| ObjectiveThis project analyzes the distribution and correlation of TCM syndromes types in patients with type 2 diabetes mellitus in Singapore Chung Hwa Medical Institution through a retrospective case series,summarizes the common types of TCM syndrome differentiation,and discusses the applicability of the "Dynamic and Definite Coherent Sequence" theory in Singapore.Promote the international development of this academic theory,and provide new thinking methods for clinical diagnosis and treatment of type 2 diabetes and its complications with traditional Chinese medicine.MethodsAccording to the inclusion and exclusion criteria,newly diagnosed clinical cases of patients with type 2 diabetes at Singapore Chung Hwa Medical Institution were screened between March 1,2019 and February 28,2022,and the data were standardized.Clinical Research Database.The SPSS statistical software was used to analyze for the 1010 cases that meet the criteria,and frequency analysis and association rule are used to conduct statistical distribution and correlation of the basic information,chronic complication types,core symptoms.TCM syndromes,and TCM syndrome types etc.And discuss the clinical practice experience in treating diabetic patients in Singapore based on the "Dynamic and Definite Coherent Sequence" theory.Results1.Among the 1010 cases that met the research criteria,Chinese patients accounted for the majority of 91.19%according to ethnic distribution,Malays and Indians accounted for 4.46%and 3.66%respectively,and the least patients were Eurasians or other ethnic groups.Women accounted for 52.67%of diabetic patients than men(47.33%).Among the age groups,the patients aged 60-69 were the most,accounting for 37.43%,followed by 26.83%aged 7079,and 18.42%aged 50-59.2.The most frequent complications were hypertension and hyperlipidemia.And peripheral neuropathy also a common complication.Diabetic patients with high blood pressure are more likely to have hyperlipidemia at the same time,and diabetic patients with peripheral neuropathy are also more likely to suffer from high blood pressure.3.The core symptom with the highest frequency is dry mouth or thirst,followed by numbness and pain in limbs,frequent urination or nocturia,fatigue,insomnia and dreaminess,soreness of waist and knees,dry stool,stomach or abdominal distension,loose stool,dry eyes and pain or blurred vision etc.Dry mouth or thirst was most associated with fatigue,frequent urination,or nocturia.Among the correlations between core symptoms and complications,dry eye pain or blurred vision and eye complications have the highest degree of confidence,and the symptom of dry mouth or thirst occurs in diabetic patients without complications.4.Among the signs of tongue and pulse in TCM syndrome differentiation,the most frequent result is pale tongue,followed by dark purple tongue or tortuous veins at the bottom of the tongue,tooth marks on the sides,red tongue,fat tongue,etc.The moss is arranged according to the frequency as thin fur,white fur,thick and greasy fur,yellow fur.dry or less moist fur.etc.A pale tongue is most strongly associated with a thin fur coating.The results of the pulse condition showed that the pulses with higher frequencies were thin,stringy,slippery,few.and deep;the correlation between thin pulses and deep pulses was high.5.The results of the distribution of TCM syndrome types show that deficiency of both qi and yin accounts for the largest proportion,and the other top ten TCM syndrome types are blood stasis syndrome,kidney deficiency syndrome,spleen deficiency syndrome,damp-heat internal resistance syndrome,liver and kidney deficiency syndrome,and internal dryness and heat Syndrome of stagnation of liver qi,syndrome of stagnation of phlegm and dampness,syndrome of heat stagnation of blood,which are summarized as "Ten Syndrome of Diabetes in Singapore".It is common for kidney deficiency syndrome and spleen deficiency syndrome to exist simultaneously.From the correlation analysis,it can be concluded that the core symptoms of fatigue,dry mouth or thirst have the highest correlation with Qi and Yin deficiency syndrome.The results of the association rules between syndrome types and complications showed that the syndrome types with a higher probability of occurrence in diabetic patients without complications were mostly dryness and heat,deficiency of both qi and yin,deficiency of liver and kidney,syndrome of kidney deficiency and spleen deficiency.Deficiency of both qi and yin is more likely to occur in diabetic patients with hypertension and peripheral neuropathy.6.According to the association rule results of race and complications,symptoms,and syndrome types,it is more common for Chinese and Indian to have diabetes without complications.Malay diabetic patients are prone to complications of peripheral neuropathy.Indians and Malays have a higher probability of limb numbness and pain,and Chinese with diabetes have a higher probability of thirst and frequent urination.It is common for Chinese diabetic patients to suffer from qi and yin deficiency syndrome,kidney deficiency syndrome,and blood stasis syndrome.Malay diabetic patients are most likely to suffer from kidney deficiency syndrome and deficiency of both qi and yin.Diabetic patients of the Indian ethnic group are also more likely to suffer from blood stasis syndrome.ConclusionThe most common TCM symptoms of type 2 diabetes patients in Singapore Chung Hwa Medical Institution are qi and yin deficiency,blood vein stasis and renal deficiency.The most common comorbidities are hypertension and hyperlipidemia.Indian and Malay diabetics are prone to peripheral neuropathy.Qiyin deficiency is most common in diabetic patients with hypertension and peripheral neuropathy,while blood stasis is most common in Indian diabetics.Through the results of retrospective analysis of case series,the "Ten Syndrome of Singapore Diabetes" was summarized,combined with the experience of clinical practice to integrate and expand the theory of "Dynamic and Definite Coherent Sequence",the "Ten Methods of Diabetes Treatment in Singapore" was proposed,the applicability of this academic theory is expounded.It also provides a new thinking method of treating diabetes and its complications with pure Traditional Chinese Medicine. |
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