| Objective:1.To investigate the general situation,daily living habits and characteristics of TCM syndromes of newly diagnosed T2DM patients;2.To explore the correlation between BMI level of newly diagnosed T2DM patients and different TCM syndromes and islet function;3.To summarize the clinical experience of professor Wei Junping in the treatment of newly diagnosed T2DM.Methods:1.Clinical cross-sectional study:This study uses cross-sectional survey research methods,on December 1,2017 to January 31,2019 at China Academy of Chinese Medical Sciences Guang’anmen Hospital,included in the study of 132 cases of newly diagnosed T2DM patients on the basis of informed consent fill out the case report form,survey of 132 patients with newly diagnosed type 2 diabetes basic situation,signs and symptoms,laboratory indexes,etc.,BMI,HOMA-β-cp,HOMA-IR-cp,area under the glucose curve(G-AUC),and area under the c-peptide curve(C-AUC)were calculated.SPSS20.0 was used for descriptive statistics,one-way anova,chi-square test,and correlation analysis.2.Summary of experience:The outpatient prescriptions of professor Wei Junping to newly diagnosed type 2 diabetes on December 1,2017 and January 31,2019 were taken as the source of the prescriptions.250 outpatient prescriptions were counted and analyzed using the software of "Traditional Chinese Medicine Inheritance Assistance System(v2.5)".Results:1.132 newly diagnosed type 2 diabetes patients were included in this study,including 36(27.27%)with a normal BMI(18.5 BMI<24kg/m2),58(43.94%)who were overweight(24 BMI<28kg/m2)and 38(28.79%)who were obese(BMI 28kg/m2).The ratio of male to female was 1.49 to 1,and the average age was 48.61.104 patients with special diet preference(78.79%)and 70 patients with low physical activity(53.03%)were included.Among the 5 patients treated for ketosis,9 patients were combined with diabetic peripheral neuropathy,32(24.24%)were combined with hyperlipidemia,30(22.73%)had a history of fatty liver,and 29(21.97%)were combined with hypertension.63 cases(47.73%)had no clear family history,and 53 cases(40.15%)had family history of type 2 diabetes.Lifestyle intervention was not performed in 92 patients(69.7%),and lifestyle intervention was performed in 40 patients(60%effective).2.Among the included patients,111 cases(84.09%)took "thirst" as the chief complaint,85 cases(64.39%)felt "tiredness and fatigue",53 cases(40.15%)felt dull red tongue,75 cases(56.82%)felt greasy tongue,69 cases(52.27%)felt fine pulse,46 cases(34.85%)felt smooth pulse,and 35 cases(26.52%)felt stiff pulse.3.According to the TCM syndrome factor scores,total 509 TCM syndrome factor levels,including the element level "I level 290(56.97%);According to the judgment results of TCM syndrome elements,there were 96 cases of "Yin deficiency"(72.73%),78 cases of "wet"(59.09%),54 cases of "hot"(40.91%),42 cases of "phlegm"(31.82%),36 cases of "liver"(27.27%),and 24 cases of "spleen"(18.18%).Five cases had no syndrome element judgment,17 cases had a single syndrome element,mainly "Yin deficiency" and "wet",and 110(83.33%)had multiple syndromes at the same time.4.The "Yin deficiency" and "liver" scores in the super-recombinant/obesity group were lower than those in the normal group(P<0.05),and the "spleen" scores in the super-recombinant/obesity group were higher than those in the normal group(P<0.05).Compared with the normal group,the fasting blood glucose/C peptide and HOMA-IR of the super-recombinant/obese group were higher(P<0.05).5.According to the TCM disease syndrome score,76 cases were classified as positive,and 54 cases as empty syndrome.There was no significant difference in the distribution of empty syndrome in the normal group,super-recombinant group and obesity group(P>0.05).Compared with the positive syndrome group,HOMA-islet was lower in the empty syndrome group(P<0.05).6."Wet" was positively correlated with BMI,and the correlation coefficients were 0.171,respectively."Yin deficiency" was negatively correlated with BMI,and the correlation coefficient was-0.262.7."Wet" and BMI were positively correlated with HOMA-IR,with correlation coefficients of 0.178 and 0.267,respectively;"Yin deficiency" and "heat" were negatively correlated with HOMA-IR,with correlation coefficients of-0.22 and-0.19,respectively.8.Professor Wei Junping treats newly diagnosed type 2 diabetes with drugs mainly based on sweet,bitter and cold,mostly attributed to stomach and spleen meridians.The commonly used drugs are pueraria,Scutellaria baicalensis,ginnekin,rhizoma coptiliae,rhizoma anrhenae,and perenne.The common drug combination in more than 50%of the prescriptions is pueraria,scutellaria baicalensis,rhizoma coptiliae and ginnekin.9.The unsupervised entropy hierarchical clustering algorithm was adopted and wei shi pointed out the following five new formulas:zaorunxiangji decoction,qingbubingshi decoction,fangxianghuashi decoction,xingpijiangwei decoction,qingrelishi decoction.Conclusion:1.Newly diagnosed type 2 diabetes mellitus has complex and diverse syndrome elements,and a variety of syndrome elements are combined,with Yin deficiency as the main one and dampness as the evil,as well as qi deficiency,heat sheng,phlegm turbidity and blood stasis;2.BMI was positively correlated with "wet" and insulin resistance,and negatively correlated with "Yin deficiency";"Yin deficiency" and "heat" were negatively correlated with insulin resistance,while "humidity" was positively correlated with insulin resistance.3.The treatment of professor Wei Junping to newly diagnosed type 2 diabetes is based on the addition and subtraction of gegenqinlian decoction.4.Generate five new prescriptions for the treatment of newly diagnosed type 2 diabetes:zaorunxiangji decoction,qingbubingshi decoction,fangxianghuashi decoction,xingpijiangwei decoction,qingrelishi decoction. |
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