Study On The Correlation Between Metabolic Syndrome And Damp-heat Theory Of Warm Diseases

Objective: Based on the understanding of relationship between damp-heat and multiple systems or major diseases and the research status of metabolic syndrome(MetS),the correlation between damp-heat and MetS is systematically discussed based on the connotation of the theoretical system of damp-heat in warm diseases,aiming to provide theoretical basis and treatment ideas for MetS.Methods: The research methods included theoretical research,literature research,data mining and epidemiological investigation.In the part of theoretical research,the concept,origin and theoretical system of damp-heat syndrome of warm disease were systematically combed.The literature research part,including the current status of the research of MetS in Chinese and Western medicine,the related discussion of the components of MetS such as damp-heat and diabetes in ancient literature,and the discussion of the correlation between damp-heat and MetS based on ancient and modern literature.In the data mining section,CNKI,Wanfang and Pub Med were used as search databases,all literatures on damp-heat syndrome/constitution of MetS in the past 50 years and related literatures on damp-heat syndrome and treatment of diabetes mellitus and other components of MetS were sorted up,analyzing respectively MetS damp-heat syndrome/constitution published quantity,distribution and other modern research status,as well as disease location,syndrome elements,frequency distribution of classical prescriptions of damp-heat syndrome,and using traditional Chinese medicine inheritance support platform to analyze medication rules of self-made prescriptions.Epidemiology investigation part,with MetS patients in Ningxia area as the research object,collecting their related lifestyle,TCM four diagnostic information,etc,after calculating and grading the weight of the four diagnostic information according to Syndrome Differentiation of Syndrome Elements,then T test,Rank sum test,Chi-square test,Logistic regression analysis,Spearman correlation analysis were used to analyze the risk factors of MetS and its correlation with other syndromes.Results:1.Research on theory and literature: The theory of damp-heat in warm disease has formed a complete theoretical system involving theory,method,prescription and medicine in Ming and Qing dynasties.Although MetS is not the traditional Chinese medicine name,the related discourse between MetS’s components such as diabetes,hypertension and dampheat appears since ancient times.Combining the classic works of Treatise on Epidemic Febrile Diseases,Detailed Analysis of Epidemic Warm Diseases,Chapter on Damp-Heat and the characteristics of MetS,it is considered that,first,the cause of MetS damp-heat syndrome is excessive eating cream and sorghum thick taste and spleen injury.Second,characteristics of pathogenesis is that damp-heat and dysfunction in spleen and stomach,spleen deficiency is the foundation and damp-heat is the standard.Third,in the process of disease progression,phlegm,blood stasis and other pathological products can be produced,which are interwoven with damp-heat,and then to obstruct the middle-jiao,block the orifices,enter the blood,gather the viscera,soak the skin,meridians,muscles and bones,that are the reasons why diabetes,stroke and other MetS associated diseases and complications appear.Fourth,bitter and pungent method is the main treatment of MetS damp-heat syndrome,Wendan decoction and Xuanbi decoction are representative prescriptions.2.Research on Data Mining: 67 literatures on correlation between MetS and damp-heat are included,no animal experiment is found,and MetS damp-heat syndrome’s location is spleen,also is easy to be combined with Qi deficiency and blood stasis.356 articles on correlation between diabetes and its complications and damp-heat are included,it is found that damp-heat syndrome of diabetes mellitus is easy to be accompanied by spleen,kidney,stomach,blood stasis,Yin deficiency and Qi deficiency.12 articles on correlation between hypertension and damp-heat are included,it is found that damp-heat syndrome of hypertension is easy to be accompanied by spleen,blood stasis,Yin deficiency and Qi deficiency.6 articles on correlation between dyslipidemia and damp-heat are included,it is found that damp-heat syndrome of dyslipidemia is easy to be accompanied by kidney,liver,Yin deficiency.17 articles on correlation between obesity and damp-heat are included,it is found that damp-heat syndrome of obesity is easy to be accompanied by spleen and phlegm.29 classical prescriptions(Gegen Qinlian decoction,Huanglian Wendan decoction,Simiao powder,etc.)and 77 self-made prescriptions are extracted from 188 literatures on damp heat syndrome.The results about anlysis of 77 self-made prescriptions involving 152 herbs show that the distribution frequency of the four natures is cold,warm and flat,as well as the distribution frequency of the five flavours is bitter,sweet and pungent,and meridian distribution is spleen,stomach,etc.On the premise that the number of support degree is 13 and the confidence degree is 0.6,the core drugs of the self-made prescriptions are the combination of Coptis with Pueraria,pinellia,Scutellaria,Salvia miltiorrhiza,Atractylodes and so on.3.Research on epidemiological investigation: In 431 cases of MetS,liver,kidney and spleen are the main MetS’s location,and Yin deficiency,Qi deficiency,blood deficiency,dampness,Yang deficiency and phlegm are the main accompanied syndrome elements.There are 61 cases(14.15%)in the damp-heat syndrome group,including 30 cases of equal severity of dampness and heat,27 cases of dominant dampness over heat,and 4 cases of dominant heat over dampness.It is also found that MetS damp-heat syndrome is easy to be accompanied by liver,kidney,spleen,Yin deficiency and phlegm.Logistic regression analysis shows that body mass index,family history of hyperglycemia,abnormal mood,sleep quality,eating out and smoking history are risk factors of MetS damp-heat syndrome.The results of correlation analysis show that the degree of liver,kidney,spleen,stomach,mind,muscles and bones,as well as the degree of Yin deficiency,phlegm,Yang hyperactivity,Qi stagnation,blood stasis and body fluid deficiency are positively correlated with the occurrence of MetS damp-heat syndrome.While the more obvious the dampness is,the more severe the spleen asthenia is,and the performance of dryness is reduced accordingly.Conclusions:1.Damp-heat is closely related to MetS,but its correlation research is obviously insufficient.In recent years,although the number of literatures has increased,the growth is slow,especially in the animal experimental research has not been reported,and lack of mechanism research on the correlation between them.2.“There are also many damp diseases in the north”.The MetS damp-heat syndrome is easy to be accompanied by spleen,stomach,liver and kidney,as well as Yin deficiency,phlegm,blood stasis,Qi stagnation,Qi deficiency and other syndrome elements,especially Yin deficiency and damp-heat often cause MetS simultaneously.Losing weight,keeping optimistic mood,improving sleep quality,eating lightly and quitting smoking are important measures to prevent Mets damp-heat syndrome.3.From etiology and pathogenesis to treatment and prescriptions,the theory of dampheat of warm disease provides theoretical guidance for MetS.Mainly in the following aspects: first,the pathogeny is fatty diet and spleen injury.Second,the pathogenesis characteristics is spleen and stomach get sick together,asthenia in origin and asthenia in superficiality.Third,the key point of prevention is light taste.Fourth,acridness relieving superficies and bitterness expelling internal heat is the main treatment method,Gegen Qinlian decoction,Huanglian Wendan decoction and Sanren decoction are effective prescriptions for resolving damp-heat.Fifth,the key points of clinical treatment are “clearing away heat and removing dampness from multiple ways” “grasping the spleen and stomach,not forgetting the liver and kidney” “nourishing Yin and resolving phlegm,taking into account both syndromes” “disease-syndrome combination,having a definite target in view”.