Research Study On Diagnostic And Treatment Of Damp-Heat(Hygropyrexia) Syndrome In Type2Diabetes Patients In Singapore

A research study on Diagnostic and Treatment of Damp-Heat (hygropyrexia) Syndrome commonly associated with Type2Diabetes Patients in Singapore was conducted through systematic statistical analysis of187clinical case-studies of diabetes patients with damp-heat syndrome collected from the medical consultation system in Singapore Chung Hwa Medical Institution with comprehensive research on ancient and modern TCM literatures,and compare and analyses against secondary research finding on clinical case-studies, research papers and journal’s articles published on similar topics, in the immediate past15years in China. The objectives were to identify the characteristic profile associatedwith Type2Diabetes Patients with damp-heat syndrome and the guiding principles of treatment through syndrome differentiation and prescription of TCM pharmacology associated with the treatment. The research study serves as a theoretical guidance providing useful and effective treatment approaches forType2Diabetes Patients with damp-heat syndrome, and serve as a foundation for future in-depth study to be conducted on similar topics.OBJECTIVE AND METHODS:Part1:Awareness of DiabetesObjective and Methods:Through in-depth literature review on ancient and modern Chinese literature related to diabetes with damp-heat syndrome, documentation of ancient TCM physician, seeks to understandthe causes of diabetes with damp-heat syndrome, the corresponding diagnostic analysis approaches, the basic pathological changes and Syndromes differentiation principles. Modern medical researches on diabetes, such as the pathogenesis of diabetes, treatment methodology, and practical researches on diabetic damp-heat syndromes were also studied.RESULTS:1. A total of187cases Medical records of patients diagnosed with diabetes were collected from Singapore Chung Hwa Medical Institution clinical management systems. Of this group,178patients,95.19%, met the inclusion criteria and their records were included in the study.93were males, accounting for52.25%; women,85, accounting for47.75%.2.76.97%lack of typical symptoms (Polydipsia, polyphagia, and polyuria) which were associated with diabetic patients; nearly55%of the patients with diabetes demonstrate syndrome of dampness while nearly40%are damp-heat predominance. Nearly50%of those over60years old and majority of middle-aged have damp-heat syndrome, accounting for34.62%, indicate that damp-heat syndrome is common in diabetes patients across age’s group.3.89.89%of patients in the study had at least one other chronic illness and among them those with high cholesterol being the majority, accounting for49.44%.4.8most commonly used TCM compound prescriptions are "liuwei dihuang wan","qiju di huangtang","san xiao tang","xiao ke heji","ganlu xiaodu yin","shen ling baizhu san","yi qi shengjin jiaonang"and"sheng mei san".5.8most commonly TCM herbal medicine are Astragalus "Huangqi", Salvia "danshen", Kudzu "gegen", Atractylodes "baizhu",Scrophulariaceae "xuan shen", herb "cangzhu",Poria"fuling", and Chinese yam.,"shanyao".Part3:Literature review on occurrence of diabetic patients with damp-heat syndrome and the corresponding TCM pharmacologyin ChinaObjective and Methods:To understand theoccurrence of diabetic patients with damp-heat syndrome and the corresponding TCM pharmacology in China. A literature review was done on a collection of186publications of research papers, excerpts, and clinical cases on treatment of diabetes using TCM, published in the immediate past15years in China. The occurrence of damp-heatiness in diabetic patients and the corresponding TCM pharmacology, the frequency of used TCM medicine were also analyzed to serve as a reference for future treatment.RESULTS:1. According the the literature review, the damp-heat syndrome has beome an inevitable course of development for diabetes patients, and the trend has shown significantly increase along the year in China. Due to the geographical spread of China and the complex culture indifferent parts of China, the syndrome pertaining to diabetes patients differs in different regions. However damp-heat syndrome among the diabetic patients account for20%to40%across the regions.2. Most of the patients with damp-heat syndrome have some degree of fatness. Patients manifested syndromes are typically fatness or abdominal bloatedness, limb fatigue, mouth stickiness, irregular stool pattern, rapid and slippery pulse and tongue with yellow greasy moss or turbid greasy, rapid and smooth rolling pulse. Key differentiations to be observed during clinical diagnostic are the overall body side of the patient, tongue diagnostic and pulse characteristics. Part4:Discussion on the Principles in the treatment of diabetic patients with damp-heat syndromeObjective and Methods:Through the analyzed conclusions derived from the research studies done, the section strive to discuss the dialectical points related to diabetic patients with damp-heat syndrome, to confirm the proposed principles of TCM pharmacology and the pharmacodynamics characteristics of frequently used TCM medicine and present a recommendation for TCM dietary approaches to diabetic patients with damp-heat syndrome.RESULTS:1. According the the literature review, the damp-heat syndrome has become an inevitable course of development for diabetes patients, and the trend has shown significantly increase along the year in China. Due to the geographical spread of China and the complex culture indifferent parts of China, the syndrome pertaining to diabetes patients differs in different regions. However damp-heat syndrome among the diabetic patients account for20%to40%across the regions.2. Most of the patients with damp-heat syndrome have some degree of fatness. Patients manifested syndromes are typically fatness or abdominal bloatedness, limb fatigue, mouth stickiness, irregular stool pattern, rapid and slippery pulse and tongue with yellow greasy moss or turbid greasy, rapid and smooth rolling pulse. Key differentiations to be observed during clinical diagnostic are the overall body side of the patient, tongue diagnostic and pulse characteristics.3. During the treatment, while treating the superficial syndrome presented, one need to keep in mind of the fundamental deficiency of the patient. While cleansing the damp-heat pathogenesis, will need to look in to the nourishing of the constitution and at the same time look into the possible changes of the pathogen, with reasonable selection of medication to aid blood circulation, nourishing the liver Qi and other appropriate therapies, will result in a better treatment.4. Principles of TCM pharmacology for diabetic with damp-heat syndrome (1) Nourishing the fundamental constitution and removing the superficial damp-heat syndrome at the same time,(2) while removing the damp-heat, need to consider which is more prevalent, damp or heat, and the location of the syndrome,(3) while nourishing the fundamental constitution, need to consider the pathogenesis relationship between the Qi, Blood, Yin and Yang,(4) in the event of prolong treatment, will need to improved blood circulation to prevent stasis in the meridian systems,(5) in the case of chronic illness need improve Qi circulation in the liver systems to manage stagnation Qi which may cause depression.5. A balanced diet, based on the maintenance of reasonable weight management with the objective of reduces the possibility of causing acute or chronic complications. The principles are to remove dampness heat, eating light, regular exercise and regulate one’s emotions.CONCLUSION:Through analyzing the results of this study, with the progress of the society and the economy, the occurrence of the damp-heat (hygropyrexia) syndrome among the diabetes patients has become inevitable in the dynamic development process of diabetes. The factors such as unique environmental impact, changes in diet pattern, stress exacerbated with the development of the society, all have significant impact on the increase of damp-heat syndrome incidence among the diabetes patients. Such impacts can be diagnosed and treated through TCM diagnostic approach by observing the symptomatic manifestation in different visceral systems. The TCM syndrome differentiation diagnostical approach in treating patients based on their unique characteristic profile serve as an advantage for treatment of diabetes patients with diabetic damp-heat syndrome.