| Backgroud: TCM syndromes differentiation is the marrow of TCM. Insulin resistance (IR) is the basic characteristic of type 2 diabetes mellitus (T2DM) .Aim: To study the relationship between the TCM syndromes and IR, and to study the relationship between sputum moist syndrome(SMS) and the TCM syndromes -. Overweight/Obesity, chronic vascular complications (VC), whick provide index for type 2 diabetes mellitus.Materials and Methods: According to WHO diagnosis criteria and TCM differentiation criteria, We selected 84 cases (38male and 46 female). The average age is 52.16 13.95 years old. The process of disease is 9.56 6.82 years. 53 cases are vascular complications (VC), 31 cases are non-vascular complications(NVC). TCM syndroms include Yin deficiency and heat excess syndrome (YDHES, 28), Qi and Yin deficiency syndrome (QYDS, 35), Yin and Yang deficiency syndrome (YYDS,21). Of the 84cases, 48 are SMS, 36 are non- SMS(NSMS). Healthy people (14 male and 16 female) were taken as the control group, the average age is 53.37 10.68 years old. We detected fasting plasma glucose (FPG) by glucose oxidase, fasting insulin (Fins) by chemiluminescent immunoassay, triglyceride (TG) and high density lipoprotein-cholesterol (HDL-C) by zymology, tumor necrosis factor-a(TNF-a)by enzyme linked immunosorbent assay (ELISA), the reverse of the product of FPG and Fins is used as the insulin sensitivity index (ISI), that is, ISI=1/FPG Fins. And measure weight ,stature , waistline and buttock line. Then count out BMI[BMI=weight(kg)/stature(m2)] and WHR[WHR=waistline(cm)/buttock line(cm)].Results: 1.Compared with the control group, the ISI of type 2 diabetes mellitus was significantly lower (P<0.01), the level of TG was higher (P<0.01), the level of HDL-C waslower (P<0.01), the level of TNF-awas higher (P<0.01), BMI and WHR were higher(P<0.01). The above-mentioned markers of VC were more serious than NVC. 2.The ISI of TCM syndromes were lower than that of the control group (P<0.01), the degree of IR was as follow: YYDS>QYDS>YDHES, and the level of TNF-a and TG were higher than that of the control group (P<0.05, PO.01), the level of HDL-C was lowest in YYDS and QYDS(P<0.01), the level of BMI and WHR of QYDS were higher than that of the control group, YDHES (PO.01), the level of WHR of YYDS was higher than that of the control group, YDHES (P<0.01). 3-Compared with NSMS , in SMS, ISI was lower (PO.01), the level of TG, TNF-awere higher (P<0.01), the level of HDL-C was lower (P<0.01), the level of BMI and WHR were higher (P<0.01); There was the same change in Overweight/Obesity. 4. There was some distribution of SMS in each TCM syndrome, and QYDS was higher than that in YYDS (P<0.01), YYDS was higher than that in YDHES (P<0.01). SMS in Overweight/Obesity was higher than that in Normar weight.S.The occurance of VC in SMS was higher than that in non- SMS (P<0.01). 6.ISI was closely positive correlated to HDL-C (P<0.05) and negative correlated to TG, TNF-a, BMI, WHR, FPG (P<0.01); The level of TNF-a was closely positive correlated to TG, BMI, WHR, FPG (P<0,01) and negative correlated to HDL-C (P<0.05, P<0.01); The level of TG was closely positive correlated to TNF-a, BMI, WHR, FPG (P<0.01), and negative correlated to HDL-C (P<0.01).Conclusion:1.TCM syndrome differentiation of T2DM reflect pathophysiological changes of different stage. IR changes obviously in TCM syndrome differentiation of T2DM, so ISI may serve as a reference index of TCM syndrome differentiation of T2DM. 2. Lipide metabolism disturbance and cytokine play an important role in the development of IR and VC of type 2 diabetes mellitus, and they are closely associated with SMS, Overweight/Obesity. 3.SMS is the chief pathologic background of QYDS, VC , Overweight/Obesity, ISI, TG, TNF-a, BMI, WHR may serve as a reference index of it. 4. Sputum and moist play an important role in the development of T2DM(specially Overweight/Obesity), so it's important that the method of removing of sputum and moist is used in clinical practice. 5. The differenc...
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