Study On The Correlation Between TCM Constitution And RAAS System In Patients With Type 2 Diabetes Combined With Hypertensio

Purpose: This study explored the distribution characteristics of TCM constitutions of patients with type 2 diabetes and hypertension,analyzed the relationship between general data such as gender and age and related physicochemical indexes of patients with different TCM constitutions,and analyzed and discussed the correlation between TCM constitutions of patients with type 2 diabetes and hypertension and RAAS levels and blood pressure variability,in order to reduce the occurrence of cardiovascular and cerebrovascular complications and provide the basis for clinical diagnosis and treatment of diabetes and hypertension through early intervention of RAAS system and related susceptible constitutions.Material and method: In this study,the patients with type 2 diabetes combined with hypertension were selected as the research subjects,and 170 patients who met the requirements were screened out according to the diagnostic,inclusion and exclusion criteria.Information collection of the enrolled patients was conducted by questionnaire,which mainly included the basic information collection table,examination information collection table and TCM constitution classification and judgment table.The collected data were entered into an Excel table,and then the distribution frequency of patients with different constitutions in type2 diabetes combined with hypertension was descriptively analyzed by SPSS26.0 software,to explore the distribution characteristics of constitutions.To analyze the relationship between constitutions of different TCM practitioners and patients’ general conditions,physical and chemical indicators: For the data consistent with the normal distribution,the analysis of variance was used,and Bonferroni multiple means comparison was conducted between groups.Data that did not conform to the normal distribution were subjected to the nonparametric Kruskal-Wallis H test.Through Spearman correlation analysis and single factor binary Logistic regression analysis,the correlation between constitutions of different Chinese medicine practitioners and RAAS level was explored.If P<0.05,the difference was considered to be statistically significant.Results:1.Distribution characteristics of TCM constitutions in 170 patients with T2 DM and hypertension: A total of 18 TCM constitutions were found.Among them,there were 22 cases(12.94%)with yin deficiency,21 cases(12.35%)with qi deficiency,17 cases(10.00%)with phlegm-dampness constitution,15 cases(8.82%)with yang deficiency,15 cases(8.82%)with damp-heat and blood stasis constitution,13 cases(7.65%)with damp-heat constitution,12 cases(7.06%)with qi deficiency and yin deficiency,10 cases(5.88%)with qi deficiency and blood stasis constitution,9 cases(5.29%)with yin deficiency and blood stasis constitution,9 cases(5.29%)with calm constitution,and phlegm-dampness and blood stasis constitution Constitution types with the occurrence number less than 5 were classified into other constitutions,totaling 19 cases(11.18%).2.Analysis of TCM Constitution and General Data of 170 Patients with T2 DM and hypertension: There were more males with Yin deficiency and phlegm-dampness constitution;There were more women with qi deficiency and yin deficiency.The average onset age of patients with yin deficiency and blood stasis was the highest,while that of patients with phlegm-dampness constitution was the lowest.The average level of BMI in patients with phlegm-dampness constitution and damp-heat constitution was the highest.The average BMI level of patients with Yin deficiency and blood stasis syndrome,and Qi deficiency syndrome was the lowest.There was no significant difference in gender,smoking or drinking among patients with different constitutions in traditional Chinese medicine(P > 0.05).Significant differences existed in age and BMI(P<0.05).3.TCM constitutions,blood glucose and blood lipid levels of 170 patients with T2 DM combined with hypertension: FBG and Hb A1 c levels of patients with yang deficiency constitution were high,and there was no significant difference in FBG and Hb A1 c levels of patients with different TCM constitutions(P>0.05).Patients with phlegm-dampness constitution had high levels of TG,TC and LDL-C,and the levels of TG,TC,HDL-C and LDL-C were significantly different among different constitutions in traditional Chinese medicine(P<0.05).4.TCM constitution and blood pressure variability in 170 patients with T2 DM combined with hypertension: the 24-HSB PCV of phlegm-dampness and blood stasis syndrome and qi deficiency and blood stasis syndrome was higher;The 24 h DBPCV of the damp-heat with blood stasis syndrome and the yin deficiency with blood stasis syndrome was higher.There were significant differences in the coefficient of variation of all-day systolic and diastolic blood pressure among patients with different constitutions in traditional Chinese medicine(P<0.01).5.TCM Constitution and RAAS in 170 patients with T2 DM combined with hypertension: The ALD level of damp-heat with blood stasis syndrome and yin deficiency syndrome was higher.The levels of PRC in phlegm-dampness constitution and yang deficiency constitution were higher.The AngⅡ levels in the damp heat with blood stasis syndrome,and qi deficiency with yin deficiency syndrome were higher.The ARR level of Yin deficiency syndrome,damp heat syndrome and blood stasis syndrome was higher.The levels of ALD,PRC,AngⅡ and ARR were significantly different among different constitutions of TCM(P<0.05).6.The common influencing factors of TCM constitution in 170 patients with T2 DM combined with hypertension were as follows: AngⅡ,24 h SBPCV,24 h DBPCV,and TG positively correlated with blood stasis syndrome.BMI,ALD,24 h SBPCV,TG,and HDL-C levels were negatively correlated with qi-deficiency constitution.Age,ARR and HDL-C positively correlated with Yin deficiency syndrome.PRC and TG had a negative correlation with Yin deficiency.BMI,AngⅡ and TG positively correlated with damp-heat constitution.There was a negative correlation between age and phlegm-dampness constitution.BMI,PRC,TG,and LDL-C positively correlated with phlegm-dampness constitution.Conclusion:1.Yin deficiency syndrome,qi deficiency syndrome,phlegm-dampness syndrome,yang deficiency syndrome,and damp-heat and blood stasis syndrome are the main TCM constitutions of T2 DM patients with hypertension,and the patients with blood stasis syndrome are the majority in the composite constitutions.2.The higher renin level in patients with T2 DM combined with hypertension is,the more likely phlegm-dampness constitution will appear,and it is often accompanied by dyslipidemia.Patients with yin deficiency syndrome are mainly characterized by increased ARR caused by high aldosterone and low renin.The higher the level of AngⅡ is,the more likely it is to develop damp-heat constitution and blood stasis constitution,and the greater the variability of blood pressure will be.Therefore,TCM constitution is closely related to the activity of RAAS.In the process of clinical diagnosis and treatment,we can intervene in advance according to the characteristics of different constitutions,in order to achieve the purpose of preventing diseases before they occur and improving the curative effect.