| Objective:The aim of the study was to classify TCM syndrome differentiation,investigate the distribution regular pattern of TCM syndromes in Type 2 diabetes mellitus(T2DM)with dyslipidemia through TCM syndrome differentiation,study the differences in the distribution of thyroglobulin antibodies(TgAb),thyroid peroxidase antibodies(TPOAb),Serum uric acid(SUA)and other related indicators and clinical data in different syndrome types,to analyze the correlation between various clinical indicators and different TCM syndrome types,in order to provide an objective reference for T2DM with dyslipidemia in TCM syndrome differentiation and treatment,and provide new ideas for the modernization of T2DM syndrome differentiation.Methods:We collected patients who suffered from T2DM with dyslipidemia and were h-ospitalized in the Department of Endocrinology,Nanjing Hospital of TCM from May 2020 to November 2020.In strict accordance with the inclusion and exclusion criteria,255 p atients were fin-ally included.According to the "Diagnosis and Treatment Standards of D iabetes with Lipid Metabolism Disorders in Traditional Chinese Medicine" in 2011,the i ncluded patient-s were classified by TCM syndrome differentiation,which were divided i-nto Qi stagnation syndrome,spleen deficiency and dampness syndrome,damp-heat intern al accumulation syndrome,liver and kidney yin deficiency syndrome,and spleen and kid ney yang defici-ency syndrome.We collected basic patient information and related clinica 1 indicators,inc-luding names,gender,age,course of illness,history of tobacco and alcoh ol,past medical hist-ory,height,weight,BMI,FBG,PBG,HbA1c,TC,TG,HDL-C,LDL-C,ApoA1,ApoB,TGAb,TP-OAb,SUA.We used SPSS26.0 software for data processing and analysis,in order to inv-estigate the correlation between the T2DM with dyslipidemia and the ab o-ve clinical indic-ators.Results:1.The study included patients with T2DM with dyslipidemia 255 cases,including 145 males and 110 females,with an average age of 58.98±14.53 years.The elderly over 60 accounted for 55.69%,and 63.54%of patients had a disease course of more than 5 years.There were 79 patients who had smoked and 46 patients who had consumed alcohol.90 patients had related family history,151 patients had hypertension,77 had cerebrovascular disease,and 41 had cardiovascular disease.65.10%of patients’ BMI≥24 kg/m2,which was in the overweight range.The mean value of HbAlc was 9.07±2.31%,and 89.58%of patients had HbA1c≥6.5%.2.The distribution of TCM syndrome types in this study was:liver and kidney yin deficiency syndrome(47.45%)>damp-heat internal accumulation syndrome(27.45%)>qi stagnation and phlegm obstruction syndrome(14.12%)>spleen deficiency and dampness syndrome(5.5%)=spleen and kidney yang False syndrome(5.5%).3.In terms of age,there were significant differences among the 5 TCM syndrome types(P<0.05).The age of damp-heat internal accumulation syndrome was the youngest,compared with Qi stagnation and phlegm obstruction syndrome,liver and kidney yin deficiency syndrome,spleen and kidney yang deficiency syndrome,the difference was statistically significant(P<0.05).4.In terms of disease course,there were differences among the 5 TCM syndrome types(P<0.05).The spleen-kidney-yang deficiency syndrome had the longest course of disease.Compared with the syndrome of qi stagnation and phlegm obstruction and internal accumulation of damp-heat,the difference was statistically significant(P<0.05);the syndrome of liver and kidney yin deficiency was the second,compared with the syndrome of qi stagnation and phlegm obstruction and the syndrome of damp-heat internal accumulation,the difference was significant(P<0.05).5.In terms of glucose metabolism indicators,there were differences in FBG among the 5 TCM syndromes(P<0.05).The FBG level of the spleen and kidney yang deficiency syndrome was the highest,which was related to the Qi stagnation and phlegm obstruction syndrome,spleen deficiency and dampness syndrome,and damp-heat internal accumulation.Compared with syndrome of liver and kidney yin deficiency,the difference was statistically significant(P<0.05).There were differences in HbAlc among the 5 TCM syndrome types(P<0.05).The HbAlc level of the spleen and kidney yang deficiency syndrome was the highest.Compared with spleen deficiency dampness syndrome,damp-heat internal accumulation syndrome,liver and kidney yin deficiency syndrome,the difference was statistical significant(P<0.05).The difference in HbAlc was statistically significant compared to phlegm-damp symptoms and internal damp-heat symptoms(P<0.05).6.In terms of lipid metabolism indicators,there were significant differences in TC,TG,and LDL-C among the 5 TCM syndrome types(P<0.05).Compared with the syndrome of internal accumulation of damp-heat and qi stagnation and phlegm obstruction,the syndrome of liver and kidney yin deficiency,and the syndrome of spleen and kidney yang deficiency,the difference in TC levels was statistically significant(P<0.05);Compared with spleen and kidney yang deficiency,the difference in TC levels was statistically significant(P<0.05)。Among the five groups of syndrome types,the highest TG level was found in the spleen deficiency and dampness trapped syndrome,and the difference was statistically significant compared with the qi stagnation and phlegm obstruction syndrome,liver and kidney yin deficiency syndrome,and spleen and kidney yang deficiency syndrome(P<0.05).The TG level was higher in the damp-heat internalized syndrome,and the difference was statistically significant compared with the syndrome of qi stagnation and phlegm blockage,liver and kidney yin deficiency,and spleen and kidney yang deficiency(P<0.05).The LDL-C of damp-heat internal accumulation syndrome was significantly higher than that of liver and kidney yin deficiency syndrome(P<0.05).7.In terms of TGAb,there were significant differences among the 5 TCM syndrome types(P<0.05).TGAb levels were significantly higher in the spleen deficiency and dampness trapped e syndrome than in the damp-heat internalized syndrome,liver-kidney yin deficiency syndrome,and spleen-kidney yang deficiency syndrome(P<0.05).The TGAb level of Qi-stagnation and phlegm obstruction syndrome was significantly higher than that of damp-heat internalization syndrome,liver-kidney yin deficiency syndrome,and spleen-kidney yang deficiency syndrome(P<0.05).In terms of TPOAb,there was no significant difference among the 5 TCM syndrome types(P>0.05).8.In terms of SUA,there were significant differences among the 5 TCM syndrome types(P<0.05).The level of SUA was significantly higher in syndrome of spleen-kidney yang deficiency than in syndrome of qi stagnation and phlegm obstruction,syndrome of spleen deficiency and dampness,syndrome of internal dampness and heat,and syndrome of liver-kidney yin deficiency(P<0.05).9.Taking the presence or absence of a TCM syndrome type as the dependent variable,and taking age,disease course,FBG,HbAlc,TC,TG,LDL-C,TGAb,SUA and other indicators as the independent variables,after performing binary logistic regression analysis,the results showed:TgAb was positively correlated with Qi stagnation and phlegm obstruction(P<0.05);TG and TgAb were positively correlated with spleen deficiency and dampness trapped syndrome(P<0.05);the internal accumulation of damp heat was negatively correlated with age and HbAlc(P<0.05),and positively correlated with TG and LDL-C(P<0.05);the deficiency of liver and kidney yin was positively correlated with the course of the disease(P<0.05),and negatively correlated with TC and TgAb(P<0.05);the spleen-kidney-yang deficiency syndrome was positively correlated with age,FBG,HbAlc,and SUA(P<0.05).Conclusions:1.Patients with T2DM with dyslipidemias were predominantly characterized by older age,longer disease duration,high BMI,and poorer glycemic control.2.The common T2DM syndromes of patients with T2DM with dyslipidemias were as follows:liver and kidney yin deficiency syndrome>damp-heat internal accumulation syndrome>qi stagnation and phlegm obstruction syndrome>spleen deficiency and dampness syndrome=spleen and kidney yang deficiency syndrome,the main syndrome types were liver and kidney yin deficiency syndrome and damp-heat internal accumulation syndrome.Damp-heat intrinsic syndrome was the youngest,the shortest course of disease,and good blood sugar control.,which was in the early stage of the disease and was closely related to the increase of TC,TG and LDL-C levels;the spleen-kidney-yang deficiency syndrome was the oldest,the longest course of disease,poor blood sugar control,and was in the terminal stage of the disease,which was closely related to the increase in SUA level;liver and kidney yin deficiency syndrome had a longer course;Spleen deficiency and dampness syndrome was closely related to the increase of TC,TG and TgAb levels;Qi stagnation and phlegm obstruction were closely related to the increase of TgAb level.3.Age,course of disease,FBG,HbAlc,TG,TC,LDL-C,TgAb,SUA can be used as the objective reference basis for T2DM with dyslipidemias. |
PDF Full Text Request