory examinations between different TCM Constitution. All of results will be verified by the statistical methods of t test, ANOVA, or X² test . Results: The number of MS pations is growing with the increasing ages, the tendency is began after 50 years old ,but is much more obvious after 60 years old. In the sickness status of MS, HBP takes the largest proportion.There are 5 main TCM Constitution in MS: phlegm-dampness constitution(43%), Qi-deficiency constitution(29.8), Yin-deficiency constitution(23.1%), Blood-constitution (19.8%), dampness-heat constitution(18.8%). In the conbined TCM constitutions, phlegm-dampness constitution and Blood-stasis constitution take the largest proportion(23 cases), and then Qi-deficiency constitution and phlegm-dampness constitution(19 cases), Qi-deficiency and Yin-deficiency constitution(15 cases), Yin-deficiency constitution and phlegm-dampness constitution(10 cases). Phlegm-dampness constitution is the most important TCM Constitution of MS, dampness-heat constitution is the development of phlegm-dampness constitution. The body weight of phlegm-dampness constitution and dampness-heat constitution is heavier then other TCM Constitutios. The patients of phlegm-dampness constitution and dampness-heat constitution like to eat fat in diet habits. The history of passive smoking and drinking is more concernd with phlegm-dampness constitution and dampness-heat constitution. In the Laboratory examinations, TC and LDL of phlegm-dampness constitution and dampness-heat constitution patients is higher than other TCM Constitutios in lipid test. In the electrocardiographic examination (ECG), abnormal rate of dampness-heat constitution patients is higher than other TCM Constitutios. In the Echocardiography examination, the left ventricular end systolic diameter dampness-heat constitution patients is higher than other TCM Constitutios. In the Echocardiography examination, the left ventricular end systolic diameter (LVESD) of dampness-heat constitution patients is larger than other TCM Constitutios, ejection fraction(EF)of dampness-heat constitution patients is Lower than other TCM Constitutios. In the Transcranial Doppler(TCD) test, the incidence of cerebral arteriosclerosis and vascular stenosis in dampness-heat constitution patients is higher than other TCM Constitutios. There were statistical significance between the comparision of different TCM Constitutios, ejection(P <0.05).Conclution:Phlegm-dampness constitution is the most important TCM Constitution of MS. The formation of Phlegm-dampness constitution is related with the bad living and diet habits. Dampness-heat constitution development of phlegm-dampness constitution. Phlegm-dampness constitution and Dampness-heat constitution are the main risk factors which cause the damage of the target organs in MS.