Research On Quantitative Syndrome Differentiation On Syndrome Of Phlegm-dampness In Type 2 Diabetes Mellitus Associated With Non-alcoholic Fatty Liver Disease In Xiamen Area

ObjectiveThe study was designed to build up quantitative syndrome differentiation form of phlegm-damp for the patients of T2DM associated with NAFLD in Xiamen area to provide quantified evidence for the diagnosis of phlegm-damp syndrome.Method1.The method of“Hall of general integration seminar”was used and the preclinical data were collected in this study.Referring to the“Four Diagnostic Information Collection Form”supported by the Traditional Chinese Medicine Syndromes Research Base of Fujian University of Traditional Chinese Medicine,the alternative symptoms of phlegm-damp syndrome were clarified among patients of T2DM associated with NAFLD and the clinical registration form was designed to collect the data of four diagnostic information of traditional Chinese medicine.2.According to the diagnoses by a panel of experts,420 cases of T2DM patients associated with NAFLD in Xiamen area were classified to syndrome of phlegm-damp group and syndrome of non-phlegm-damp group,which were then randomly divided into calculation group and validation group with 210 cases each.3.The occurrence frequency of selected clinical features in the calculation group were compared according to multiple comparisons ofχ~2-test among several samples to verify the typical symptoms of phlegm-damp syndrome in T2DM associated with NAFLD in Xiamen area.4.Afterwards,the selected typical symptoms were assigned with scores converted by conditional probability and the critical value of quantitative syndrome differentiation was analyzed through maximum likelihood method.The results of quantitative syndrome differentiation and expert syndrome differentiation were tested retrospectively and prospectively.The statistical analyses were performed by SPSS21.0.Results1.In the cases of T2DM associated with NAFLD with phlegm-damp syndrome in Xiamen area,the clinical features were recognized as physical obesity,large fat tongues,white and slimy tongue fur,slippery pulse,heavy cumbersome head and body,loose stool and greasy skin.Relatively,a score of 9 points,10 points,12 points,10 points,8 points,12 points and 11points was assigned to each and the critical value of quantitative syndrome differentiation was set up as 25 points.2.The results of both quantitative syndrome differentiation and expert syndrome differentiation group were compared.The relative p value,Sen,Spe,FPR,FNR,CAR,YI,+LR and-LR were 0.458,85.08%,87.50%,12.05%,14.91%,86.19%,0.73,6.81,0.17 accordingly in the calculation group.While in the validation group,the relative p value,Sen,Spe,FPR,FNR,CAR,YI,+LR and-LR were 0.856,85.05%,86.41%,13.59%,14.95%,85.71%,0.71,6.26,0.17respectively.Conclusion1.The results of quantitative syndrome differentiation was highly consistent with those of expert syndrome differentiation referring to the syndrome of phlegm-damp in T2DM associated with NAFLD in Xiamen area.2.The scale of quantitative syndrome differentiation made by this study was designed on the local conditions around syndrome of phlegm-damp in T2DM associated with NAFLD in Xiamen area,which has a certain value of accuracy,stability and practicality with clinical reference.