The Relevance Research Between TCM Syndrome Types And Glycemic Variability In Type 2 Diabetes

Objective:In this study,the topic intends to explore the relationship between different TCM syndrome types of type 2diabetes（T2DM）and glycemic variability（GV）and its relationship with disease courses,comorbidities,chronic complications,etc.It enriches the digital and graphic data of TCM theory,which provides a digital objective basis for the dialectical classification of medicine and help clinicians to accurately use drugs.Its aim is to provide ideas and methods for the standardization construction and promotion of TCM in the future.Methods:This study used descriptive clinical research methods that enrolled 155 patients with T2DM in the outpatient and inpatient department of Kaifeng City Hospital of Henan Province from April 2018 to February 2019.Referring to"the 22 professional and 95diseases of Chinese medicine diagnosis and treatment programs"published by the State Administration of TCM,it is divided into five syndrome types according to clinical practice,including 27 cases of heat injuring fluid syndrome,and 38 cases of phlegm-dampness blocking collaterals syndrome.There were 40 cases of qi-yin deficiency syndrome,27 cases of spleen-kidney qi deficiency syndrome,and 21 cases of liver stagnation and spleen deficiency syndrome.Based on the unified basic treatment,the capillary Self-monitoring of blood glucose（SMBG）was performed 7 times in 3 days,namely:fasting blood glucose（FBG）,2 hours blood glucose after breakfast(BG_AB),Blood glucose before lunch(BG_BL),2hours blood glucose after lunch(BG_AL),Blood glucose before supper(BG_BS2 hours blood glucose after supper(BG_AS),Blood glucose before retiring(BG_BR)to calculate the intra-day GV index,that is,standard deviation of blood glucose（SDBG）,postprandial glucose excursion（PPGE）,largest amplitude of glucose excursion（LAGE）,and the daytime GV index,that is,fasting blood glucose variation coefficient（FBG-CV）.In addition,the patient’s demographic information（age,gender,etc.）,the course of disease,body mass index（BMI）,laboratory indicators,diagnostic information（comorbidities,chronic complications）were recorded and statistical analysis was performed to analyze the intrinsic relevance of the above indicators and TCM syndrome types,especially to observe the relevance between T2DM TCM syndrome types and GV and to draw conclusions.Results:1.Basic situation:Age composition ratio of patients:There is no significant difference in age between the five groups（P>0.05）,and the affected population is concentrated in middle-aged patients;there is no statistically significant gender distribution and the course of disease among the five groups of syndromes（P>0.05）.BMI situation:for the five groups of syndrome type,BMI is in the normal range or overweight,the syndrome of phlegm-dampness blocking collaterals’BMI is the highest compared with the other four groups（P<0.05）.2.Comparison of laboratory parameters between the five groups:There are no significant difference in fasting plasma glucose and glycosylated hemoglobin Alc（Hb Alc）between the subjects（P>0.05）.3.The morbidity of comorbidities in 5 groups of patients:there is no significant difference in the morbidity of hypertension,dyslipidemia,coronary atherosclerotic heart disease（P>0.05）.4.The morbidity of chronic complications of T2DM in 5 groups:the morbidity of syndromes of phlegm-dampness blocking collaterals,qi-yin deficiency,spleen-kidney qi deficiency are the highest and the differences are statistically significant（P<0.05）.5.The relevance between the five groups of TCM syndromes and the 7-point blood glucose spectrum:The overall difference in the inter-group,time and interaction of the7-point blood glucose was statistically significant（P<0.05）.There are no significant difference in FBG and BG_BL between the groups（P>0.05）.BG_AB and BG_AS are the syndrome of phlegm-dampness blocking collaterals>the syndrome of qi-yin deficiency,the syndrome of spleen-kidney qi deficiency,the syndrome of heat injuring fluid>the syndrome of liver stagnation and spleen deficiency（P<0.05）.BG_AL is the syndrome of phlegm-dampness blocking collaterals>the syndrome of qi-yin deficiency,the syndrome of spleen-kidney qi deficiency>the remaining two groups（P<0.05）.BG_BS is the syndrome of qi-yin deficiency,the syndrome of spleen-kidney qi deficiency>the remaining three groups（P<0.05）.BG_BR is the syndrome of qi-yin deficiency>the syndrome of phlegm-dampness blocking collaterals,the syndrome of spleen-kidney qi deficiency>the remaining two groups（P<0.05）.6.The relevance between the TCM syndromes of five groups and intra-day GV:SDBG and LAGE of syndrome of phlegm-dampness blocking collaterals,syndrome of qi-yin deficiency,and syndrome of spleen-kidney qi deficiency are significantly higher than those of remaining two groups（P<0.05）,The PPGE of syndrome of phlegm-dampness blocking collaterals is higher than the other four groups（P<0.05）.7.The relevance between the five groups of TCM syndromes and daytime GV:FBG-CV of syndrome of qi-yin deficiency,and spleen-kidney qi deficiency is significantly different from the other three syndromes（P<0.05）.Conclusion:T2DM GV has obvious relevance with TCM syndrome types.The intra-and inter-day GV of syndromes of qi-yin deficiency,spleen-kid qi deficiency and phlegm-dampness blocking collaterals is higher,and the greater the GV amplitude,the higher the incidence of chronic complications of T2DM GV can be used as an objective basis for T2DM TCM syndrome differentiation.In the treatment,we should pay more attention to the GV of the above three types of syndromes,in order to achieve the goal of fine hypoglycemic and smooth compliance.