| Purpose:In this study,we investigated the distribution patterns of TCM disease location and TCM disease evidence in obese patients with type 2 diabetes mellitus and non-obese patients with type 2 diabetes mellitus by comparing the differences between TCM evidence and Western metabolic indexes,and analyzed the association between TCM disease location and metabolic indexes in obese patients with type 2 diabetes mellitus,so as to provide a better objective basis for clinical diagnosis and treatment.Material and Method:The clinical data of patients with type 2 diabetes mellitus who attended the outpatient clinic and ward of the Department of Endocrinology at the Affiliated Hospital of Liaoning University of Chinese Medicine from October 2018 to November 2020 were collected,from which 295 patients who met the inclusion and exclusion criteria were selected as study subjects,and then divided into obese group(102 cases)and non-obese group(193 cases)according to whether they were combined with obesity.The basic data of the two groups were compared,and the distribution characteristics of TCM evidence and the differences of related metabolic indexes in obese patients with combined type 2diabetes were summarized.The basic information of the patients including gender,age,disease duration,body mass index(BMI),waist circumference(WC)were collected.Glycated hemoglobin(HbA1c),fasting plasma glucose(FPG),fasting insulin(FINS),total cholesterol(TC),and triglycerides(TG)were collected at the time of consultation or admission.(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),and other physicochemical parameters,LDL-C)and other physicochemical indicators.The homeostasis model insulin resistance index(HOMA-IR),TC/HDL-C value,LDL-C/HDL-C value and TG/HDL-C value were also calculated.Referring to the developed TCM four diagnosis information questionnaire,relevant TCM clinical symptoms were entered to determine the TCM clinical evidence.The collected data,using Excel to build a database,were statistically analyzed by applying SPSS23.0 statistical software.The difference was considered statistically significant by stipulating(P < 0.05).Results:1.Statistical results of the general data of the two groupsThe statistical results of this study showed that the included 295 patients with type 2diabetes were 103 obese(34.91%)and 193 non-obese(65.09%),and the differences in gender composition ratio,age and disease duration between the two groups were not statistically significant(P > 0.05),indicating that the data of the two groups were comparable.2.The statistical results of syndrome elements of disease position in the two groupsThe results of the TCM pathological evidence showed that the most frequent pathological evidence in 103 obese patients was the spleen(65.7%),followed by the kidney(32.4%),liver(30.4%),and stomach(28.4%);among the 193 patients in the non-obese group,the top four pathological evidence were the kidney(39.4%),spleen(36.3%),liver(30.1%),and stomach(23.3%),of which the differences between the two groups were statistically significant(P<0.01).3.According to the statistical results of disease in the two groups,According to statistics,the proportion of pathological elements in the obese group,in descending order,were: dampness(44.1%),qi deficiency(43.1%),qi stagnation(22.5%),heat(22.5%),yin deficiency(12.7%),blood stasis(8.8%),yang deficiency(2.9%),and blood deficiency(0.0%);in the non-obese group,in descending order,were: yin deficiency(46.1%),qi deficiency(32.1%),heat(22.8%),yang deficiency(19.7%),blood stasis(7.3%),and blood deficiency(3.6%)),Yang deficiency(19.7%),blood stasis(18.1%),qi stagnation(7.3%),dampness(6.2%),and blood deficiency(3.6%);among them,the pathological nature of dampness and qi stagnation was higher in the obese group than in the non-obese group by statistical analysis,and the difference was statistically significant(P < 0.01).4.The statistical results of metabolic indexes between the two groupsAfter statistical analysis,TG,TC,HDL-C,TG/HDL,HOMA-IR and FINS indexes were higher in the obese group than in the non-obese group,and the differences were statistically significant(P<0.05),while the differences of the remaining metabolism-related indexes were not statistically significant.5.Statistical analysis of metabolic indexes in different sitesAfter statistical analysis,the TG,TC,LDL-C,TG/HDL-C,FINS and HOMA-IR of the obese group were higher than those of the non-obese group in patients with disease in the liver;the TG,LDL-C,FINS and HOMA-IR of the obese group were higher than those of the non-obese group in patients with disease in the kidney;the TG,HDL-C,FINS and HOMA-IR of the obese group were higher than those of the non-obese group in patients with disease in the spleen;the TG,HDL-C,FINS and HOMA-IR of the obese group were higher than those of the non-obese group in patients with disease in the stomach.In patients with disease location in the spleen,TG,HDL-C,FINS and HOMA-IR were higher in the obese group than in the non-obese group;in patients with disease location in the stomach,FINS and HOMA-IR were higher in the obese group than in the non-obese group,and the above differences were statistically significant(P < 0.05).6.Statistical analysis of metabolic indexes under different diseasesAmong patients with Qi deficiency,TG,HDL-C,FINS and HOMA-IR were higher in the obese group than in the non-obese group.Among patients with pathologies of Yin deficiency,heat and blood stasis,patients in the obese group had higher FINS and HOMA-IR than those in the non-obese group;among patients with pathologies of Qi stagnation,patients in the obese group had higher TG,FINS and HOMA-IR than those in the non-obese group;among patients with pathologies of Dampness,patients in the obese group had higher HOMA-IR than those in the non-obese group,and the above differences were statistically significant(P< 0.05).Conclusion:1.In obese patients with combined type 2 diabetes mellitus,the TCM pathogenic evidence is mainly in the spleen,kidney and liver,and the pathogenic evidence is commonly in dampness,qi deficiency and qi stagnation.2.Patients with obesity combined with type 2 diabetes are more likely to have dyslipidemia.3.Obesity may exacerbate the development of insulin resistance in patients with type 2diabetes. |
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