Clinical Reserch On The Distribution Characteristics Of Tcm Syndrome Elements In Early Renal Injury Of Type 2 Diabetes Mellitus Based On The Thought Of Preventive Treatment Of Disease

Objective: Under the thought of TCM preventive treatment,use the "Dimension reduction and rank upgrade" syndrome research method to explore the distribution characteristics of TCM syndrome elements in early renal injury of T2 DM,summarizing the main syndromes of disease’s occurrence,development and pathogenesis transformation,which provides reference for clinical syndrome differentiation and treatment.Methods: Using multicenter clinical research method,pick 90 patients with T2 DM and 112 patients with T2 DM early renal injury in 5 research centers and collect their general information,four-diagnosis information and laboratory examination data(UACR 、 TC 、 TG 、 LDL-C 、 HDL-C 、 Cys-C)to conduct TCM syndrome elements differentiation.Using descriptive analysis,Spearman correlation analysis and Logistic regression analysis to explore the distribution characteristics of TCM syndrome elements in T2 DM early renal injury.Results:(1)General information: The age of T2 DM early renal injury group was significantly older than T2 DM group’s.45-59 years old is the most common age distribution of T2 DM group,and 60-74 years old is the most common age distribution of T2 DM early renal injury group,all with significant statistical differences(P<0.01).The BMI of T2 DM early renal injury group was lower than that of T2 DM group(P<0.05).There is no significant statistical difference in gender and duration of diabetes(P>0.05).(2)Laboratory examination data: The mean of cholesterol and median of HDL-C in T2 DM early renal injury group are higher than those in T2 DM group,with statistical differences(P<0.05 or P<0.01);The median of Cys-C in T2 DM early renal injury group is higher than that in T2 DM group,with significant statistical differences(P<0.01).(3)Symptoms: The top 10 high frequency symptoms of the patients in the T2 DM group are weak waist and knees,frequent urination/yellow urine,fatigue,thirst,polydipsia,spontaneous sweating,insomnia,hot flashes,large food intake with rapid hungering/intolerance to cold and cold limbs/dizziness and acroanesthesia.The top 10 high frequency symptoms of the patients in the T2 DM early renal injury group are thirst,polydipsia,fatigue,weak waist and knees,dry pharynx/frequent urination,acroanesthesia,insomnia,yellow urine,polyuria,limbs pain.(4)Syndrome elements: The top three high-frequency syndrome elements of both the two groups are Qi deficiency and Yin deficiency,with the frequency of occurrence more than 50%.The Qi deficiency,Yin deficiency frequency of T2 DM group is are higher than that of T2 DM early renal injury group,with statistical differences(P<0.05),and its’ blood stasis frequency is lower than T2 DM early renal injury group,with statistical differences(P<0.05).Among the syndrome elements combination form of the two groups,Qi deficiency + Yin deficiency is the most common double syndrome elements combination of both groups,and Qi deficiency + Yin deficiency + phlegm dampness is the most common triple syndrome elements combination of both groups.Qi deficiency + Yin deficiency + phlegm dampness + sthenic heat is the most common quadruple syndrome elements combination in T2 DM group.Qi deficiency + Yin deficiency + phlegm dampness + blood stasis is the most common quadruple syndrome elements combination in T2 DM early renal injury group.Among penta syndrome elements combination,both groups are mainly based on Qi deficiency +Yin deficiency,combined with other syndromes.In T2 DM early renal injury group,Qi stagnation syndrome with TC and TG,phlegm dampness syndrome with age,blood stasis syndrome with age and duration of diabetes,sthenic heat syndrome with weight and TC are positively correlated separately,with statistical differences(P < 0.05 or P < 0.01).And sthenic heat syndrome is negatively correlated with duration of diabetes(P<0.01).Qi deficiency syndrome and sthenic heat syndrome are the risk factors of TCM syndromes in the stage of T2 DM early renal injury,with statistical differences(P<0.05).Conclusion: In the process of diabetes progression to early renal injury,Qi deficiency,Yin deficiency as well as phlegm dampness are the core pathogenesis of the disease.With the progress of the disease,the sign of blood stasis gradually appears,combined with Qi deficiency syndrome and sthenic heat syndrome risk factors,which leads to the imbalance of Qi,blood,Yin,Yang,phlegm,blood stasis and renal injury.The thought of preventive treatment of disease should be implemented in clinical treatment.According to the change of syndrome elements,prevent and treat the occurrence and development of DKD dynamically.