Study On TCM Syndrome And Pathogenesis Of Metabolic Syndrome And Its Correlation With Micro-Indicators

Section 1 Theoretical Study of Metabolic SyndromeProposition of MS think each other independent in the past,disease and supersession disorder that cut apart each other regard IR as core their link together,make people know and deal with and take place the great change to a lot of important diseases.At present,the incidence of MS rise rapidly in the whole world,especially in developing economic country, the prevention and cure situation of MS has been already very severe.The pathogenic of MS is complicated,and have the characteristic of many causes resulted by many kinds of factors such as heredity,environment and life style.It is very complicated that MS has illness coming on in the mechanism,do not have a single factor that explain satisfactorily,the generally more acknowledged one is that IR is the thread run through many kinds of metabolic disorder at present,it is the physiological foundations of common pathology of these diseases.Secondly,the relation between reacting in inflammation,unusual factor of neural endocrine and MS can't be ignored either.The diagnostic standard of MS existed greatly discussion,CDS works about MS in 2004 was defined and relatively suitable for the eastern.MS involves a wide range of knowledge,the clinical manifestation is complicated and various,get up disease to be slow usually,can have any subjective symptoms early,the only ones that checked in the laboratory.Seeing that present MS popular situation,how to prevent arid cure MS become a great challenge that the administrative department of the hygiene and medical personnel face scientifically.There is not the guide unified MS that prevent and cure at present,modern medical science regards preventing or delaying emergence and development of heart and brain blood vessel disease and 2 type diabetes as the main goal.In these decades nearly,modern medical science has made considerable progress in view of basic research and preventing and curing clinically of MS,but also there are a great deal of difficulties,the mistaken idea exists in reducing,micro research way,and the present prevention and cure method is also at primary stage.And TCM by way of its whole view's understanding,"Cure before the disease" medical thought,whom dialectical theory manage make a diagnosis system,abundant health care study method and natural,low toxicity,safe,cheap traditional Chinese medicine,can many composition,many link,many target afford to order,bring a lot of new thought,new methods for the prevention of MS, there are irreplaceable obvious advantages in preventing and curing.There is no corresponding disease to MS in TCM,in "Huang Di Nei Jing" era leave for some records relevant where MS know,Doctors have some exertion in later age,but has not taken described systematiclly,has recorded relatively scattered.In recent years,TCM workers have carried on research from all angles to MS involving the cause of disease,ill machine,curing method,prescription,acupuncture and moxibustion,etc.But it has not formed unifying understanding yet.We considered that to set up objectify,standardized,can reflect MS pathogenesis differentiation type,could guide the clinical treatment effectively,and improve curative effect.And fully utilize the modern medical achievement,probe into the corresponding of the macro and micro Differentiation.Section2 Investigation to TCM Syndromes and study on pathogenesis of Metabolic SyndromeObjective:Research and analysis MS patients' Syndromes of Guangzhou adults, probe into the pathogenesis and Syndromes regular pattern of developing of MS.Methods:Cross section,investigation research approach when it is prospective,it adopts define CDS about work of MS on the 2004 and "National standard in the People's Republic of China·the part of Syndromes of TCM clinical diagnosis and therapy terms", and defines the standard of including and the standard of excluding,and make the analytical table of the investigation by myself,has observed 518 MS patients.Carries on classify analysis to the four methods of diagnosis materials,and carries on principal components analysis to every kind of results of classify analysis,and sum up the TCM Syndromes of MS according to the statistics.Meanwhile,carry on artificially Differentiation on every MS patients,and analyzes the result compared with cluster's analysis'.Meanwhile,pass to every patient with Liujing Differentiation and analyzed with Frequency Analysis. Results:(1)The result of the frequence analysis of syndrome differentiation:It is often concurrently appeared a lot of Syndromes on MS patients,the patient with 3 kinds of Syndromes accounts for 77.22%.As a whole,accumulation of phlegm occupies the first place of DM Pathogenesis,and the deficiency of vital energy occupies the second place, and stagnation of the circulation of vital energy,blood silt,deficiency of Yin,strongly fragrant and hot,suffers from a deficiency of the kidney,the spleen is empty in following.(2) The result of artificially Liujing Differentiation:MS pathological change involves Liujing,among them the morbidity of the Taiyin disease is the highest,accounts for 77.61%; and the Jueyin disease(52.32%),the Shaoyang(48.07%),the Shaoyin disease(45.37%) secondly;and the Yangming disease have many proportion too(31.08%);And the Taiyang disease only 2.12%.Most MS patient has More than two Jing disease.(3)The results classify analysis and principal components analysis:deficiency of liver-yin,hyperactivity of liver-yang syndrome;accumulation of phlegm,damp more than heat,damp flourishing and Yang decline syndrome;Qi stagnation of the liver,the deficiency of Yang-qi syndrome;blood stasis and kidney deficiency syndrome;spleen deficiency and stagnation of Qi and damp-heat impairment Yin syndrome.Discuss:(1)The artificial Differentiation can deal clinical situation flexibly,but there are unavoidably stronger subjectivity,experience in it,but with classify analysis and principal components analysis,it can make prospective analysis the results in case of not personal-conception first at all,has improved the objectivity and science of Differentiation greatly.But what classify analysis is analyzed is only a simple one-to-one relation,while analyzing the complicated problem,it may ignore the characteristic with multifactor and non-linear relationship.The resulting conclusion of two kinds of research approaches of this thesis is basically identical,have certain credibilities.(2)This thesis considered disease location of MS is on the spleen,kidney and liver,the syndromes is the deficiency of essence and excess of Surface,and inclusion deficiency and excess.The deficiency of kidney and spleen is the essence,and accumulation of phlegm and blood stasis is the Surface,the disorder of Liver to maintain free flow of Qi is the important link,and changing into the weakness syndrome is the final result.(3) This Thesis deal MS Differentiation with Liujing Differentiation for the first time. Though there are many shortage,the research has done the bold,beneficial attempt to MS prevention and cure.Among MS,the Taiyin disease is the largest,it accord with the disease machine characteristic of the Lingnan patients.Because it is closely related to spiritual factor,and the disease machine characteristic is apt to cold and hot,and inclusive with Deficiency and excess Syndromes,so MS linked to the Shaoyang disease and the Jueyin disease closely.Meanwhile,the function of kidney-Qi can't be neglected,and long disease will injure the kidney,especially old MS patients often have the factor of the kidney deficiency,so the Shaoyin disease are not small number in MS.the Yangming disease comes up to a large number among MS patient too.But Taiyang sun disease is actually rare in MS.Section3 Study on the correlation with TCM Syndromes of Metabolic Syndrome and micro-IndicatorsObjective:Research on the correlation with the mainly TCM Syndromes of Metabolic Syndrome and micro-indicators of modern medical,in order to establish the initial foundation of the Standardization Study of TCM Syndromes and Micro-differentiation of MS.Methods:Based on the second Section research,common three main MS syndrome types(accumulation of phlegm and deficiency of Qi syndrome;deficiency of Qi-Yin, damp-heat inside flourishing syndrome;accumulation of phlegm and blood stasis and kidney deficiency syndrome),selected 90 MS patients,and 30 for every group.In addition, choose 30 healthy persons as the control group.Then measure the indicators such as FINS, 2hINS,HbA1c,IAI,ADP,LEP,FFA,TNF-α,IL-6,etc.Resuits and Discuss:(1)FINS level in normal level basically in three syndrome types. Because of the normal value of FINS is 1.9～23μIU/ml,the discrepancy is great,so it is difficult to regard FINS as a micro-Indicators of MS TCM Syndromes.2hINS level,the three groups of MS are on the high side than normal.It indicats that insulin is secreted the compensating and increased,there is high insulin blood level after the meal.It is one representation of IR.But it is difficult to regard as a micro-Indicators of MS TCM Syndromes too.(2)HbA1c is basically in the normal level in the accumulation of phlegm and deficiency of Qi syndrome group.But it is the majority higher than normal in the deficiency of Qi-Yin,damp-heat inside flourishing syndrome group and the accumulation of phlegm and blood stasis and kidney deficiency syndrome group.HbA1c can comparatively reflect the patient's average blood glucose level truly.So it can be regarded as a micro-Indicators of MS TCM Syndromes.(3)From the accumulation of phlegm and deficiency of Qi syndrome group to the deficiency of Qi-Yin and damp-heat inside flourishing syndrome group,to the accumulation of phlegm and blood stasis and kidney deficiency syndrome group,the numerical value of IAI is reduced gradually,has reflected comparatively truly that IR intensity is aggravated from is early to later stage of MS.IAI can be seen as an objective Indicators of Micro-differentiation of MS.(4)Among the deficiency of Qi-Yin,damp-heat inside flourishing syndrome group and the accumulation of phlegm and blood stasis and kidney deficiency syndrome group patients,the APN level is lower than the normal group and the accumulation of phlegm and deficiency of Qi syndrome group patients.Its level from high to low order is:the normal control group≈the accumulation of phlegm and deficiency of Qi syndrome group>the deficiency of Qi-Yin,damp-heat inside flourishing syndrome group≈the accumulation of phlegm and blood stasis and kidney deficiency syndrome group.APN can be seen as an objective Indicators of Micro-differentiation of MS.(5)In the accumulation of phlegm and blood stasis and kidney deficiency syndrome group,the serum level of LEP is higher than the other groups.With the development of MS condition,IR intensity is more and more serious,thereupon LepR aggravates too,so the serum level of LEP obviously increases in later course of MS.LEP can be seen as a referenced Indicators of Micro-differentiation of MS.(6)In MS group,the serum levels of FFA is higher than the normal group,the difference is significance,prove FFA is closely related to MS.But FFA level does not have significance difference among three syndrome types.This maybe relates to the fact that three syndrome types all have the phlegm Factor.By the look of result of this subject,FFA is difficult to become the Micro-differentiation Indicators of MS.(7)TNF-αand IL-6 are the Indicators that reflect the inflammation reaction of the organism.This research indicates,the change of TNF-αlevel is:the accumulation of phlegm and deficiency of Qi syndrome group≈the deficiency of Qi-Yin,damp-heat inside flourishing syndrome group>the accumulation of phlegm and blood stasis and kidney deficiency syndrome group≈the normal control group.But among three syndrome types groups,the IL-6 level only the deficiency of Qi-Yin,damp-heat inside flourishing syndrome group is obviously higher than the normal control group.TNF-αand IL-6 can be seen as a referenced Indicators of Micro-differentiation of MS,it reflects the Intensity of fighting with Vital-Qi and pathogens.