Clinical Evaluation Of Urethral Acid Treatment Of Type 2 Diabetes Mellitus Combined With Hyperuricemia (Damp - Heat Turbidity)

Text one:The retrospective study of clinical cases about Type 2diabetes with HyperuricemiaPurpose: To find the risk factors, clinical treatment, guiding basis for the clinical trials of Type 2 diabetes mellitus(T2DM) with hyperuricemia, we analyzed and compared part of 4795 medical records of T2 DM on multiple exposure factors and the results of physical and chemical examinations from 2011 to 2013 in our Department of Endocrinology.Methods: In 4795 patients there were 1037 patients had been diagnosed as hyperuricemia by serum uric acid. On the one hand,we chose 428 medical records from 1037 records, which had comparatively complete informations. On the other hand,429 medical records were randomly selected from the 4795 patients of T2 DM whose serum uric acid were normal. We made contrast of parameters, which including sex,age,course of disease;hypertension,coronary heart disease;the history of smoking and drinking;SBP,DBP;BMI,WC;Hb A1C;TG, CHOL, HDL-C, LDL-C, Scr,BUN.The results were treated statistically.Results: 1. The prevalence of T2 DM with hyperurcemia was more than 21.6% from 2011 to 2013 in our Department of Endocrinology. 2. The two groups had statistically significant differences in aspects of course of disease;hypertension,coronary heart disease;history of drinking;SBP;BMI;Hb A1c;TG、HDL-C;Scr、BUN,which gave the result of P<0.05. It also revealed that excepet Hb A1 c and HDL-C,the condition of observation group was worse than control group.There were no significant differences in aspects of sex,history of smoking,WC,DBP,CHOL,LDL. 3.Among multiple observed indexes, just hypertension,BMI,Hb A1 c,TG and Scr wereselected into regression equation by way of Logistic regression analysis. The regression equation had Statistically significant with 71.1% accuracy and test indicators,which is P<0.01.The equation was that: Logit P=-3.178+0.474 hypertesion+0.08 BMI-0.145 Hb A1c+0.133 TG+0.023 Scr.Conclusion: 1. This study found that the prevalence of T2 DM with HUA was nearly 21.6% in our Department of Endocrinology from 2011 to 2013.To comparing with the T2 DM patients of non hyperuricemia,pe ople who had hyperuricemia usually accompanied with longer course of disease, higher value of BP, BMI,Scr,BUN and TG,lower value of Hb A1 c and HDL-c.They often had history of drinking. In order to defer the happening of hyperuricemia in T2 DM patients, we proposed that keeping effectively control of BP, TG,Scr as well as BUN and avoiding drinking for non hyperuricemia patients.2. In variety of parameters, just hypertesion, BMI,TG, and Scr were statistically analyzed to be the risk factors of T2 DM with hyperuricemia.Text two: The clinical observation of Jiangniaosuan Decoction on the treatment of T2 DM with Hyperuricemia.Purpose: To observe the clinical effects and the medication safety of Jiangniaosuan Decoction.To provide more effective drugs for TCM treatment of T2 DM with HUA.Methods: The clinical study selected 60 patients who were T2 DM with HUA and TCM syndrome of damp heat phlegm stasis type.The 60 patients were randomly assigned to the treatment group and the control group. The former with 30 patients took Jiangniaosuan Decoction, while the latter with 30 patients took benzbromarone tablets on the basic therapy of control blood glucose,low purine diet,limit drinking.After two weeks and four weeks,the integration and efficacy of clinical symptom as well as the parameters were observed, which including SUA,Scr,BUN, TG, CHOL, LDL-C, HDL-C,24 h UUA,UV,FPG,2h PG, TCM syndrome integral,UPH,routine blood test,liver function test and ECG.The results were treated statistically.Results:1. Treatment group reaches the total efficiency as high as 90.0%, while in benzbromarone group the total effective rate is 86.2%,without significant difference.Treatment group SUA decline degree was(131.30±42.88)μmol/L,and control group SUA decline degree was(126.72±43.27)μmol/L.There were no significant difference between the two groups.2. SUA,TG,CHOL w ere decreased significantly in treatment group.And 24 h UUA、UV were increased significantly(P<0.05).There were no significant differences in the statistical comparison of FPG,2h PG,Scr,BUN,LDL,HDL,UPH between before and after treatment showed that P>0.05. 3. After treatment, P<0.01 showed the significant differences between two groups in the TCM syndrome integral,There was significant difference between treatment group and control group(p<0.01).The treatment group is better. 4.The relationship between SUA levels and uric acid excretion index was analysised by using correlation analysis.SUA was positively correlated with Scr,negatively correlated with UUA,24 h UUA,FEUA,and FEUA has the strongest correlation with SUA. 5.The liver function,blood routine,ECG were monitored in order to observe the medication safety.After the clinical observation,there were no adverse reaction in the two groups.Conclusion: 1.Jiangniaosuan Decoction(treatment group)showed obvious efficacy in the treatment of T2 DM with HUA,who have the syndrome of damp heat and phlegm stasis.Jiangniaosuan Decotion had similar efficacy as benzbromarone. The total effective rate of treatment group of TCM clinical syndrome integral effect was significantly better than the control group 2. The clinical study showed that Jiangniaosuan Decoction could promote 24 h UUA,and increased UV to decrease the level of SUA. 3.Jiangniaosuan Decoction had the function of regulating blood lipid.