Research On Traditional Chinese Medicine (TCM)Pathogenesis Characteristics Of T2DM And Its Therapeutic

Objective:To investigate the Distribution and Main Syndrome Pattern of TCM (Traditional Chinese Medicine) and influence factors of T2DM of in-patients and out-patients in Department of Endocrinology, Affiliated Hospital of Chengdu University of TCM.Methods:Firstly,a systematic review is given to both Chinses and Western recognization of T2DM.Then search the diagnosis criteria of relevant syndrome pattern and to determine the syndrome differentiation and differentiation standard based on the basic theory of TCM and clinical practice combined.The main obseratory parameters is difinited simultaneously.Adapted the way of incidental sampling,105T2DM patients including in-patients and out-patients in Department of Endocrinology, Affiliated Hospital of Chengdu University of TCM,are enrolled. Differentiate for each patient,record the general indicators such as age,gender and disease duration,objective examination indicators such as HbAlc,TG,TC,et al.To explore the Constituent ratio of each Syndrome Pattern.For each Syndrome Pattern, the patients are divided into Syndrome or non-Syndrome. To reseach the Distribution and Main Syndrome Pattern of TCM and influence factors, the variaion of two groups are compared and the data are analyzed by Single-and multiple-factor non-conditional Logistic regression analysis.Results:1.In the constituent ratio of Syndrome Pattern of T2DM,six cases are puerly deficiency syndrome, accounting for5.7%,10cases are puerly excess syndrome, accounting for9.5%,89cases are pattern of deficiency-excess complex,accounted for84.8%.5cases are excess cold syndrome and10cases are blood deficiency syndrome, accounted for4.8%、9.5%. The Main Syndrome Pattern of T2DM is qi deficiency syndrome,yin deficiency syndrome,yang deficiency syndrome,qi depression syndrome,phlegmatic dampness syndrome,blood stasis syndrome,fire heat syndrome,spleen deficiency syndrome,liver qi stagnation syndrome and kidney deficiency syndrome, accounted for more than30%,especialy phlegmatic dampness syndrome,up to83.3%,the highest.2. Adopted single-and multiple-factor non-conditional Logistic regression analysis,qi deficiency syndrome is related to disease duration, complications and HbA1c.(P<0.05)3.Adopted single factor analysis,yin deficiency syndrome is related to age, TG、HDL-C.(P<0.05) The age, HDL-C are statistically significant by multiple factor analysis.(P<0.05)4. Adopted single factor analysis,yang deficiency syndrome is related to age,disease duration and complications.(P<0.05) The disease duration is statistically significant by multiple factor analysis.(P<0.05)5.Adopted single factor analysis,qi depression syndrome is related to emotion and disease duration.(P<0.05) The emotion is statistically significant by multiple factor analysis.(P<0.05)6.Analyzes each research factor by single factor analysis, phlegmatic dampness syndrome have no statistics significance.(P<0.05)However,the level of TG is higher compared to non phlegmatic dampness syndrome.(P<0.05)7.Adopted single-and multiple-factor analysis,there is statistically significant between blood stasis syndrome and disease duration,smoking,hypertension,complicitions and HbAlc.(P<0.05) by multiple factor analysis.(P<0.05)8.Adopted single factor analysis,fire heat syndrome is related to gender,disease duration,alcohol,BMI,HbA1c and TG.(P<0.05) The disease duration and HbAlc are statistically significant by multiple factor analysis.(P<0.05)9.Adopted single factor analysis, slenic deficiency syndrome is related to age,disease duration,complications and LDL-C.(P<0.05) The disease duration,complications and LDL-C are statistically significant by multiple factor analysis.(P<0.05)10.Adopted single factor analysis, liver qi stagnation syndrome is related to disease duration and emotion.(P<0.05) The emotion is statistically significant by multiple factor analysis.(P<0.05)11.Adopted single factor analysis, kidney deficiency syndrome is related to complications and HbAlc.(P<0.05) The complications is statistically significant by multiple factor analysis.(P<0.05)Conclusion:1. Pattern of deficiency-excess complex is the Main Syndrome Pattern of T2DM.Attention should be paied to differentiate deficiency and excess clearly and prescribe for both in clinic.2. The Syndrome Pattern of T2DM is diersity. Pattern of yin deficiency and heat motivation could not summarize the characteristic of pathogenesis.3. Phlegmatic dampness syndrome is prevalence of T2DM.It may be the primary pathogenesis of T2DM,but this need further study.4. As an increasing disease duration and incidence of complications, patients with T2DM are vital qi damege,viscera fatigue,so that a variety of deficiency syndrome is emerging,such as qi deficiency syndrome, yang deficiency syndrome and kidney deficiency syndrome.At the same time, the incidence blood stasis syndrome is at an increasing risk.5. Fire heat syndrome appears in the early stage of T2DM. As an increasing disease duration,the incidence of fire heat syndrome is falling down.Regarding with the harm of the fire heat syndrome to the development of T2DM,attention should be paied to apply’clearing away heat with sweet and cold way’for patients at an early stage of T2DM in clinic. Simultaneously,male with higher BMI and drinking is tend to develop fire heat syndrome.6. The clinical objective examination indicators are related to Syndrome Pattern of T2DM. The blood glucose levels of patients with qi deficiency syndrome, blood stasis syndrome,fire heat syndrome and kidney deficiency syndrome is relatively higher. The TG levels of patients with yin deficiency syndrome and fire heat syndrome is relatively higher. The LDL-C levels of patients of spleen deficiency syndrome is relatively lower. The HDL-C levels of patients of yin deficiency syndrome is relatively lower.Especially,patients of fire heat syndrome are prone to develop metabolism disorders of blood glucose and blood lipid.It is vital to alert the pathogenesis of ’Glycolipid stagnation’in clinic.7. The clinical objective examination indicators are related to Syndrome Pattern,but the’relationgship between the two needs a further study.Adopted Logistic regression analysis which excluded other influencing factors, the change of examination indicators,as an independent influencing factor,can affect the incidence probability of related Syndrome Pattern.According to the statistical analysis significance,the indicators,which are statistical significance in Logistic regression analysis,may used as the influencing factors cause the Syndrome Pattern. However, the examination indicators,as a long-term or short-term influencing factors related to Syndrome Pattern still need further study.In recent research,the toxicity of Glycolipid was found to play a significant role in the development of T2DM,so important attension should be paied to’Regulate blood glucose and Purge the toxin way’in clinic.8. For the T2DM patients who are difficult to differentiation,the findings of this research about influencing factors above may be usful.