Study On The Correlation Between TCM Syndrome Types And Clinical Data Such As Homocysteine And Serum Uric Acid In Patients With Newly Diagnosed Type 2 Diabetes Mellitus Combined With Non-alcoholic Fatty Liver Disease

Objectives:By collecting relevant clinical materials including homocysteine and uric acid of patients with newly diagnosed type 2 diabetes mellitus(T2DM)combined with nonalcoholic fatty liver disease(NAFLD),this study is to analyze the correlation between TCM syndrome types and clinical data such as homocysteine,uric acid,etc,to provide objective basis for Traditional Chinese Medicine(TCM)prevention and treatment of newly diagnosed T2 DM combined with NAFLD and TCM syndrome classification.Methods:289 cases of newly diagnosed T2 DM combined with NAFLD patients that had been hospitalized in the endocrinology department of Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January 2019 to December 2019 were included in the study,and name,gender,age,and results of the four diagnostic methods(inspection,auscultation and olfaction,inquiry and pulse-taking)of patients were collected.According to TCM syndrome diagnostic standards,they were divided into five groups:syndrome of hyperactivity of both lung and stomach heat,syndrome of stagnation of liver qi,qiyin deficiency syndrome,internal accumulation of damp-heat syndrome,syndrom of intermingled phlegm and blood stasis.Body mass index(BMI),homocysteine,uric acid,glycolsylated hemoglobin,fasting blood glucose,fasting insulin and blood lipid(total cholesterol,triglyceride,high-density lipoprotein and low-density lipoprotein)of all subjects were tested.All data were collected and entered into the database.Multinomial logistic regression was used to analyze the relevance between TCM syndrome types and clinical data.Results:1.Among 289 cases of newly diagnosed T2 DM combined with NAFLD patients,there were 44 cases with syndrome of hyperactivity of both lung and stomach heat(15.2%),51 cases with syndrome of stagnation of liver Qi(17.6%),64 cases with qi-yin deficiency syndrome(22.1%),70 cases with internal accumulation of damp-heat syndrome(24.2%),and 60 cases with syndrom of intermingled phlegm and blood stasis(20.8%).There are more men in terms of gender,accounting for 60.90% of the total.The age distribution is dominated by 56~75 years old,accounting for 57.79% of the total.Among them,the patients with two syndromes of deficiency of qi-yin deficiency syndrome and syndrom of intermingled phlegm and blood stasis are older,and the difference had statistical significance with the other three groups(P<0.05).2.In this study,UA level of the patients was the highest in the internal accumulation of damp-heat syndrome,and internal accumulation of damp-heat syndrome>qi-yin deficiency syndrome,and the differences had statistical significance(P<0.05).Hcy level of patients was the highest in the syndrom of intermingled phlegm and blood stasis.Syndrom of intermingled phlegm and blood stasis>syndrome of hyperactivity of both lung and stomach heat,syndrom of intermingled phlegm and blood stasis>qi-yin deficiency syndrome,Syndrome of stagnation of liver qi>qi-yin deficiency syndrome,and the differences had statistical significance(P<0.05).Hcy was positively related to syndrome of stagnation of liver qi and syndrom of intermingled phlegm and blood stasis in multinomial logistic regression analysis,with correlation coefficients 0.112 and 0.091 respectively.3.In this study,BMI level of patients was the highest in the internal accumulation of damp-heat syndrome,and internal accumulation of damp-heat syndrome>syndrome of stagnation of liver qi,the differences had statistical significance(P<0.05).TG level of patients was the highest in the internal accumulation of damp-heat syndrome,and internal accumulation of damp-heat syndrome>syndrome of stagnation of liver qi,internal accumulation of damp-heat syndrome>qi-yin deficiency syndrome,the differences had statistical significance(P<0.05).TC level and HDL-C level difference between different syndromes had no statistical significance(P>0.05).LDL-C level of patients was the highest in the syndrom of intermingled phlegm and blood stasis,and syndrom of intermingled phlegm and blood stasis>syndrome of stagnation of liver qi,syndrome of hyperactivity of both lung and stomach heat>syndrome of stagnation of liver qi,the differences had statistical significance(P<0.05).HOMA-IR level of patients was the highest in the internal accumulation of damp-heat syndrome,and internal accumulation of damp-heat syndrome>qi-yin deficiency syndrome,the differences had statistical significance(P<0.05).HOMA-IR was positively related to syndrome of hyperactivity of both lung and stomach heat,internal accumulation of damp-heat syndrome and syndrom of intermingled phlegm and blood stasis,with correlation coefficients 0.306,0.251 and 0.182 respectively.HbA1 c level of patients was the highest in the internal accumulation of damp-heat syndrome,and internal accumulation of damp-heat syndrome>syndrome of hyperactivity of both lung and stomach heat,internal accumulation of damp-heat syndrome>syndrome of stagnation of liver qi,internal accumulation of damp-heat syndrome>qi-yin deficiency syndrome,the differences had statistical significance(P<0.05).HbA1 c was positively related to internal accumulation of damp-heat syndrome,with correlation coefficient 0.314 respectively.Conclusion:1.Damp-heat and phlegm stasis are the key pathogenesis of newly diagnosed T2 DM complicated with NAFLD.2.Hcy is closely related to syndrome of syndrom of intermingled phlegm and blood stasis,syndrome of stagnation of liver qi,UA level is the highest in internal accumulation of damp-heat syndrome.Hcy,UA can be used as the objective basis for syndrom of intermingled phlegm and blood stasis,syndrome of stagnation of liver qi and internal accumulation of damp-heat syndrome.BMI,HOMA-IR,HbA1 c,TG,LDL-C and age has certain guiding significance for TCM syndrome differentiation of newly diagnosed T2 DM combined with NAFLD.