| Objective: To investigate the Xinjiang Uygur and Han Chinese medicine in type 2 diabetes patients with basic syndromes, metabolic characteristics and compare TCF7L2 gene polymorphism. The first part, literature and theory. Modern medicine for type 2 diabetes do recognize systematic review of modern medicine to clear the main symptoms of type 2 diabetes objective understanding, based on these characteristics of the main symptoms of the TCM classical literature related syndromes are discussed, in order to test the idea of system theory Zhongjing comb, in order to find a suitable system of differentiation of diabetes and determine its basic syndromes. The second part, clinical investigations and experiments. Peacekeeping and Han type 2 diabetes patients with Syndrome investigations to clinical testing in diabetic basic syndromes scientific theory; simultaneous acquisition of the patient's medical history, eating habits of life, on anthropometric and biochemical metabolism tested to contrast dimension metabolic characteristics and Han and its relationship with the syndromes of TCM clinical basis to provide microscopic differentiation. The third part, through the Uigur and Han ethnic type 2 diabetes patients and normal control subjects were TCF7L2 gene polymorphisms explore two susceptibility genes Uighur and Han ethnic diabetes. By studying the characteristics of metabolic syndromes and genes interact TCF7L2 explore genomics essence of TCM syndrome. Method:(1) A systematic literature review method, through academic discrimination, the ancient Chinese medicine literature to classify content, analysis, logical reasoning and combining traditional Chinese medicine analogy, Summarization evolution of Diabetes, diabetes find basic certificate candidates.(2) A method of clinical epidemiology, select type 2 diabetes in line with the standard 580 cases, including 288 cases of Uygur and Han 292 cases for the study,(1) fill out our group through literature review, expert advice compiled the " Uygur and Han people with type 2 diabetes Syndrome scale survey "survey conducted Syndrome,(2) record patient's medical history, eating habits, smoking, alcohol consumption, exercise and other dietary habits, measure patient height, weight, waist and hip circumference, systolic blood pressure, diastolic blood pressure and other anthropometric indicators, biochemical detection of metabolic parameters, including fasting plasma glucose(FBG), glycosylated hemoglobin(HbA1c) testing, the blood lipid profile cholesterol(CH), triglyceride(TG), high density lipoprotein cholesterol(HDL), low density lipoprotein cholesterol(LDL) and uric acid(UA), urea nitrogen(BUN), creatinine(Cr).(3) all the data from the EPI data software input for SPSS version 19.0 software for statistical analysis, to study the dimensions and Han type 2 diabetes syndrome characteristics, among metabolic characteristics compared and different syndromes anthropometric compare students of metabolic markers.(3) Using a case-control study in patients with type 2 diabetes in line with the standard 580 cases, including 288 cases of Uygur and Han 292 cases, 307 cases of healthy control group, in which 99 people of Uygur, Han 208 people. ImLDRTM use multiple SNP genotyping technology TCF7L2 gene rs290487, rs4430796, rs864745 and rs231362 single nucleotide polymorphism(SNP) loci were genotyped, and chi-square test and evaluate these various genetic model analysis and SNP 2 relevance diabetes disease, and also record the patient's anthropometric students of metabolism, fill in the questionnaire Syndrome, by association analysis interaction of metabolic Syndrome and TCF7L2 gene. Results:(1) TCM ancient literature systematic collation found Han previous literature, "Nei Jing" "Febrile Diseases, " emphasized the physical factors of internal endowments, it is the basic condition onset by exogenous, food, housing and other labor induced. The pathogenesis, "via" stressed Yin hot, cold treatment is beneficial to the drug; drugs to test evidence, "by" understanding of the disease pathogenesis is empty(yin or yang), the main pathological factors to heat, there are water retention and blood stasis, "doctors do not record" that is mainly for the deficiency, the major pathological factors for the hot gas and water also stopped inverse; "Febrile Diseases, " is in recognition of the onset of fever Shangyin also stressed deficiency, the gas is not Buzin main pathogenesis, disease can occur during hot Yin deficiency pathological factors(4) drinking water and stressed the mutual conversion between pathological factors, the final four main pathological factors coexist.From the Tang and Song dynasties, heat YangYinShengJin law has become mainstream, Jin and Yuan Dynasties, Chinese medicine has experienced prosperity and development, under the influence of Liu Hejian, Yin hot pathogenesis recognized.ming physicians for Diabetes awareness further emphasize diagnosis and treatment. Diabetes clear fluid and heat for the main machine, not of the kidney are not uncommon.Because different times of the natural environment, human conditions, disease of the ancient physicians formed a personal theoretical ideas. Sun Simiao, Liu Hejian, Zhang Zi and Zhu Dan, Li Dongyuan, who pay attention to hot deficiency syndrome, the three consumer dialectical constant development and improvement, Cheng Peng summed up as "the rule Consumers are advised to run their lungs, and clear their stomach, two winter soup master of; governance Consumers who Yiqing its stomach, renal and AIDS, habitat eight was Tom Lord; next rule Consumers were advised renal AIDS, and fill their lungs, to yellow soup, and the Lord of the other Shengmaisan On the one hand, the Chen Yan, Chen no choice, Li Chan and other physicians pay more attention to water yang syndrome, common kidney pills, SHENLINGBAISHU scattered.(2) The survey, peacekeeping and Han T2 DM occurrence frequency of the top ten symptoms are fatigue(98.3%), lip throat dried(93.3%) thirst(83.3%), numbness(80.5%), short gas lazy Introduction(71.4%), urinary frequency(70.3%) and blurred vision(70.2), polydipsia(68.3%), pale complexion(68.1%), dizziness(66.6%).(3) Dimension, and Han compared to patients with type 2 diabetes,(1) diet habits, peacekeeping and Han there are significant differences in alcohol consumption, exercise, eating habits aspect, and statistically significant(2) complications, peripheral vascular disease Han The incidence(43.49%) lower than the Uighur(52.08%), the incidence of diabetic nephropathy in Han(15.07%) lower than the Uighur(28.13%), the incidence of diabetic ketoacidosis Han(5.14%) higher than Uygur(2.08%).(3) complications compared with cerebral infarction or bleeding between Han and Uygur, dyslipidemia prevalence statistically significant. Han cerebral infarction or hemorrhage rate(14.04%) was higher than Uygur(6.25%), Hans dyslipidemia incidence(49.66%) lower than the Uighur(59.38%). There were significant differences(P<0.05)(4) history and ergonomic comparative measurements, Uighur waist, hip, heart rate, respiration, systolic and diastolic blood pressure were higher than the Han(P<0.05),(5) metabolic parameters compared Weihan there are between HbA1 c, LDL protein, uric acid statistically significant difference(P<0.05). Han uric acid above the Uygur, Han glycated hemoglobin, a protein LDL less than Uygur.(6) between different ethnic groups of C-peptide, glucose tolerance was not statistically significant, the difference was statistically significant insulin release. Han fasting and postprandial 30 min, meal 1h, postprandial 2h, 3h postprandial insulin release were higher than Uygur patients. (4) T2 DM patients in this study spleen phlegm highest proportion(48%), followed by the ASDP, Qi Deficiency "other card" lowest percentage. Different Types of gender, ethnic, age, the difference was not statistically significant(P>0.05). Among the main symptoms of different syndromes(1)(2) no significant difference between eating habits compared to no significant difference(3) anthropometric indexes compared no significant difference(4) biochemical metabolism, the difference was statistically significant uric acid, Qi type uric acid is higher than the other three syndromes, the remaining differences were not statistically significant. Differences(5) different syndromes of glucose tolerance was not statistically significant(F=0.229, P=0.876).(6) difference between different syndromes of insulin release was not statistically significant(F=0.264, P=0.852).(7) C-peptide at different time difference also was not statistically significant(F=1.826, P=0.124).(5) Medical history, anthropometric and metabolic indicators compare the test, diastolic blood pressure between different syndromes of Han difference was statistically significant between Han patients with different syndromes, Yin Deficiency type diastolic blood pressure higher than the other three syndromes(P<0.05).(6) Medical history, anthropometric and metabolic indicators of comparison between different syndromes Uighur patients, the test, the weight difference between Uighur different syndromes statistically significant weight higher than the other three Yin Deficiency type certificate type(P<0.05).(7) Two Uighur and Han Nationality and TCF7L2 genetic diversity study found,(1) In Xinjiang Uygur population, rs290487, rs864745, rs231362 genotype TCF7L2 gene were in type 2 diabetes patients and healthy control subjects were significantly different, TCF7L2 gene mutations rs290487 CC genotype is a risk factor of T2 DM Uighur, rs864745 CC genotype of the mutation is a protective factor of T2 DM Uighur mutant genotype of rs231362 AA is a protective factor of T2 DM Uighur.(2) Han population in Xinjiang, rs290487, rs4430796, rs864745, rs231362 genotype TCF7L2 gene in type 2 diabetes patients and healthy control subjects were not significantly different, respectively.(3) In the Xinjiang Uygur and Han type 2 diabetic population, rs290487, rs4430796, rs864745, rs231362 genotype TCF7L2 gene respectively Uighur group and Han group were significantly different.(4) Phenotype association studies found that, TCF7L2 gene rs290487 locus and diabetes waist, hip, DBP, FPG, HbA1 C interactive relationship, rs4430796 locus TCF7L2 gene and diabetes FPG interactive relationship, rs231362 bit TCF7L2 gene point interactive relationship with diabetes HDL-C.(5) Uygur type 2 diabetes Syndrome Types with TCF7L2 gene rs231362, rs290487 polymorphism loci have internal relations, Han type 2 diabetes syndromes typing has inherent relationship with TCF7L2 gene rs290487 polymorphism loci. The innovation of this study is to 1, the system using the method of literature research by academic discrimination, the ancient Chinese medicine literature content classification, analysis, theory Zhongjing to the viewpoints Evolution Summarization Diabetes, Looking basic syndrome diabetes waiting. 2, to carry out a cross-sectional epidemiological survey Xinjiang type 2 diabetes syndrome distribution, providing ideas and methods with type 2 diabetes syndromes objective research data confirm the spleen phlegm is the main(basic) Modern type 2 diabetes one syndromes. 3, combined with modern medical research progress Select several anthropometric and biochemical parameters, and study genetic diversity, genomics biological basis of type 2 diabetes Spleen phlegm were multi-angle, multi-level active exploration. Conclusion:(1) water retention syndrome Yang Syndrome and Yin hot card is the basic syndrome type 2 diabetes candidate.(2) In this study two ethnic Uighur and Han T2 DM patients spleen phlegm as the main syndromes, the highest proportion(48%), followed by the ASDP. And gender, other family, there was no difference in age.(3) two-dimensional Han nationality T2 DM occurrence frequency of the top ten symptoms followed by fatigue, lips and throat dry, thirst, numbness, short gas lazy words, frequent urination and blurred vision, polydipsia, pale complexion, dizziness.(4) metabolic characteristics of different dimensions and Han, Uygur waist, hip, heart rate, respiration, systolic blood pressure, diastolic blood pressure, glycated hemoglobin, low-density lipoprotein were higher than the Han. The uric acid index lower than the Han. Han fasting and postprandial 30 min, meal 1h, postprandial 2h, 3h postprandial insulin release were higher than Uygur patients.(5) between the two peoples eating habits, complications of type 2 diabetes, complications were different. Complications, Han peripheral vascular disease, diabetic nephropathy incidence lower than Uygur, and the high incidence of diabetic ketoacidosis in Uygur; complications compared with Han cerebral infarction or hemorrhage was higher than Uygur, and the rate of occurrence of dyslipidemia less than Uygur.(6) different syndromes compared to Qi Deficiency highest uric acid; between Han patients with different syndromes diastolic Qi Deficiency highest; Uygur patients with different syndromes difference between weight, Qi syndrome> ASDP> spleen phlegm. Tip uric acid, diastolic blood pressure, body mass index may be microscopic Qi Deficiency Syndrome of.(7) TCF7L2 gene rs290487, rs864745, rs231362 polymorphism genotype and Xinjiang Uygur type 2 diabetes related, has nothing to do with the onset of the Han.(8) TCF7L2 gene and type 2 diabetes-related metabolic characteristics: TCF7L2 gene point with diabetes waistline rs290487 position, hip, DBP, FPG, HbA1 C interactive relationship, rs4430796 locus TCF7L2 gene and diabetes FPG interactive relations, rs231362 locus TCF7L2 gene and diabetic patients HDL-C interactive relationship.(9) TCF7L2 gene and type 2 diabetes-related syndromes: Uygur type 2 diabetes Syndrome Types with TCF7L2 gene rs231362, rs290487 polymorphism loci have internal relations, Han type 2 diabetes Syndrome Classification type intrinsically relationship with TCF7L2 gene rs290487 polymorphism loci. |
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