| Purpose:To study the blood sugar fluctuation and the distribution of blood stasis syndrome in patients with type 2 diabetic kidney disease(DKD)in G2A2 and G2A3,and analyze the correlation between DKD and blood sugar fluctuation and blood stasis syndrome,so as to provide reference for better application of traditional Chinese medicine to treat DKD in the future.Method:149 patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the endocrinology ward of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from June 2021 to November 2022 and met the inclusion and exclusion criteria were collected.According to the levels of urinary albumin/creatinine(UACR)and glomerular filtration rate(e GFR),the patients were divided into three groups: no DKD group,G2A2 DKD group and G2A3 DKD group,and the complete blood glucose information at 7 o’clock on the first day of admission(fasting,before lunch and dinner,2 hours after three meals and before going to bed)was collected.Calculate the blood glucose level standard deviation(SDBG),the maximum blood glucose fluctuation range(LAGE),the time percentage of glucose within the target range(e TIR),the time percentage of glucose above the target range(e TAR)and the coefficient of variation(CV).The general information of patients,blood pressure and laboratory indexes such as glycosylated hemoglobin(Hb A1c),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),glomerular filtration rate(e GFR),urea nitrogen(BUN)and serum creatinine(Scr)were collected.All the data were statistically analyzed by SPSS23.0,and the correlation between DKD and blood sugar fluctuation was analyzed.Then 77 cases of DKD patients with deficiency of both qi and yin in G2A2 DKD group and G2A3 DKD group were divided into blood stasis group and non-blood stasis group according to whether they were accompanied by blood stasis syndrome.The general data,clinical data and physical and chemical indexes between the two groups were statistically analyzed by SPSS23.0,and the correlation between blood stasis syndrome and blood sugar fluctuation and DKD was analyzed.Results:1.General information: Among 149 patients with T2 DM,there were 71 females and 78 males,with an average age of(58.07±12.02)years and a course of diabetes of 7.00 (3.00,11.50)years.There was no statistical difference in sex,age and course of diabetes among the three groups(P > 0.05).Among 77 patients with deficiency of both qi and yin syndrome DKD(G2A2 and G2A3),38 were male and 39 were female.There were 34 patients with G2A2 DKD with blood stasis syndrome(63.0%),20 patients with non-blood stasis syndrome(37.0%),22 patients with G2A3 DKD with blood stasis syndrome(95.7%)and 1 patient with non-blood stasis syndrome(4.5%).There was no statistical difference in sex,age and course of disease between the two groups(P > 0.05).2.Clinical data and physical and chemical indexes: There G2A2 no significant difference in systolic blood pressure(SBP),diastolic blood pressure(DBP),Hb A1 c,TG and TC among the three groups(P > 0.05).There were significant differences in LDL-C,UACR,BUN,Scr and e GFR(P < 0.05).There was no significant difference in SBP,DBP,Hb A1 c,TG,TC,LDL-C,BUN and Scr between blood stasis group and non-blood stasis group(P > 0.05).The difference of UACR and e GFR was statistically significant(P < 0.05).3.Blood sugar fluctuation index: There were significant differences in SDBG,LAGE,e TIR,e TAR and CV among the three groups without DKD,G2A2 DKD and G2A3 DKD,and between the blood stasis group and the non-blood stasis group(P < 0.05).The blood sugar fluctuation range of G2A3 DKD group was greater than that of G2A2 DKD group,and that of blood stasis group was greater than that of non-blood stasis group.4.Correlation analysis: DKD staging is positively correlated with LDL-C,UACR,BUN,Scr,SDBG,LAGE,e TAR,CV,and negatively correlated with e GFR and e TIR;Blood stasis syndrome was correlated with DKD stage and blood sugar fluctuation(P < 0.01).Conclusion:1.The fluctuation range of blood glucose in DKD patients in 1.G2A3 phase is larger than that in G2A2 phase.SDBG,LAGE,e TIR,e TAR and CV may be related to the occurrence and development of DKD.2.Blood stasis syndrome may be related to blood sugar fluctuation range and DKD stage.3.The fluctuation range of blood sugar can be used as a dialectical reference index for DKD patients with blood stasis syndrome. |
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