| Objective:To explore the distribution law of the six meridians of patients with type 2 diabetes mellitus and its relationship with related factors by collecting general data of Type 2 diabetes mellits,four diagnosis data of traditional Chinese medicine,traditional Chinese medicine constitution and clinical biochemical indexes,so as to provide reference for patients with type2 diabetes mellitus in the clinical application of Jingfang for the treatment of phlegm and wet constitution,and broaden the clinical ideas used by Classic formula.Methods:A questionnaire survey and clinical data collection were conducted among patients with type 2 diabetes who were treated and hospitalized in the outpatient clinic of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from December 2021 to December 2022,and216 patients with T2DM were selected and divided into type 2 diabetes mellitus sputum wet group(group A)and type 2 diabetes non-sputum wet group(group B)according to the physical condition of traditional Chinese medicine,and their general data including gender,age,exercise frequency,dietary preferences,course of disease,complications,comorbidities,etc.,four diagnosis data of traditional Chinese medicine,Biochemical indicators such as fasting blood glucose(FBG),2 hour postprandial blood glucose(2h PBG),glycated hemoglobin(Hb A1c),fasting C-peptide(FCP),insulin resistance index index,HOMA-IR),Serum total cholesterol(TC),Triglyceride(TG),Low density lipoprotein cholesterol(LDL-C),High density lipoprotein cholesterol HDL-C),at the same time,the collected general data,biochemical indicators and other data were collated,and SPPS software was used for data processing to analyze the differences between the two groups and the relationship between the six types of sputum and related factors in patients with type 2 diabetes mellitus.Results:Ⅰ.Comparison of clinical data between the two groups:1.Comparison of the two groups of general data:A total of 216 patients with type 2 diabetes were collected in this project,including 103 cases in group A and 113 cases in group B.There were 51 female patients and 52 male patients in group A,the gender distribution of the two was basically the same,the average age was 56.17±12.68 years,the average body mass index(BMI)was 24.97±4.13kg/m~2,the diet preference was mainly sweet,and the exercise frequency was mainly occasional exercise(1-2 times/week),accounting for 49.5%.There were 48 female patients and 65 male patients in group B,more men than women,the average age was 59.94±9.82 years,the average BMI was 23.74±3.72kg/m~2,the diet preference was mainly light,and the frequency of exercise was mainly regular exercise(3-5 times/week),accounting for 39.8%.The course of diabetes in both groups was mainly<5years,and hyperlipidemia,hypertension and fatty liver were more common in comorbidities,and the complications were mainly diabetic peripheral neuropathy,diabetic macrovascular disease and diabetic retinopathy,and diabetes was the least,accounting for only 2 cases.After statistical analysis,there were statistically significant differences in BMI,dietary preference,exercise frequency,diabetic peripheral vascular disease,diabetic macroangiopathy,hyperlipidemia and coronary heart disease(P<0.05),and there were no significant differences in gender,age,course of disease,family history,history of tobacco and alcohol,diabetic retinopathy,diabetic autonomic neuropathy,diabetic peripheral neuropathy,diabetic nephropathy,fatty liver disease,and hypertension(P>0.05).2.Distribution of medical symptoms in the two groups:Group A:light red lips,dry mouth and thirst,thirst and no desire to drink,fat body,numbness,greasy skin,multi-colored urine,easy to eat and hungry,stool sticky and unpleasant,etc.,tongue texture is more common with tooth mark tongue,light red tongue,fat tongue,tongue moss is white moisture,thin white moss,thick moss is more common,and the veins are mainly slippery veins,several veins,and wet veins.Group B:light red lips,dry mouth,thirst and drinking,numbness,frequent urination color light yellow,blurred vision,fatigue,stool formation,etc.,tongue quality is more common with light red tongue,red tongue,light white tongue,tongue moss is more common with thin white moss,white moisture,yellow greasy moss,veins are more common with fine veins,several veins,slippery veins.After statistical analysis,the two groups were statistically significant in terms of TCM syndrome(P<0.05).3.Comparison of the two groups of six-meridian type:the two groups were dominated by single meridian disease,accounting for 63.1%and 53.1%respectively,and etheryin disease was the most common in group A’s six-meridian type,accounting for 39.8%,followed by oligo-yin disease(21.4%)and Yangming disease(15.5%);Among the six certified types in group B,Yangming disease was the most common,accounting for 32.7%,followed by Yin disease(24.8%)and oligo-Yin disease(14.2%).In terms of comorbidities,group A mainly saw Yangming and less yin syndrome(6.8%),oligoyin and yin syndrome(6.8%),Yangming less yang and taiyin syndrome(1.9%),and yin and yin and less yin syndrome(1.9%),and group B mainly saw Yangming taiyin syndrome(9.7%),Yangming less yang syndrome(5.3%),Shaoyang Yangming yin syndrome(3.5%),Yangming Shaoyang taiyin syndrome(1.8%),and yin and yin disease(0.9%).After statistical analysis,the two groups had statistical significance in the distribution of six warp types(P<0.05).4.Comparison of biochemical indexes between the two groups:group A FBG,Hb A1c,FCP,HOMA-IR,TC,TG,LDL-C were higher than Group B,and the two groups had statistical significance in Hb A1c,FCP,HOMA-IR,TC,TG,LDL-C(P<0.05),and there was no difference in FBG,2h PBG,HDL-C(P>0.05).5.Correlation analysis of T2DM sputum wet patients:Binary logistic regression analysis was carried out on the influencing factors with statistical differences in the comparison between the two groups,showing that occasional exercisers,sweet diets,coronary heart disease,FCP,TG,LDL-C,Hb A1c were statistically significant(P<0.05),and the relative risk(OR)was2.462,9.356,4.704,1.492,1.344,1.888,respectively.1.232,and all were positively correlated with type 2 diabetes mellitus sputum humidity.Ⅱ.T2DM sputum wet patients six certified type and related factors analysis1.The relationship between the six-meridian type and phlegm wet syndrome:phlegm wet syndrome is mainly seen in light red lips,fat body,dry mouth and thirst,thirst and drinking,numbness,greasy skin,easy to eat and hunger,multi-colored urine,sticky stool,tooth marks and tongue,white tongue,smooth pulse.In the distribution of the six meridians,the stool is sticky and unpleasant,the lip color is light red,numbness,dry mouth,thirst and no desire to drink,fat body,greasy skin,tooth marks and tongue,white moss,slippery veins are mainly seen in taiyin disease,urine volume is more colorful,mainly seen in oligoyin disease,taiyin disease,and eating more and hunger is more common in yangming disease.After testing,P=0.013(P<0.05),the distribution of six meridian types was correlated with the clinical syndrome of sputum hygroplasm.2.The relationship between the six-scripture type and general information:in terms of age,the first place in all ages is taiyin disease;In terms of BMI,T2DM sputum wet matter patients were mostly distributed in the range of 24.0～28.0 kg/m2,and the six proof types were mainly taiyin disease and oligoyin disease.In terms of exercise frequency,patients who exercise occasionally are mainly taiyin disease,oligoyin disease,and yangming disease in the six-proof type;In terms of dietary preferences,patients with type 2 diabetes mellitus with sputum and wet matter mostly have sweet diet and etheryin disease,and raw and cold dieters are mainly seen in Yangming disease;Patients with a history of alcohol and tobacco are mainly seen in oligo-negative disease;Among complications,diabetic retinopathy is more common;Among the comorbidities,hyperlipidemia is more common with etheryin disease and oligonegative disease.After statistical analysis,the distribution of six syndromes in patients with T2DM sputum and wet matter was correlated with the history of tobacco and alcohol,diabetic retinopathy,and hyperlipidemia(P<0.05).There was no association in sex,age,course of disease,BMI,frequency of exercise,dietary preferences,family history,diabetic peripheral vascular disease,diabetic peripheral neuropathy,diabetic autonomic neuropathy,diabetic macrovascular disease,diabetic nephropathy,diabetic foot,coronary heart disease,hypertension,fatty liver(P>0.05).3.The relationship between the six-certified type and biochemical indexes:FBG was higher in Yin disease and oligonegative disease,the increase in blood glucose 2h after meals was most obvious with etheryin disease and Yangming disease,and glycated hemoglobin was the highest in etheryin disease;Total cholesterol and LDL cholesterol are higher in Yangming disease.After statistical analysis,the six-certified type of T2DM sputum wet matter patients was correlated with Hb A1c,TC,LDL-C,but not with FBG,2h PBG,FCP,HOMA-IR,TG,HDL-C.Conclusion(s):1.Patients with type 2 diabetes mellitus with sputum and wet quality are more common in patients with overweight body mass index,do not like exercise,and eat a sweet diet,and are prone to diabetic peripheral vascular lesions,diabetic macrovascular lesions,coronary heart disease,hyperlipidemia and other diseases,and there are often poor blood sugar control and insulin resistance.2.Common TCM symptoms in patients with phlegm and wet constitution of type 2 diabetes are:light red lips,fat body,dry mouth,thirst,thirst and drink,numbness,greasy skin,easy to eat and hunger,multi-colored urine,sticky stool,tooth marks and tongue,white moss,smooth pulse.Patients with type 2 diabetes mellitus and phlegm wet constitution are involved in the six types of traditional Chinese medicine,and there are both single menstrual disease and multiple meridian syndrome,mainly with single menstrual disease,the first is taiyin disease,accounting for 39.8%,followed by less yin disease,yang ming disease,and solar disease is the least.3.The six-certified type of traditional Chinese medicine in patients with type 2 diabetes mellitus sputum wet constitution is related to the history of tobacco and alcohol,diabetic retinopathy,hyperlipidemia,Hb Alc,TG,LDL-C,occasionally exercisers,sweet diet,coronary heart disease,FCP,TG,LDL-C,Hb Alc are risk factors for patients with T2DM sputum wet constitution,and are positively correlated with the occurrence of sputum wet constitution.Among them,smokers and drinkers are more common in oligo-yin disease,diabetic retinopathy and hyperlipidemia are more common in taiyin disease,Hb Alc elevation is more common in taiyin disease,and TG and LDL-C are the most obvious in Yangming disease. |
