Correlation Between TCM Syndrome Differentiation And Glutathione C And Chronic Complications In Type 2 Diabetes Mellitus

Objective: By observing the correlation between TCM syndrome differentiation,cystatin C level,glucose and lipid metabolism index and chronic complications in patients with type 2 diabetes mellitus(T2DM),this paper discussed whether cystatin C can be used as a specific index for the classification of common syndromes of type2 diabetes mellitus(T2DM).To provide a reference for the objective classification of TCM syndrome differentiation of diabetes,and to provide certain guiding significance for the prevention and treatment of chronic diabetic complications with the integration of traditional Chinese and western medicine.Methods: A total of 306 inpatients with type 2 diabetes mellitus were selected from Department of Endocrinology,affiliated Hospital of Chengdu University of traditional Chinese Medicine.All patients met the diagnostic criteria of WHO type 2 diabetes mellitus in 1999.According to the "guiding principles of Clinical Research on New drugs of traditional Chinese Medicine" of the Ministry of Health in 2002,the syndrome was divided into Yin deficiency and Heat excess Syndrome,dampness-Heat stagnation spleen Syndrome,Qi-yin deficiency Syndrome,Yin-Yang deficiency Syndrome and Blood stasis-Water stagnation Syndrome(abbreviated as Yin-Yang deficiency Syndrome).General data(age,sex,course of BMI,)and glucose metabolism of different syndrome types were observed in patients with blood stasis and choroid syndrome.The indexes(fasting blood glucose,2 hour postprandial blood glucose,glycosylated hemoglobin),lipid metabolism indexes(triglyceride,cholesterol,low density cholesterol lipoprotein),cystatin C,chronic complications,etc.,were analyzed statistically.To explore its correlation.Result:1.There was significant difference in sex among different TCM syndrome types(P <0.01).2.there was statistical difference among different TCM syndrome types in age,damp-heat stagnation spleen syndrome was significantly lower than Qi-yin deficiency syndrome,yin-yang deficiency syndrome and blood stasis collateral syndrome(P <0.01),and there was significant difference between them(P < 0.01).Compared with Qi-Yin deficiency syndrome,Yin-Yang deficiency syndrome and Blood stasis vein syndrome,there was statistical difference between Yin-deficiency and heat-bearing syndrome(P < 0.05).3.the course of disease,there are statistical differences among various TCM syndrome types,among them,qi-yin deficiency syndrome,yin-yang deficiency syndrome,blood stasis syndrome patients have a longer course of disease than Yin.There were significant differences between deficiency-heat syndrome and damp-heat stagnation syndrome(P < 0.01).4.There was no significant difference in fasting blood glucose(FBG),HDL-C,triglyceride(TG)and TCM syndrome types in BMI.5.2 hours postprandial blood sugar,there was statistical significance among the TCM syndrome types,qi-yin deficiency syndrome was significantly higher than blood stasis collateral syndrome,the comparison was statistically significant(P < 0.05).6.Glycosylated hemoglobin(HbA1c)was statistically significant among TCM syndrome types(P < 0.05).7.there are statistical differences in serum total cholesterol among TCM syndrome types,including Yin deficiency and heat-rich syndrome,dampness-heat syndrome.The serum total cholesterol of the patients with spleen retention syndrome was significantly higher than that of the blood stasis choroid syndrome,and there was a statistical significance between the two groups(P < 0.05).There was statistical difference in LDL-C among the syndrome types of TCM.The syndrome of yin deficiency and heat was significantly higher than that of blood stasis and choroid syndrome,and there was statistical significance between the two groups(P < 0 05).8.Cystatin C was statistically significant among all TCM syndrome types,Yin-yang deficiency syndrome > blood stasis vein syndrome > qi-yin deficiency syndrome >damp-heat stagnation spleen syndrome > yin deficiency syndrome > heat-rich syndrome,in which blood stasis syndrome and yin-yang deficiency syndrome weresignificantly higher than those of yin-deficiency syndrome.The difference was statistically significant(P < 0.01).Compared with damp-heat syndrome of stagnation of spleen,blood stasis syndrome and deficiency of yin and yang syndrome,the level of cystatin C was statistically significant(P < 0.01).The syndrome of deficiency of both yin and yang was significantly higher than that of deficiency of both qi and yin(P < 0.01),and the syndrome of blood stasis and collaterals was higher than that of deficiency of both qi and yin(P < 0.05).9.there was no significant difference in serum uric acid,fasting insulin,HOMA-IR and 24-hour urinary protein between different TCM syndrome types of homocysteine(Hcy).10.the level of UACR in patients with yin-yang deficiency syndrome was significantly higher than that in Yin-yang deficiency syndrome group,and there was a statistical difference among different TCM syndrome types.Syndrome,damp-heat stagnation spleen syndrome,the comparison has statistical difference(P < 0.05).11.the incidence of all kinds of complications of type 2 diabetes mellitus increased gradually according to the syndrome of dampness-heat stagnation of spleen,deficiency of yin and heat,deficiency of both qi and yin,deficiency of both yin and yang,blood stasis and collaterals.There are many chronic complications of diabetes in the patients with deficiency of both qi and yin.12.There was a positive correlation between cystatin C and homocysteine in all type 2diabetes mellitus and syndrome of yin deficiency and heat,dampness heat trapping spleen syndrome,deficiency of both qi and yin and deficiency of both yin and yang.13.ROC curve analysis showed that cystatin C was valuable in the diagnosis of Yin-Yang deficiency syndrome and blood stasis collaterals syndrome in type 2diabetes mellitus.Conclusion:1.Cystatin C is closely related to TCM syndrome differentiation and classification of type 2 diabetes mellitus,which can be regarded as a reference index of TCM dialectical classification of type 2 diabetes mellitus.ROC curve analysis showed thatcystatin C was valuable in the diagnosis of Yin-Yang deficiency syndrome and blood stasis collaterals syndrome in type 2 diabetes mellitus.2.Many objective indexes of type 2 diabetes mellitus patients are closely related to the syndrome differentiation and classification of type 2 diabetes mellitus,which is helpful to objectify the differentiation of syndrome differentiation of traditional Chinese medicine.3.The different TCM syndrome types of type 2 diabetes are closely related to the chronic complications,and the patients with deficiency of both qi and yin have the most chronic complications of diabetes mellitus,so the method of integrating traditional Chinese medicine and western medicine should be used as early as possible.It can effectively delay the progress of the disease and prevent the occurrence and deterioration of complications.