Study On The Correlation Between Constipation Type Of Type 2 Diabetes Mellitus And Its Risk Factors

Objective:To detect the physical and chemical indicators of blood glucose,blood lipids and inflammation in type 2 diabetic constipation patients,record the related factors of weight,age,sex,course of disease and type 2 diabetic constipation,analyze the correlation between each TCM syndrome type of the disease and the above indicators and factors.To understand the TCM pathogenesis and disease evolution rule of type 2 diabetic constipation patients,and provide clinical basis for TCM syndrome differentiation and treatment of type 2 diabetic constipation.Methods:1.Case source:Patients who were admitted to the inpatient department of the Endocrinology Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from June 2018 to December 2019 were collected.Type 2 diabetes diagnosis criteria were based on the 2017 edition of China Guidelines for the Prevention and Treatment of Type 2 Diabetes,and constipation diagnosis The standard is based on the Rome IV standard.2.Data collection:Basic data and relevant laboratory examination indexes of 126 patients were collected.We conducted TCM symptom questionnaires and do TCM syndrome differentiation by the information of incision and tongue and pulse.According to the 2016Guidelines for Evidence-Based Practice of Diabetic Traditional Chinese Medicine,the diagnostic criteria for syndrome types were formulated,which were divided into Qi-Yin deficiency,blood stasis and collaterals,Yin-Yang deficiency and Qi-qi weakness.3.Statistical method:SPSS 21.0 statistical software was used for data analysis.Counting data Counting data was described by number of cases and percentage.Differences between groups were tested using ~2;Shapiro-Wilk method was used to detect whether the data conformed to the normal distribution The F test was used for comparison between groups with normal distribution measurement data,the LSD-t method was used for pairwise comparison within the group,and the non-parametric rank sum test was used for comparison between measurement groups with non-normal distribution measurement data.For multivariate correlation analysis,multiple logistic regression models were used to enter the model analysis.The difference was statistically significant at P<0.05.Results:1.The majority of patients of each syndrome type were females,and there was no significant gender difference between the groups(P>0.05).The average age of T2DC patients was 65 years,and there was no statistical difference in the age of patients between groups(P>0.05).The average duration of type 2 diabetes in T2DC patients was 15.603±8.013 years,and there were differences between the groups(P<0.05).Pairwise comparisons were available between groups,and the course of Qi and Yin Deficiency was lower than that of Yin and Yang Deficiency,Blood Stasis and Collaterals,and Spleen Qi Deficiency(P<0.05).There were differences in BMI among different syndrome types,and the comparison between two groups showed that the BMI of Qi-Yin deficiency group was lower than that of Yin-Yang deficiency group,and the difference was statistically significant(P<0.05).There was no significant difference in BMI between the other two groups(P>0.05).2.Comparison of Hb A1c and MAGE:There were differences in Hb A1c among dif ferent syndromes,and Hb A1c in Qi-Yin deficiency group was lower than that in Yin-Yang deficiency group and blood stasis collaterals group(P<0.05).The Hb A1c in the S pleen-qi weakness group was lower than that in the yin-yang deficiency group and the blood stasis collaterals group,and the difference was statistically significant(P<0.05).There was no significant difference in Hb A1c between the other groups in pairwise co mparison(P>0.05).There were differences in MAGE among different syndrome types.Two-way comparison showed that the MAGE of blood stasis collaterals group was hig her than that of Qi-Yin deficiency group and spleen weakness group,and the differenc e was statistically significant(P<0.05).3.Comparison of blood lipids:There was no significant difference in TG and TC between different syndrome types(P>0.05),and there was a difference in LDL-C between different syndrome types.It was found that the blood stasis and collaterals group was significantly higher than the Yin-Yang deficiency group and the Qi-Yin deficiency group,and the difference was statistically significant(P<0.05).4.Comparison of inflammation indicators:There were differences in ESR among different syndrome types.It was found by pairwise comparison between groups that ESR in Qi-Yin deficiency group was lower than that in Yin-Yang deficiency group,and the difference was statistically significant(P<0.05).There was no significant difference in ESR between the other two groups(P>0.05).There was no significant difference in CRP among different syndrome types(P>0.05).5.Regression analysis:The qi and Yin deficiency syndrome has the shortest course of T2DM and can be used as the initial syndrome type of T2DC,so the qi and Yin deficiency syndrome is used as the reference syndrome type for regression analysis.Conclusions:1.The course of T2DM is instructive to the classification of TCM.The average age of T2DC patients was 65 years old,with a long history of diabetes and an average course of 15years.Patients with qi and Yin deficiency syndrome had the shortest course of T2DM,and the longer the course of disease,the greater the probability of suffering from Yin and Yang deficiency syndrome,blood stasis syndrome and spleen and spleen syndrome.2.Body weight has guiding significance to T2DC classification;The number of patients with T2DC who were overweight accounted for 66.67%of the total number of patients.Among all the syndromes,the patients with deficiency of Yin and Yang syndrome had the highest proportion of overweight,accounting for 79.48%.The BMI of patients with qi and Yin deficiency syndrome was lower than that of patients with Yin and Yang deficiency syndrome,and the higher the BMI was,the greater the probability of suffering from Yin and Yang deficiency syndrome3.Blood glucose control is of guiding significance to T2DC classification.The Hb A1c of patients with Yin and Yang deficiency syndrome and blood stasis syndrome was higher than that of patients with qi and Yin deficiency syndrome and deficiency of temper syndrome.MAGE of patients with vein syndrome of blood stasis is higher than that of patients with deficiency of qi Yin and deficiency of temper.The higher the Hb A1c in patients with qi and Yin deficiency syndrome,the greater the probability of suffering from Yin and Yang deficiency syndrome and blood stasis syndrome.The higher the MAGE of qi and Yin deficiency syndrome,the greater the probability of blood stasis.4.Among the indexes of blood lipid,LDL-C has guiding significance for T2DC classification.LDL-C in patients with blood stasis syndrome was significantly higher than that in patients with qi-yin deficiency syndrome and blood stasis syndrome.5.In terms of inflammatory indicators,ESR has a guiding significance for TCM classification of T2DC patients;ESR of patients with Yin and Yang deficiency syndrome was significantly higher than that of patients with qi and Yin deficiency syndrome.6.Through the combination of laboratory indexes and the theory of syndrome differentiation and syndrome,the evolution law of TCM pathogenesis of T2DC can be derived.Qi and Yin deficiency syndrome is the initial syndrome type of T2DC.If the disease is relieved,it will be classified as deficiency syndrome of temper.If the disease is aggravated,it will develop into deficiency syndrome of Yin and Yang or blood stasis syndrome.The number of patients with disease aggravation is 4.7 times of the number of patients in remission.