Study On The Distribution And Evolution Of TCM Syndromes In Elderly Type 2 Diabetes Mellitus Patients With CKD Stage

Objective: To observe the distribution characteristics of TCM syndromes in elderly patients with type 2 diabetes mellitus in different stages of renal function and explore the rules of syndrome evolution.Methods: from January 2018 to January 2019 the clinical data and TCM syndromes of 300 inpatients with type 2 diabetes aged 60 years or above in the department of endocrinology and nephrology of the Hospital of Chengdu University of Traditional Chinese Medicine were collected for statistical analysis.Results: 1.Among the 300 elderly patients with type 2 diabetes,149 were males and 151 were females,and the ratio of males to females was0.98:1;95.3% of the patients were han Chinese.64.7% of patients had diabetes for more than 10 years.2.TCM syndromes include qi and blood deficiency with blood stasis syndrome(27.7%)were the most common.3.There were statistically significant differences in the composition ratio of TCM syndromes in different age groups,smoking history and G stage(P < 0.05),while there were no statistically significant differences in the composition ratio of TCM syndromes in gender,drinking history and diabetes course(P > 0.05).4.Phlegm(wet)heat intermingled syndrome was the most common in G1(28.0%),qi and Yin deficiency and blood stasis syndrome was the most common in G2(38.0%),qi and Yin deficiency and blood stasis syndrome was the most common in G3a(46.0%),qi and Yin deficiency and blood stasis syndrome was the most common in G3b(44.0%),Yin and Yang deficiency with blood stasis syndrome was the most common in G4(22.0%),and Yin and Yang deficiency syndrome was the most common in G5(32.0%).5.The data is normally distributed with homogeneity of variance,the different TCM syndrome types population groups of height,weight,BMI,waist circumference,systolic blood pressure,diastolic pressure,Pulse,eGFR,FPG,2hPG,HbA1 c,ACR,Scr,UA,differences in HDLC,LDLC,TG,TC,single factor variance analysis to different TCM syndrome types population groups in systolic blood pressure,eGFR,FPG,2 HPG,HbA1 c,ACR,Scr,UA,the differences were statistically significant(P < 0.05).6.With TCM syndrome type as the dependent variable,the difference was statistically significant in the analysis of the factors of age group,smoking history,systolic blood pressure,EGFR,FPG,2 HPG,HbA1 c,ACR,Scr,UA as independent variables,the reference category for two virtual folder stasis syndrome of Yin and Yang,TCM syndrome type of multinomial logistic regression analysis showed that phlegm(wet)heat each other by the main influencing factors;Compared with the 81-92 age group,the probability of the 60-70 age group being the syndrome of severe heat injury is 4.754,and the probability of the 71-80 age group being the syndrome of severe heat injury is 2.612.Systolic blood pressure and UA were the main influencing factors of qi and Yin deficiency syndrome.UA is the main influencing factor of liver-kidney Yin deficiency syndrome.FPG is the main influencing factor of Yin-Yang deficiency syndrome.EGFR is the main influencing factor of qi and Yin deficiency with phlegm syndrome.Scr is the main influencing factor of qi-Yin deficiency with blood stasis syndrome.Compared with those with a history of smoking,those without a history of smoking are deficient in both qi and Yin,and the probability of mutual syndrome of phlegm and blood stasis is 7.958.EGFR and Scr were the main influencing factors of the syndrome of liver-kidney Yin deficiency with blood stasis(P < 0.05).Conclusions: 1.Age,smoking history and renal stage are the factors affecting TCM syndrome type.2.In the elderly patients with type 2 diabetes,the clinical manifestations of various stages of renal function are complex and diverse.The most common syndrome type is the syndrome of deficiency of qi and blood combined with blood stasis.The evolution of syndrome types is as follows:Phlegm(dampness)and heat syndrome-qi and Yin deficiency and blood stasis syndrome-Yin and Yang deficiency and blood stasis syndrome-Yin and Yang deficiency.3.The probability of 60-70 years old group with syndrome of severe heat injury is 4.754 times that of 81-92 years old group,and the probability of 71-80 years old group with syndrome of severe heat injury is 2.612 times that of 81-92 years old group.Those with no smoking history had qi and Yin deficiency,and the probability of phlegm and blood stasis syndrome was 7.958 times of those with smoking history.Systolic blood pressure and abnormal blood uric acid are easy to occur in the deficiency of qi and Yin.Liver and kidney Yin deficiency syndrome is prone to abnormal blood uric acid;The deficiency of Yin and Yang is prone to abnormal fasting blood glucose.The abnormality of glomerular filtration rate is easy to appear in the syndrome of qi and Yin deficiency with phlegm.The syndrome of qi and Yin deficiency with blood stasis is prone to abnormal blood creatinine.Kidney Yin deficiency with blood stasis is prone to the glomerular filtration rate,blood creatinine abnormalities.4.There is a close correlation between TCM syndrome types of renal function stages of type 2 diabetes in the elderly and conventional laboratory indicators,which has certain auxiliary reference value for TCM syndrome differentiation.