| This study, from the two aspects of theory and clinical, discusses the relation of the TCM pathology of diabetes type 2 to "Gan Xie" through the relationships between the diet and syndrome distribution characteristics of patients with diabetes type 2 and the collateral pathological evolution.Purpose1. The theoretical partThrough the study on the change of the TCM name of diabetes, analyzes the TCM name of diabetes and summarizes the TCM evolutionary process of diabetes, that is, spleen heat→(hanker after, splenic diabets, GE consumer, kidney dryness)→Xiaoke→Xiaodan, providing theoretical basis for treating diabetes clinical syndrome differentiation stage; also, illuminates "Gan Xie" and its relationships with diabetes to explore the cause for the disease.2. The clinical partOn the basis of theoretical study, by using the method of clinical research, explores the correlation between the diet and syndrome characteristics of patients with diabetes type 2 and the evolution of Xiaoke so as to give evidence for TCM diagnosis and treatment while providing reference for the prevention of diabetes as well as the guidance for health care.Methods:1. For the theoretical part, collects relevant documents and uses the analysis induction to analyze documents from the past generations, so that the evolutionary rule of diabetes can be summarized.2. For the clinical part, using 200 cases of patients with diabetes type 2 as research objects, through the combination of syndrome element differentiation and scale assessment, studies the diet and characteristics of syndrome distribution of patients with diabetes type 2 on different stages (pre-diabetes stage, diabetes stage, diabetes complications stage) as well as the TCM syndrome element pathological features and evolutionary rule of diabetes in its different stages.Results:The theoretical part1. The course of diabetes can be divided into four stages which are spleen heat, (hanker after, splenic diabets, GE consumer, kidney dryness), Xiaoke and Xiaodan.2. The pathogenesis of diabetes by "Gan Xie" lies in spleen dysfunction, which causes the loss of essence of water and grain in distribution, making fat and water retained in the body. The pathopoiesis of "Gan Xie" includes causing chills and fever, dampness as well as phlegm and retained fluid. The Yin and Yang properties of "Gan Xie" is determined by partial victory of Yin of Yang of individual constitution.The clinical part1. The TCM location of diabetes type 2 is given priority to spleen, kidney and liver and its characteristics are mainly dampness, phlegm, qi stagnation and blood stasis.2. The TCM syndrome element pathological features of patients with diabetes type 2 in different genders are:in terms of the frequency of disease location, women are mainly with spleen, kidney and liver while men with spleen; in terms of disease potential integral, women score higher than men in liver potential integral (P< 0.01), while men higher than women in the potential integral of spleen and stomach (P< 0.01). On the frequency of disease characteristics, female group is higher than male group in qi stagnation, phlegm and dampness (P< 0.05), significantly higher in liver (P< 0.01), while male group was obviously higher in sputum than that of female group (P< 0.01); in integral, women score higher in qi stagnation and blood stasis (P< 0.05) and liver, Yin deficiency and blood stasis integral are significantly higher than the male group (P< 0.01), while male group claims higher in phlegm integral than female group (P< 0.01).3. The TCM pathological element features of patients with diabetes type 2 of different sizes:among the three groups (obesity, the medium, and marasmus), both in the frequency or integral, phlegm, dampness, qi stagnation, qi deficiency, spleen and large intestine of the obesity group are higher than the other two groups, while marasmus group in heat, Yin deficiency, blood stasis and liver is significantly higher than the other two groups (P< 0.05～ 0.01); in terms of the integral, marasmus group is higher than the other two groups in heat, Yin deficiency, stomach and liver (P< 0.05).4. The characteristics of diabetes type 2 syndromes distribution in different periods:(1) In pre-diabetes period, spleen heat caused by "Gan Xie" as the main pathological changes, the syndrome elements of disease location≥100 points are spleen, stomach, liver and large intestine, disease of syndrome elements≥100 points are dampness, phlegm, and qi stagnation. The first 20 of symptom appear frequency are elevated blood sugar, reduce obesity, tongue and teeth marks, abdominal distension, form, mouth, gooey and greasy tongue coating, food after the new expansion, sweet mouth, vein smooth, not great, pulse string, defecate hunger nor the desire of peng of the food, diarrhea, abdominal, defecate pond, belching, xing thirsting rancidness gas, heat, or sigh. (2) In diabetes period, splenic diabetes, GE Consumer, Kidney dryness and Xiaoke as the main pathological changes, the syndrome elements of disease location≥100 points are stomach, spleen, kidney and liver, disease of syndrome elements≥100 points are heat, phlegm, dampness, qi deficiency, qi stagnation, jin kui, Yin deficiency, dryness and Yang hyperactivity. The first 20 of symptom appear frequency are elevated blood sugar, thirst, dry throat, tongue coating thirsting greasy, cold, pulse hong, gas acid turn sour, bitter, mouth feed more easy hunger to urinate, body fat, Trinidad and Tobago, trap, languid lazy words, body weight, easy to emotional, no hot, drink more, irritated heat, bad breath, constipation, urinate turbid. (3) In the period of complications of diabetes, Xiaodan as the main pathological changes, the syndrome elements of disease location>100 points are respectively kidney, heart, spleen, liver, skin, channels and collaterals, disease of syndrome elements≥100 points are gas is not solid, Yin deficiency, blood stasis, phlegm, hand, dryness and damage of essence. The first 20 of symptom appear frequency are elevated blood sugar, urine sugar, dry skin, weight loss, urine of Trinidad and Tobago, complexion Thomtas hardy leahey, hair loss, dizziness, dark red tongue, blurred vision, body skin numbness, forgetfulness, or yawn, the valley is not, high blood pressure, pulse acerbity, skin crack in a fault, tongue, lumbar debility and heart palpitations.5. The relationships between patients with different diet habits and syndrome element distribution:the top three disease location syndrome element with patients who like sweet, sour and fat food are spleen, stomach and large intestine, while the top three disease of syndrome elements are dampness, phlegm and heat; the top three disease location syndrome element with patients who like cold drinks are stomach, spleen and liver, while disease of syndrome elements are mainly heat, Yin deficiency and dryness; the top three disease location syndrome element with patients who have irregular meals are liver, stomach and spleen, while disease of syndrome element is stagnation; the top three disease location syndrome element with drug addicted patients are lung, stomach and spleen, while disease of syndrome elements are with phlegm and heat; the top three disease location syndrome element with spirit-addicted patients are mainly spleen, intestines and liver, while disease of syndrome elements are with dampness and hot; the top three disease location syndrome element with wine-addicted patients are spleen, liver and stomach, while disease of syndrome elements are with dampness and stagnation; those who like bean products, milk and vegetables, disease location is mainly with spleen, disease of syndrome elements are with phlegm and dampness, but its syndrome element score is low; the top three disease location syndrome element with patients lack of exercises are liver, spleen and stomach, while disease of syndrome elements are with qi deficiency, qi stagnation and dampness.6. The lifestyle of patients with diabetes type 2:69.5% of patients like sweet, sour and fat; 67% like cold drinks; 62% with irregular meals; 55% are addicted to drugs; 33% are addicted to alcohol; 7% like bean products, milk and vegetables. Although there is as much as 76% like sports, only 6% have the habit of exercise, among which 50% are mere housework.7. The relationships between diabetes type 2 syndrome distribution and diet habits: pre-diabetes patients mainly like greasy/fried and sweet food, most of whom overeat, love to eat animal organs or fat and cold drinks. Most patients are intellectuals with high pressure, alcohol and tobacco addict and lack exercises; patients in diabetes period are mainly self-controlled, have lighter and regular diet, taste bitter and reduce alcohol and tobacco, but most still lack exercise, or only participate in household chores, still like cold drinks; in the period of diabetes complications, patients eat less, have fewer cold drinks or more hot drinks and move less.Conclusion1. Diabetes is a disease with Xiaoke. The existence of Gan Xie is one of the common factors and the main causes of diabetes. The period of pre-diabetes is associated with spleen heat, the diabetes period is related to splenic diabets, GE consumer, kidney dryness and Xiaoke, while the period of diabetes complications is associated with Xiaodan.2. The basic pathogenesis of "spleen heat" is "sluggish temperament and transport disorder" caused by "Gan Xie". "Gan Xie" is in spleen, and has something to do with stomach, liver and large intestine. Its pathological characteristic is "filled with" and "internal heat". The early clinical syndrome characteristics of "Gan Xie" shows the "obesity (rich people, eating sweet)" "sweet mouth"; the mid-term period is "filled with", and the later period shows "internal" into the "elimination". Therefore, early diabetic patients are without obvious symptoms, or the symptoms with a thirst or hunger equating cremation hot before angelica belong to TCM symptoms of "spleen heat".3. The key of the disease location of "Xiaoke" period is in kidney, and related to stomach, spleen and liver. The "Gan Xie" clinical syndrome of this phase is characterized by "Three more and one less" or sweet urine.4. The disease location of "Xiaodan" period is related to spleen, kidney and liver. The "Gan Xie" clinical syndrome of this phase is characterized by changing the beings. As a result, people with diabetes complications are belong to the category of "Xiaodan".5. The TCM pathology of syndrome element for diabetes type 2 differs in genders. In terms of syndrome element pathology, women are mainly related to qi stagnation, blood deficiency and blood stasis, while men involves in phlegm and dampness; therefore in clinical treatment, women can be treated by regulating qi and blood, while men can be treated based on the elimination of dispel phlegm and dampness6. The TCM pathology of syndrome element for diabetes type 2 differs in sizes of body. Obesity group are characterized by phlegm, dampness, qi stagnation, qi deficiency, spleen and large intestine, while marasmus group heat, Yin deficiency, the upper energizer and liver. In terms of integral, marasmus group is higher than other groups in heat, Yin deficiency, stomach and liver. Therefore, clinically, the obese can invigorate spleen wet and facilitate the treatment of phlegm, while thin can be treated from liver stomach Yin deficiency syndrome and/or Heat stagnation in the chest and diaphragm Yin deficiency syndrome.7. The onset of diabetes type 2 is associated with life and diet:those with overeating, high fat and sugar, cold drinks, excessive cigarettes and alcohol, lack of exercise as well as work stress are in higher risk of getting diabetes type 2. Symptoms of patients with diabetes type 2 can be from obesity, thirsty to easy hunger, frequency of urine, or urine with sweet taste. Above mentioned all prove that "Gan Xie" is a major cause for diabetes type 2. |
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