| ObjectiveBy investigating the characteristics of distribution of TCM constitution in patients with type 2 diabetes mellitus(T2DM)complicated with osteoporosis(OP),study the internal relationship between TCM constitution and the occurrence and development of this disease,which provides some basis and methods for clinical application of using TCM constitution theory in prevention and treatment.MethodsIn this study,T2DM patients hospitalized in endocrinology department of affiliated hospital of Chengdu university of TCM from December 2018 to December2019 were selected according to inclusion criteria and exclusion criteria.According to the results of bone mineral density(BMD),the patients were divided into three groups:normal bone mass group,osteopenia group and osteoporosis group.The general information and related metabolic indexes of patients were recorded and the TCM constitution was determined.SPSS20.0 was used for statistical processing to analyze the relationship between general information,relevant metabolic indexes and the disease,and to explore the relationship between TCM constitution and the general situation of the disease as well as the correlation with various indexes.Result1.A total of 181 T2DM patients were collected in this study,including 50 cases in normal bone mass group,73 cases in osteopenia group and 58 cases in osteoporosis group.Compared with the sex of three groups,the proportion of females in osteoporosis group and osteopenia group is higher than that of males(P<0.05).Compared with the age of three groups,osteoporosis group is older than osteopenia group and older than normal bone mass group(P<0.05).Compared with the course of diabetes in three groups,osteoporosis group is longer than osteopenia group and longer than normal bone mass group(P<0.05).Compared with BMI of three groups,osteoporosis group is lower than normal bone mass group and osteopenia group(P<0.05).Compared with PTH of three groups,osteoporosis group is higher than osteopenia group and higher than normal bone mass group(P<0.05).Compared with N-MID of the three groups,osteoporosis group is lower than normal bone mass group and osteopenia group(P<0.05).With normal bone mass,osteopenia and osteoporosis as dependent variables and sex,age,course of disease,BMI,PTH and N-MID as independent variables,corrected by logistic regression analysis,the result showed that sex,age,BMI,PTH and N-MID were the independent influencing factors of bone mass change in T2DM patients(P<0.05).2.The determination of TCM constitution shows that there are 35 cases of mild constitution,36 cases of yin deficiency constitution,30 cases of phlegm-dampness constitution,26 cases of blood stasis constitution,21 cases of yang deficiency constitution,and 33 cases of other constitutions in a group.The general conditions,bone mass changes and test indexes of patients were compared and analyzed in six groups:mild constitution group,yin deficiency constitution group,phlegm-dampness constitution group,blood stasis constitution group,yang deficiency constitution group and other-constitution group.Compared with the age of six groups,yin deficiency constitution group,blood stasis constitution group and yang deficiency constitution group are older than mild constitution group and other-constitution group(P<0.05).Compared with the course of diabetes in six groups,yin deficiency constitution group and yang deficiency constitution group are longer than mild constitution group and phlegm-dampness constitution group(P<0.05).Compared with 24h-u TP in six groups,yang deficiency constitution group is higher than mild constitution group,yin deficiency constitution group,phlegm-dampness constitution group and other-constitution group(P<0.05),and blood stasis constitution group is higher than mild constitution group(P<0.05).Compared with UACR in six groups,the blood stasis constitution group is higher than the mild constitution group and yin deficiency constitution group(P<0.05),while the yang deficiency constitution group is higher than the mild constitution group,yin deficiency constitution group,phlegm-dampness constitution group and other-constitution group(P<0.05).ConclusionThe vast majority of T2DM patients have biased constitution,with yin deficiency constitution being the most common,followed by phlegm-dampness constitution,blood stasis constitution and yang deficiency constitution.There is no obvious correlation between TCM constitution and bone mass changes of patients.With the increase of age and diabetes course,the patient who is mild constitution,phlegm-dampness constitution and other-constitution may gradually shift towards yang deficiency constitution,yin deficiency constitution and blood stasis constitution.The risk of kidney damage in patient with yang deficiency constitution and blood stasis constitution may be higher than that in patients with other constitutions such as mild constitution and yin deficiency constitution.The risk of T2DM patients complicated with abnormal bone mass is positively correlated with age.At the same time,it is also related to gender.The risk of female patients complicated with abnormal bone mass is higher than that of male patients.Obesity may have a protective effect on bone mineral density.On the premise of not being seriously overweight,the higher BMI,the lower the risk of osteoporosis.PTH and N-MID may be sensitive indicators for T2DM complicated with abnormal bone mass. |
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