Study On Distribution Of TCM Syndromes And Relationship Between Syndromes And The QOL Of The Patients With Type 2 Diabetes

Background and purpose: Type 2 diabetes is one of the main diseases which threaten people's health. Traditional Chinese Medicine plays an important role in improving clinical symptoms and signs,patient's quality of life(QOL)and preventing the chronic complications.As the diagnosis of TCM syndromes and the evaluation of the the clinical therapeutic efficiency at present,there is not a common,regular and objictive standard system,this current situation makes the clinical curative effect assessment not provid enough evidences. Therefore,it is important to study the normalization and standardization of the syndromes of type 2 diabetes. The purpose of this study is to preliminary reveal the distribution regularity of TCM syndromes,to explore the relationship between TCM syndromes and QOL of the patients with type 2 diabetes, and to offer the basis on designing a common and regular standard system of the diagnosis and the clinical evaluation in TCM,then to improve the curative effect and the patients'QOL.Methods In accordance with the design of the survey, 516 patients with type 2 diabetes in three hospitals who consulted in 2001 ~ 2003 are surveyed and analyzed.Besides,among all subjects ,275 hospitalized patients's QOL are measured and evaluated with the GQOL-74 questionnaire.ALL data are analyzed by Simple Factor Analysis,Logistic Regression and Stepwise Regression.Results The results indicated that the incidence of TCM syndromes in 516 patients with type 2 diabetes are ranked in turns as following: deficiency of both Qi and Yin(51.9%),stagnation of Qi and Blood(22.5% ),deficiency of both liver-Yin and kidney-Yin(16.9%),dominant of heat of both lung and stomach(16.3%),obstruction by dampness (14.1 % ),deficiency of both Qi and Yin of spleen and and stomach(7.8%),deficiency of both Yin and Yang(1.9%), heat produced due to stagnancy of liver-Qi(1.4 % ).The results showed that age(P=0.003),course of disease(P=0.000)and chronic complications(P=0.000)were main influencing factors related to the distribution and changes of syndromes,but the fasting blood-glucose was not significant in statistics(P=0.626).The study showed that the level of patients'QOL decreases generally, the total score was obviously low(58.31 ±9.62).According to the scores of suffered dimension ,it ranked in turns as following: body dimension, material dimension, social dimension and mental dimension. In all factors which influence the QOL,this survey indicated that the main influencing factors according to the standard partial regression coefficient (Bate)is filed in turns as follows: self-evaluation of health(0.567),the level of education(0.181),the syndromes of deficiency of both Qi and Yin (0.168), chronic complications(-0.147),clinical syptoms(-0.143)and lifestyle(0.095).The result of the relationship between TCM Syndromes and Quality of Life showed that the scores of QOL in patients with the syndrome of deficiency of both Qi and Yin was highest(60.2 ±9.1),but in patients with the syndrome of deficiency of both Yin and Yang was lowest(45.9 + 2.2). By simple factor and multiple factor analysis,it showed that the syndrome of deficiency of both Qi and Yin , deficiency of both liver-Yin and kidney-Yin ,and the syndrome of deficiency of both Yin and Yang were important syndromes which influnced the QOL of patients with type 2 DM(/> <0.05),other syndromes were not significant in statistics(/>>0.05).Conclusion It is preliminary revealed in the study that the incidence of TCM syndromes in 8 common clinical syndromes of type 2 diabetes are ranked in turns as following: deficiency of both Qi and Yin,stagnation of Qi and Blood,deficiency of both liver-Yin and kidney-Yin,dominant of heat of both lung and stomach,obstruction by dampness,deficiency of both Qi and Yin of spleen and and stomach,deficiency of both Yin and Yang, heat produced due to stagnancy of liver-Qi. In the old patients,the common syndromes of manifeste themselves are the syndrome deficiency of both Qi and Yin,deficiency of both liver-Yin and kidney-Yin,stagnation of Qi and Blood,obstruction by dampness.The result shows that age, course of disease and chronic complications are the main influencing factors related to the distribution and changes of syndromes, but the fasting blood-glucose is not significant in statistics.The incidence of the syndromes of deficiency of both Qi and Yin,and obstruction by dampness tend to increase with age,the syndrome of deficiency of both liver-Yin and kidney-Yin tends to increase with the course of disease,but the syndrome of dominant of heat of both lung and stomach tends to decrease with age and the course of disease. The survey indicates that the level of quality of life of patients decreases generally,dysfunction of physical dimension is more serious than that of psychosocial dimension.In all influencing factors,self-evaluation of health is the most importantfactor,certain social factors such as age,the level of educationjob and incomes play more important role in affecting the patients'QOL,and in the medical factors,course of disease,chronic complications and clinical symptoms are the major factors.Hypertention maybe the most important chronic complications which influence QOL of patients with type 2 diabetes.The result indicates that the QOL of patients is related to the TCM syndromes. The syndrome of deficiency of both Qi and Yin , deficiency of both liver-Yin and kidney-Yin .and the syndrome of deficiency of both Yin and Yang are important syndromes on influncing the QOL of patients with type 2 diabetes.The damaged level of QOL is different in the patients with different syndromes,and the main aspects of functions damaged are different.