| Purpose: Based on the syndrome differentiation system,this paper discusses the distribution of TCM disease sites and pathological syndromes of type 2 diabetes mellitus complicated with asymptomatic hyperuricemia,and further analyzes the correlation between main TCM disease sites and pathological syndromes and general data and physical and chemical indexes,so as to provide reference for clinical syndrome differentiation,diagnosis and treatment.Material and method:From October 2021 to October 2022,118 patients with type 2diabetes mellitus complicated with asymptomatic hyperuricemia who were hospitalized in the Department of Endocrinology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine and met the discharge criteria were collected.The general data,physical and chemical indicators and four diagnostic information of patients were collected by filling out questionnaires.According to the syndrome differentiation method,the collected four diagnostic information was diagnosed by TCM syndrome factors,and the syndrome factors were statistically analyzed by SPSS26.0 statistical software to explore the correlation between the main TCM disease locations and pathological syndrome factors and the general data and clinical physical and chemical indicators.Results:1.General information(1)There are 118 subjects in this study,including 78 males and 40 females,most of whom are males;(2)In terms of age,there are 40 cases in the elderly group(age ≥60 years old),accounting for 33.9%,and 78 cases in the non-elderly group(age < 60 years old),accounting for 66.1%,which are mostly young and middle-aged;(3)In the course of disease,there were43 patients whose course of disease was less than 5 years,accounting for 36.4%;39 patients with a course of 5-10 years,accounting for 33%;There are 27 patients with a course of 10-20 years,accounting for 22.9%,and 9 patients with a course of more than 20 years,accounting for 7.6%.The short course of disease and new onset of the disease are more common.(4)In the history of drinking,smoking and heredity,there are 41 people with drinking history and77 people who don’t drink;There are 40 people with smoking history and 78 people without smoking history;The number of people with family genetic history is 40,and the number of people without family genetic history is 78.(5)On BMI,waist circumference and whether to use insulin,1 patient with BMI < 18.5 kg/m 2,21 patients with18.5 kg/m 2≤ BMI < 24kg/m2,47 patients with 24kg/m 2≤BMI < 28kg/m 2,and 49 patients with BMI ≥28kg/m2;There were50 men with a waist circumference > 90 cm,28 women with a waist circumference > 85 cm,83 with insulin use and 35 without insulin use.2.The general distribution of TCM syndrome elements(1)The distribution frequency of TCM syndrome elements in T2 DM patients with asymptomatic HUA is as follows,kidney(47cases)> liver(42cases)> Spleen(34cases)>Heart(22 cases)> Meridian(15 cases)> stomach(12 cases)> Lung(8 cases)> muscle and bone(7 cases)> large intestine(3 cases)> Bladder(2 cases),the main syndrome elements were kidney(39.83%),liver(35.59%)and spleen(28.81%).(2)The distribution frequency of syndrome elements of deficiency and venereal diseases was as follows: yin deficiency(89 cases)> Yang deficiency(51 cases)> Qi deficiency(24 cases)> blood deficiency(19 cases)> body fluid deficiency(3 cases).The main syndrome elements of deficiency and venereal diseases were yin deficiency(75.42%),Yang deficiency(43.22%)and Qi deficiency(20.33%).(3)The distribution frequency of syndrome elements of solid diseases was as follows:phlegm-dampness(55cases)> Heat(51cases)> water-stasis(16cases)> blood stasis(9 cases)> Qi stagnation(6cases)> Yang hyperactivity(2cases)> dryness(1case).Phlegm-dampness(46.61%)and heat(43.22%)were the main syndromes of solid diseases.3.The distribution of TCM syndrome elements in different SUA level groups The distribution of TCM syndrome elements in different SUA levels groups was as follows:18 cases(42.9%)in Group 1(420 μmol/L < 480 μmol/L)were renal syndrome elements;In Group 2(480 μmol/l ≤2 < 540 μmol/L),17 cases(43.4%)were renal syndrome element,18cases(46.2%)were hepatic syndrome element;The levels of serum uric acid 3≥540 μmol/L)in 3 groups were 12 cases(32.4%)of renal syndrome element,13 cases(35.1%)of hepatic syndrome element and 13 cases(35.1%)of spleen syndrome element.The distribution of the main TCM syndrome elements in different SUA levels groups were as follows: 31 cases(73.8%)in Group 1 and 28 cases(71.8%)in Group 2,respectively,30 cases(81%)of yin-deficiency syndrome and 21 cases(56.8%)of phlegm-dampness syndrome were found in the 3 groups.4.Study on the correlation between TCM syndrome elements and indexes.(1)In gender,women are independent influencing factors of TCM syndromes of liver,spleen,qi deficiency and yang deficiency,and women are more prone to liver,spleen,qi deficiency and yang deficiency than men.(2)Age is an independent influencing factor of syndrome differentiation liver in traditional Chinese medicine,which is negatively correlated with syndrome differentiation liver;The course of disease is an independent influencing factor of syndrome differentiation kidney in traditional Chinese medicine,and it is positively related to syndrome differentiation kidney.(3)Waist circumference is an independent influencing factor of vegetarian liver and heat in TCM syndrome,and it is positively correlated with syndrome vegetarian liver and heat.(4)Smoking is an independent risk factor for qi deficiency,and patients with smoking history are more likely to have qi deficiency syndrome.Insulin is an independent risk factor for yang deficiency,and patients using insulin are more likely to have yang deficiency syndrome.(5)Hb A1 c is the independent influencing factor of spleen and qi deficiency,which is positively correlated with spleen and qi deficiency.(6)SUA,BMI and alcohol drinking are the independent influencing factors of phlegm-dampness.SUA and BMI are positively correlated with phlegm-dampness,and phlegm-dampness syndrome is more likely to have a history of drinking.Conclusion:1.The location of T2 DM with Hua mainly involved the kidney,liver and spleen,the deficiency and excess of the disease were mixed,the deficiency syndrome was mainly yin deficiency,yang deficiency and Qi deficiency,and the excess syndrome was mainly phlegm-dampness and heat.2.There were differences in TCM syndrome elements among patients with different levels of SUA.In Group 1,the syndrome elements of kidney and yin deficiency were dominant,while in Group 2,the syndrome elements of kidney,liver and yin deficiency were dominant Blood uric acid.3 groups mainly by kidney,liver,spleen,yin deficiency,phlegm-dampness syndrome element.It is suggested that with the development of the disease,the location and nature of the disease also change dynamically.The main location and nature of the disease should be grasped in the clinical treatment,and the comprehensive treatment based on syndrome differentiation should be given.3.There are many risk factors of TCM syndrome elements in T2 DM complicated with Hua.In clinic,we should predict the TCM syndrome elements that may appear in patients according to their general data and the risk factors in physical and chemical indexes,so as to prevent them,to achieve the goal of pre-disease prevention. |
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