Study On The Relationship Between TCM Syndromes And Syndrome Types Of Type 2 Diabetes With Objective Indexes Such As Blood Glucose And Blood Fat

Objectives TCM syndromes differentiation as the core,to study the relationship between type 2 diabetes TCM syndromes and TCM syndrome types with blood pressure,BMI,blood glucose,Hb Alc,blood lipid,blood routine,blood clotting,liver function and renal function.So as to explore TCM syndrome types for type 2 diabetes approach of objective,so as to provide certain basis for clinical TCM diagnosis and treatment.Methods First,collecting the clinical data of patients with type 2 diabetes mellitus in the endocrinology department in Shijiazhuang Municipal Hospital of TCM from January to December,2017.Second distinguish the TCM syndromes and TCM syndrome types.Third,measure the objective indexes of blood pressure,BMI,blood glucose,Hb Alc,blood lipid,blood routine,blood clotting,liver function and renal function.Last,the relationship between type 2 diabetes mellitus’ TCM syndromes and TCM syndrome types with the above objective indexes was studied by using binary Logistics regression model and disordered multi-classification Logistic regression model.Results 1)Syndromes of disease nature in frequency from high to low in turn is blood stasis 160 person-times,Qi deficiency 156 person-times,Yin deficiency 87 person-times,phlegm turbidity 52 person-times,Yang deficiency 35 person-times,hotness 28 persontimes,fluid deficiency 14 person-times,respectively accounted for 79.60%,77.61%,43.28%,25.87%,17.41%,13.93%,17.41% of the total.Syndromes of disease location in frequency from high to low in turn is the heart 75 person-times,kidney 68 person-times,liver 50 person-times,large intestine 42 person-times,spleen 39 person-times,bladder 33 person-times,lung 26 person-times,stomach 25 person-times,gallbladder 6 person-times,respectively accounted for 37.31% 33.83%,24.88%,20.90%,19.40%,16.42%,12.94%,12.44%,2.99% of the total.2)According to excess and deficiency syndrome,there are 26 cases of deficiency syndrome,17 cases of excess syndrome,and 158 cases of intermingled deficiency and excess syndrome.According to the phlegm and stasis syndrome,there are 11 cases of phlegm,121 cases of blood stasis,42 cases of phlegm and blood stasis,and 27 cases of no phlegm and stasis.According to the deficiency of Qi and Yin deficiency,there are 87 cases of Qi deficiency,54 cases of Yin deficiency,37 cases of Qi and Yin deficiency,23 cases of no Qi and Yin deficiency.The main syndromes are Qi deficiency and blood stasis,Qi deficiency and blood stasis with phlegm syndrome,deficiency of liveryin and kidney-yin with stasis syndrome,Qi and Yin deficiency with stasis syndrome,Qi and Yin deficiency syndrome.3)The relationship between TCM syndromes and objective indexs.(1)Syndromes of disease nature and objective indexes The positive change of qi deficiency and cholinesterase.The positive change of Yin deficiency and age,2h insulin multiple,and fasting C peptide.The negative change of Yin deficiency and serum urea and 1h insulin.The positive change of Yang deficiency and low density lipoprotein cholesterol,2h insulin multiple,and insulin resistance index.The positive changes of fluid deficiency and FBG,D dimer.The negative changes of of fluid deficiency and serum creatinine and Hb A1 c.The positive changes of hotness and 1h insulin multiple.The negative changes of hotness systolic blood pressure and thrombin.The positive changes of phlegm turbidity and diastolic blood pressure,triglyceride,and 0.5 hour insulin multiple.The negative changes of phlegm turbidity and the time of thrombin,1h insulin multiple.The positive changes of blood stasis and Hb A1 c.(2)Syndromes of disease location and objective indexes The positive changes of lung and cholinesterase.The negative changes of lung and LDL and fasting insulin.The positive changes of spleen and the fasting C peptide.The negative changes of spleen and serum urea and insulin resistance index.The positive changes of liver and systolic blood pressure,2h insulin.The negative changes of liver and fasting blood glucose and HDL.The positive changes of kidney and age and BMI.The negative changes of kidney and fasting blood glucose.The positive changes of heart and APTT, heart rate.The negative changes of heart and diastolic blood pressure,platelet count,PT,APTT,TT.The positive changes of stomach and serum urea and 2h C peptide.The negative changes of stomach and LDL and HDL.The positive changes of large intestine and FBG,platelet count and PT.The negative changes of large intestine and heart rate.The positive changes of bladder and age,urine microalbumin.The negative changes of bladder and triglyceride,blood uric aci.There are no variables of gallbladder enter the the regression equation.4)The relationship between syndrome types and objective indexes.(1)In the syndrome types distribution of excess and deficiency syndrome,the patients with the increase of the total cholesterol in the range of 5.2~6.2mmol/L are more likely to be deficiency syndrome than those who were≥6.2mmol.Patients with Hb Alc<6% are more likely to be deficiency syndrome than those with Hb Alc>9%.(2)In the syndrome types distribution of phlegm and stasis,the patients with Hb Alc<6% were more likely to have stasis syndrome than those with Hb Alc>9%.The patients with the increase of the total cholesterol in the range of 5.2~6.2mmol/L are more likely to have sputum stasis syndrome than those who are≥6.2mmol.Patients with Hb Alc<6%,6≤Hb Alc<7% and 7≤Hb Alc≤9% are more likely to have phlegm and stasis syndrome than patients with Hb Alc>9%.Patients with FBG under 7mmol/L and 7~ 11.1mmol/L are more likely to have phlegm and stasis syndrome than those with more than 11.1mmol/L.(3)In the syndrome types distribution of of qi or Yin deficiency,no correlation was found between syndrome types and objective indicators.(4)In the distribution of the main syndrome types.Compared with qi and Yin deficiency syndrome,the patients aged between 50 and 65 years were more likely to have the syndrome of qi deficiency with blood stasis than those aged between 80 and 99.Compared with qi and Yin deficiency syndrome,the patients FBP is less than 7mmol/L were more likely to have liver and kidney Yin deficiency with stasis syndrome than the patients with FBP>11.1mmol/L.Conclusions 1)There is an unbalanced distribution of TCM syndrome and syndrome type in type 2 diabetes mellitus.Syndromes of disease nature in frequency from high to low in turn is blood stasis,Qi deficiency,Yin deficiency,phlegm turbidity,Yang deficiency,hotness,fluid deficiency.Syndromes of disease location in frequency from high to low in turn is the heart,kidney,liver,large intestine,spleen,bladder,stomach,lung,gallbladder.The main syndromes are Qi deficiency and blood stasis,Qi deficiency and blood stasis with phlegm syndrome,deficiency of liver-yin and kidney-yin with stasis syndrome,Qi and Yin deficiency with stasis syndrome,Qi and Yin deficiency syndrome.2)The TCM syndromes and some objective indicators have some positive and negative changes.Qi deficiency,blood stasis and some objective indexes have some positive changes.Yang deficiency and some objective indexes have some negetive changes.Yin deficiency,fluid deficiency,hotness,phlegm turbidity,heat,lung,spleen,liver,kidney,heart,stomach,large intestine and some objective indexes have some positive and negative changes.3)The syndrome types and some objective indicators have a certain correlation.Deficiency syndrome is associated with TC and Hb Alc.Blood stasis syndrome is associated with Hb Alc.Sputum stasis syndrome is associated with TC,Hb Alc and FBG.Qi deficiency and blood stasis syndrome is associated with age.Deficiency of liver-yin and kidney-yin with stasis syndrome is associated with FBG.4)There is a certain relationship between the syndromes,syndrome types and the objective indicators.In some cases,the positive and negative changes of a certain index can occur,such as: the Yin deficiency and the 2h insulin multiple are positively correlated,while the Yang deficiency is the opposite;the Yin deficiency and the 1h insulin multiple are inversely correlated,while the hotness is the opposite.So it is possible to apply objective indicators to explore the objectification of TCM syndrome types of type 2 diabetes.