Clinical Study On Relationship Between Deficiency Of Spleen-kidney Syndrome And Obstruction By Phlegm-blood Stasis Syndrome Of The Elder With Type2Diabetes Mellitus And Cognitive Impairment

Objective:To investigate the relationship between inflammatory factor such as C-reactive protein and interleukin-1β、cognitive impairment and deficiency of spleen-kidney syndrome and obstruction by phlegm-blood stasis syndrome of the elderly patients with type2diabetes mellitus.Methods:Collecting120patients whom is older than60years old in the wards of geriatrics division in Nanjing Durm Tower Hospital geriatrics from March2010to December2011,which includes80type2diabetes mellitus patients and40patients without diabetes mellitus. The group of the elder with type2diabetes is grouped deficiency of spleen-kidney syndrome group and obstruction by phlegm-blood stasis syndrome group by the Traditional Chinese Medicine. All the patients are graded by Mini-Mental State Examination, and their heights weight、waistline and hipline are measured. Counting Body Mass Index(BMI) and Weight Hip Rate(WHR). Detecting interleukin-1β(IL-1β) by ELISA, C-reactive protein(CRP) by immune diffusion method, HbA1c by high pressure liquid chromatography, fasting blood-glucose(FBG) by glucose oxidase method, fasting serum insulin(FINS) by radioimmunoassay, and counting homeostasis model assessment-insulin resistance(HOMA-IR).Comparing BMI、WHR、HbA1c、HOMA-IR、CRP、IL-1βliver and kidney function blood pressure、blood fat and MMSE among each group.Results:1、There is no difference of the age、sex、degree of education、family income、smoking or no、blood pressure、 blood fat and liver-kidney function between the group of the elder with type2diabetes and the group of the elder without diabetes(P>0.05); there is no difference of the age、sex、course of disease、degree of education、 family income、smoking or no、blood pressure、 blood fat and liver-kidney function between deficiency of spleen-kidney syndrome group and obstruction by phlegm-blood stasis syndrome group(P>0.05).2、Compared with the group of the elder without diabetes, the level of BMI、WHR、HbA1C、HOMA-IR、CRP and IL-1β in the group of the elder with type2diabetes are increased(P<0.05),and the level of MMSE is decreased, which has significant difference(P<0.01).And the level of MMSE in the group of the elder with type2diabetes is negatively correlated with WHR、HbA1C、HOMA-IR. CRP and IL-1β.3> Between the two syndrome types of the group of the elder with type2diabetes, the level of BMI、WHR、HbA1c、CRP and IL-1β in the obstruction by phlegm-blood stasis syndrome group are increased than deficiency of spleen-kidney syndrome group, which has difference(P<0.05),but there is no difference of HOMA-IR in the two syndrome types(P>0.05). The level of MMSE in the obstruction by phlegm-blood stasis syndrome group is decreased than deficiency of spleen-kidney syndrome group, which has significant difference(P<0.01).Conclusion:1、Abdominal obesity、chronic hyperglycemia、insulin resistance and inflammatory response may be the related factors of cognitive impairment in the elderly patients with type2diabetes mellitus.2、The patients due to obstruction by phlegm-blood stasis in the elder with type2diabetes mellitus are more likely to have cognitive impairment, which may have relationship with insulin resistance due to inflammatory response.