Research On The Relatioship Between The Stability Of Carotid Atherosclerotic Plaques And TCM Syndrome Of Type2Diabetes

Objective:This study observed the effects of type2diabetes mellitus (T2DM) patients with carotid atherosclerosis plaques, preliminary explore the relation between the stability of carotid atherosclerotic plaques and insulin resistance (IR), glycated hemoglobin Ale (HbAlc), blood lipids, f ibrinogen (Fib), serum uric acid (SUA),high sensitivity C-reactive protein (hs-CRP) and TCM syndromes; and further study the relation between different syndromes T2DM and IR, SUA, HbAlc, Fib and so on. By way of T2DM and carotid atherosclerosis in the clinical differentiation to provide reference indicators, as well as traditional Chinese and western medicine to provide guidance to combat.Methods:Selected in March2010to October2011in Wuhan of Endocrinology, First Hospital of hospitalized patients diagnosed with T2DM were132cases, male68, women64cases. Patients are in line with1999 WHO diagnostic criteria and Chinese Medicine of the standard for diabetes. Divided the patients with T2DM into unstable plaque group, stable plaque group and non-plaque group by Color Doppler Ultrasound,42case of unstable plaque group,44case of stable plaque group and46case of non-plaque group,all patient related laboratory tests and examined by Color Doppler Ultrasound. Refer to "traditional Chinese medicine Diabetes drug treatment (diabetes) clinical study of the guiding principles" for TCM syndrome is divided into Yin Deficiency and Heat in which28cases,35cases of Qi and Yin Deficiency,28case of yin and yang deficiency,42cases of Qistagnation and blood stasis. Select both healthy examination center in our hospital,30case were the control group, examined the related laboratory tests and Color Doppler, respectively compared with T2DM patients. All the measurement data expressed in X±S (mean±standard deviation), using t test, X2test with count data, observations were statistically using SPSS16.0Analysis.Results:①Unstable plaque group has the highest level of Homeostasis model assessmeni insulin resistance index (HOMA-IR), HbAlc, Fib, SUA, hs-CRP, Low density lipoprotein cholesterol (LDL-C), and the extent of the level of HOMA-IR、 HbAlc、 Fib、 SUA、 hs-CRP. LDL-C are rising by non-plaque group�'stable plaque group�'unstable plaque group. Comparison between HOMA-IR、 HbAlc、 Fib、 SUA、 hs-CRP、 LDL-C levels:the unstable plaque group,stable plaque group has significantly different compared with non-plaque group (P<0.01, P<0.05), the unstable plaque group has significantly different compared with stable plaque group (P<0.05)②he unstable plaque group mainly to Qistagnation and blood stasis, it is higher than stable plaque group and non-plaque group (P<0.01); stable plaque group mainly to Qi and Yin Deficiency, it is higher than unstable plaque group and non-plaque group (P<0.05); non-plaque group mainly to Yin Deficiency and Heat, it is higher than stable plaque group and unstable plaque group (P<0.01).③The patient with Qistagnation and blood stasis has the highest incidence of carotid atherosclerosis plaques,and it alsohas significantly different comparedwith Yin Deficiency and Heat(P<0.01).④Comparing to Yin Deficiency and Heat, the patient with Qistagnation and blood stasis has rised in level of fasting plasma glucose (FBG),HOMA-IR,Total cholesterol (TC), Trigly cerid(TG), LDL-C, SUA, Fib, hs-CRP, HbAlc, and the level of fasting plasma insulin(FINS) has decreased (P<0.01).Conclusion:1. IR, hyperglycemia,lipid metabolism disorder,high uric acid, high fibrinogen of blood, inflammation is closely relate with unstable plaque,and at its carotid atherosclerosis plaques, the occurrence and development of certification has its significance.2. DM with carotid atherosclerosis plaques has different clinical syptoms in different stages of development, in this study, if there is no plaque formation mainly to Yin Deficiency and Heat; there is stable plaque formation mainly to Qi and Yin Deficiency. With disease progression, if there is unstable plaque formation mainly to Qistagnation and blood stasis.3. Qistagnation and blood stasis and carotid atherosclerosis plaques of patient with DM, which reflects the blood circulation in the treatment of the importance of DM with carotid atherosclerosis of diabetes.