| Objective:1.To investigate the distribution of TCM Constitution in elderly patients with Type 2 diabetes(T2DM),so as to provide an epidemiological basis for the health management of TCM in the elderly with T2 DM chronic disease(T2DM).2.To observe the clinical efficacy and safety of "phlegm dampness constitution conditioning formula" in the intervention of elderly T2 DM patients with phlegm dampness constitution,so as to provide the basis for the clinical application of "phlegm dampness constitution conditioning formula".Methods:1.Using the method of systematic sampling,one community health service center and one township health center were randomly selected from each of 11 cities in Shanxi Province to communicate with the staff,introduce the research purpose and general situation of this topic,obtain the files of elderly T2 DM physical identification from January 2019 to December 2019,and collect the gender,age,course of disease,residence,age,etc.of the patients The distribution characteristics of TCM Constitution in elderly patients with T2 DM were analyzed by statistical software.2.From January 2019 to December 2020 in the Affiliated Hospital of Shanxi University of traditional Chinese medicine,65 cases of patients over 65 years old who met the diagnostic criteria of type 2 diabetes and were diagnosed as phlegm dampness constitution by TCM Constitution were collected.The subjects were introduced the research contents and items,and were included in this study after they agreed and signed the informed consent.They were intervened by the prescription of phlegm dampness constitution.A course of treatment was 4 weeks,and a total of 3 courses were observed.Fasting blood glucose(FPG),2-hour postprandial blood glucose(2h PG),glycosylated hemoglobin(Hb A1c),insulin resistance index(IRI),insulin sensitivity index(IAI),body mass index(BMI)and other related physical and chemical detection indexes,TCM constitution transformation score and TCM syndrome score were observed before and after the intervention(FPG,2h PG were observed before and 1,2,3 months,the other indexes were observed before and after treatment.Results:1.A total of 1100 elderly T2 DM patients were investigated in this study.Results the distribution of TCM Constitution in elderly patients with type 2 diabetes was mainly biased constitution.The main biased constitution types were phlegm dampness,yin deficiency,Qi deficiency and yang deficiency.The constitution of elderly patients with T2 DM was mixed,mainly phlegm dampness mixed with Qi deficiency,yin deficiency and yang deficiency;Yin deficiency was mixed with phlegm dampness and Qi deficiency;Qi deficiency syndrome was mixed with phlegm dampness syndrome and yin deficiency syndrome;Yang deficiency and Qi deficiency;2.There was no significant difference in the distribution of TCM Constitution in elderly T2 DM patients of different genders;There are differences in the distribution of TCM Constitution among elderly T2 DM patients in different regions.Phlegm dampness,calmness and yin deficiency are the main types in Jinzhong,Jinnan and Jindongnan,while calmness,phlegm dampness and yang deficiency are the main types in northern Shanxi;The distribution of TCM Constitution in elderly patients with type 2 diabetes mellitus with different body mass index is different.The body mass index is too light and the proportion of yin deficiency substance is the highest in the normal patients.The body mass index is overweight and the phlegm dampness quality accounts for the highest in obese patients.The distribution of TCM Constitution in elderly patients with type 2 diabetes mellitus with or without hypertension is different.The major TCM constitution types of hypertension patients in turn are phlegm dampness,yin deficiency and flat temperament.The major TCM constitution types of patients without hypertension are: Yin deficiency,phlegm dampness,and peace.The average age of Yang deficiency group was the largest,while that of qi deficiency group and yin deficiency group was the smallest;By comparing the course of five main TCM Constitution Types in elderly patients with T2 DM,it was found that there were statistical differences between mild constitution and yin deficiency constitution,Yang deficiency constitution,Qi deficiency constitution and yin deficiency constitution,Yang deficiency constitution.3.The levels of FPG,2h PG,Hb A1 c,IRI,IAI and BMI were significantly different after the intervention;The total effective rate of TCM constitution transformation was 91.7%,the total effective rate of TCM syndrome integral comparison was 93.3%,and the total effective rate of physical and chemical detection index was 86.7%;There was no obvious adverse reaction during the treatment period,and the safety was good.Conclusion:1.The main biased constitution of T2 DM patients in the elderly is phlegm wet quality,yin deficiency quality,Qi deficiency quality and yang deficiency quality;The distribution of constitution in T2 DM patients is complex,and there are many kinds of constitution.2.There was no significant difference in the distribution of TCM Constitution in elderly T2 DM patients of different genders;There were differences in the distribution of TCM Constitution in T2 DM patients with and without hypertension;There are differences in age and course of disease between some physical types.3.With the aging of the population and the increase of the prevalence of diabetes,in the field of Public Health chronic diseases,we should give full play to the advantages of TCM Constitution identification and intervention in the diagnosis and treatment of chronic diseases,and reduce the burden of chronic diseases.4."Phlegm dampness constitution conditioning formula" has a significant effect on elderly T2 DM patients with phlegm dampness constitution.It can improve patients’ Constitution bias,phlegm dampness syndrome and blood glucose metabolism,increase the sensitivity of peripheral tissue to insulin,and reduce blood glucose level and body mass index. |
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