Insulin Resistance In Type 2 Diabetes Mellitus:study On The Relevance Between Distribution Regularities Of TCM Syndrome And Objective Indicators

Objective:The paper in order to investigate the distribution regularities of type 2diabetes mellitus(T2DM)with insulin resistance(IR)patients in intraditional Chinese medicine(TCM)of clinical syndrome types by using cluster analysis and explore the link between TCM syndromes and objective indicators,so as to provide objective basis for clinical syndrome differen-tiation.Methods:1、Informations by four diagnostic methods of 252 T2 DM with IR patients were collected,and more than 10% frequency of symptoms,tongue and pulse were used as variables for cluster analysis of spss 21.0 statistical software to generalize TCM syndromes of T2 DM with IR.2、The relationship between general data(sex,age,course of disease,BMI),objective indexes(HOMA-IR,GLU 、 Fins 、 Hb A1 c,TC,TG,HDL-C,LDL-C,m Alb,islet beta function index,hs-CRP)and distribution of TCM syndromes was analyzed by variance analysis and non-parametric test.Results:1.Informations of four diagnostic methods of the T2 DM with IR 252 patients were clustered into five types by cluster analysis,which included the syndrome of dampness-heat due to spleen deficiency,liver and stomach swelter type,the type of deficiency of Qi and Yin,the type of phlegm and blood stasis combined with Yin deficiency,the type of phlegm and blood stasis combined with Yin deficiency.Distribution of syndromes as follows :syndrome of dampness-heat due to spleen deficiency(31%)>the type of phlegm and blood stasis combined with Yin deficiency(20%)> the type of deficiency of both spleen and kidney(18%)>the type of deficiency of Qi and Yin(17%)> liver and stomach sweltertype(14%);2.From the point of gender,There has no statistically significant difference in all the TCM syndrome diffrentiations(P>0.05);3.From the point of age,the type of deficiency of both spleen and kidney and the type of phlegm and blood stasis combined with Yin deficiency are significantly higher than the type of deficiency of Qi and Yin,liver and stomach swelter type and syndrome of dampness-heat due to spleen deficiency(P<0.01);4.From the course of the disease,the course according to the follow increasing trend:syndrome of dampness-heat due to spleen deficiency< liver and stomach swelter type< the type of deficiency of Qi and Yin< the type of deficiency of both spleen and kidney<the type of phlegm and blood stasis combined with Yin deficiency;5.From the body mass index(BMI),syndrome of dampness-heat due to spleen deficiency is significantly higher than all the other four types(P<0.01);6.From the GLU,Hb A1 c and hs-CRP,the type of deficiency of both spleen and kidney and the type of phlegm and blood stasis combined with Yin deficiency are significantly higher than the other three types(P <0.01);7.From the Fins,syndrome of dampness-heat due to spleen deficiency is significantly higher than all the other four types(P<0.01);liver and stomach swelter type and the type of deficiency of Qi and Yin are significantly higher than the type of deficiency of both spleen and kidney and the type of phlegm and blood stasis combined with Yin deficiency(P<0.01);8.From the HOMA-IR,syndrome of dampness-heat due to spleen deficiency andthe type of phlegm and blood stasis combined with Yin deficiency are significantly higher than the other three types(P <0.01);9.From the HOMA β,syndrome of dampness-heat due to spleen deficiency is significantly higher than all the other four types(P<0.01);liver and stomach swelter type andthe type of deficiency of Qi and Yin are significantly higher than the type of deficiency of both spleen and kidney and the type of phlegm and blood stasis combined with Yin deficiency(P<0.01);10.Look from the lipid:(1)look from the TC and TCH,syndrome of dampness-heat due to spleen deficiency andthe type of phlegm and blood stasis combined with Yin deficiency are significantly higher than the other three types(P <0.01);(2)Look from the HDL-C,there has no statistically significant difference in all the TCM syndromes(P>0.05);(3)From the LDL-C,the type of phlegm and blood stasis combined with Yin deficiency is significantly higher than all the other four types(P<0.01);11.Look from the m Alb,the type of deficiency of both spleen and kidney issignificantly higher than all the other four types(P<0.01).Conclusions:1.the distribution of TCM syndromes with T2 DM IR has certain regularity,there are more the deficiency of spleen and dampness heat and phlegm and blood stasis type in clinica;2.The syndrome of phlegm and blood stasis runs through the syndrome all the time,which indicates that "phlegm and blood stasis" plays a vital role in insulin resistance of type2 diabetes mellitus,suggesting that attention should be paid to the treatment of resolving phlegm and activating blood circulation in clinic.3.The TCM syndromes of insulin resistance in type 2 diabetes mellitus were different in age,course of disease,BMI,GLU,Hb A1 c,hs-CRP,Fins,HOMA-IR,islet beta cell function index,TC,TG,LDL-C and m Alb,but no difference was found in sex and HDL-C.Therefore,BMI,Hb A1 c,hs-CRP,HOMA-IR,islet beta cell function index,TC,TG,LDL-C,m Alb can be used as microcosmic reference indicators of insulin resistance in type2 diabetes mellitus.