| The promotion and advantages of traditional Chinese medicine in the prevention and treatment of type 2 diabetes(Type 2 Diabetes Mellitus,T2DM)continue to increase.It has attracted much attention at home and abroad.For various reasons,previous clinical scientific research lacked a unified standard and standardized T2 DM syndrome.The specific situation of the type distribution,which leads to the standardization of the treatment plan and the safety and effectiveness of the evaluation of the treatment effect are seriously insufficient,which seriously affects the scientific rationality of the clinical conclusions in the scientific research of traditional Chinese medicine.The application and promotion of scientific research achievements of traditional Chinese medicine has been severely restricted.Moreover,exploring the basic laws of the development of T2 DM TCM disease and syndrome distribution is of great significance for improving the standardization and standardization of T2 DM TCM diagnosis and treatment.[Objectiv]A total of 2000 patients with type 2 diabetes mellitus(T2DM)from 2018 to 2020 in the Zhongke Health Checkup Center in Nanchang City,Jiangxi Province were selected as specific and specific objects for scientific research.Investigate the main characteristics of T2 DM TCM syndrome type distribution and related factors that affect the distribution of TCM syndrome types,to provide an objective basis for T2 DM TCM syndrome differentiation,and to explore the relationship between TCM etiology,pathogenesis,and main influencing factors.[Methods]Literature-related research uses the content of questionnaires and related literature review,etc.,first,with the help of relevant databases such as Wanfang Medical-related database,How Net,and VIP research methods to classify and search related T2 DM TCM syndrome differentiation literature in the past 10 years,and then use traditional Chinese medicine.The common methods of original literature review and modern literature analysis were used to organize and summarize the pathogenesis of T2 DM.The system collects and organizes the relevant physical examination data of the Chinese Medical Examination Center from2018 to 2020,establishes the "T2DM TCM Disease Syndrome Diagnosis System Database",and uses the standard frequency for the various information on syndromes of 2000 T2 DM data samples that meet the inclusion reference standard.The method of analysis is to count the different types of TCM disease names and syndromes.In addition,according to the original literature,the content of the questionnaire is designed for the relevant influencing factors,specifically including the TCM syndrome score table of type 2 diabetes and the statistical table of relevant data of type 2diabetes.,and the correlation between other correlations of count data and syndrome composition is carried out in-depth data research and analysis using the commonly used method of x2 test(Chi-square Test).[Results]1.After screening of cases and questionnaires,a total of 2,000 related cases were included in this study.Among the 2,000 patients,1,086 were male,accounting for 54.30%.The average age was(52.37±4.35)years old.All male patients were in the age range of 25.～77 years old,with an average disease duration of(7.46±3.92)years;914 female patients accounted for 45.70%,with an average age of(53.21±7.31)years old.All female patients ranged from 25 to 69 years old with an average disease duration of(6.48 ±6.04)years.2.Among the 2000 cases,there were 677 cases of Qi deficiency syndrome,accounting for 33.85%;412 cases of blood deficiency syndrome,accounting for 20.6%;120 cases of Yin deficiency syndrome,accounting for 6.0%;76cases of Yang deficiency syndrome,accounting for 3.8%;There were 180 cases of damp turbidity syndrome,accounting for 9.0%;161 cases of phlegm turbidity syndrome,accounting for 8.05%;and 374 cases of blood stasis syndrome,accounting for 18.7%.This study found that the T2 DM syndrome type was mainly Qi deficiency syndrome,followed by blood deficiency syndrome,which was in line with the characteristics of chronic wasting disease of diabetes.3.From the gender distribution of the samples in this study,there is no significant relationship between the influencing factors of T2 DM TCM syndrome distribution characteristics and the gender relationship.Among male patients,there were 315 cases(29.01%)of Qi deficiency syndrome,179 cases(16.48%)of blood deficiency syndrome,63 cases(5.80%)of Yin deficiency syndrome,31 cases(2.85%)of Yang deficiency syndrome,and79 cases(7.27%)of dampness syndrome.%),94 cases(8.66%)of phlegm syndrome,227 cases(20.90%)of blood stasis syndrome;among female patients,362 cases(39.61%)of qi deficiency syndrome,233 cases(25.49%)of blood deficiency syndrome,and 57 cases of yin deficiency syndrome cases(6.24%),45 cases(4.92%)of yang deficiency syndrome,101 cases(11.05%)of damp turbidity syndrome,67 cases(7.33%)of phlegm turbidity syndrome,and 147 cases(16.08%)of blood stasis syndrome.Among them,in the gender comparison of T2 DM syndrome types,through one-way analysis of variance,the results showed that the comparison of phlegm turbidity syndrome was not significant(P>0.05)and did not have statistical significance;Qi deficiency syndrome,blood deficiency syndrome,Yin deficiency syndrome,Yang deficiency syndrome There were significant differences(P<0.05)in the comparison of syndromes,wet turbidity syndrome and blood stasis syndrome(P<0.05)with statistical significance.4.In terms of age,the average age of 677 cases of Qi deficiency syndrome is 55.18±6.46(years),the average age of 412 cases of blood deficiency syndrome is 57.23±4.51(years),and the average age of 120 cases of Yin deficiency syndrome is 67.17±3.01(years),and the average age of 120 cases of Yin deficiency syndrome is 67.17±3.01(years).The average age of 76 cases with syndrome is 63.11±4.01(years),the average age of 180 cases of dampness syndrome is 60.26±2.64(years),the average age of 161 cases of phlegm turbidity syndrome is 62.91±5.02(years),and the average age of 374 cases of blood stasis syndrome is 69.47±3.28(age).Among them,patients with Yin deficiency syndrome and blood stasis syndrome are older than other syndrome types,suggesting that the actual age of diabetic patients is closely related to the overall course trend of diabetes from Yin deficiency and heat to Qi and Yin deficiency and Yin and Yang deficiency.At the same time,it indicates that there is more deficiency and more blood stasis without healing after a long illness,and most of the time it will cause blood stasis due to deficiency;it shows that with age,righteousness gradually weakens,and deficiency of qi is the beginning of deficiency of yang.The dynamic progression process of diabetes etiology and pathogenesis is basically consistent with the transformation process.Qi-yin deficiency syndrome is a major turning point in the development of type 2 diabetes.Because diabetes is in the early stage of the course of the disease when the syndrome of yin deficiency,dryness and heat is present,many patients have not paid enough attention to their own diabetes because they have no obvious symptoms in the early stage of the disease course.When the patient’s disease course enters the later stage of diabetes,various related complications break out one after another,and then the treatment effect of the disease is definitely not ideal.Therefore,it is an effective treatment method to significantly improve the prognosis of patients,which is to make full use of traditional Chinese medicine treatment methods to keep patients stable in the stage of Qi and Yin deficiency for a long time.5.From the perspective of disease course,the average disease course of677 cases of qi deficiency syndrome was 6.11±2.16(years),the average disease course of 412 cases of blood deficiency syndrome was 7.32±1.01(years),and the average disease course of 120 cases of yin deficiency syndrome was 6.75±2.43(years),and the average disease course of 120 cases of yin deficiency syndrome was 6.75±2.43(years).The average course of disease in 76 cases with turbidity syndrome was 7.17±2.47(years),the average course of disease in 180 cases with turbidity syndrome was 5.12±1.64(years),the average course of disease in 161 cases with phlegm turbidity syndrome was 6.05±3.01(years),and the average course of disease in 374 cases with blood stasis syndrome was 7.38±3.01(year).There is a trend of increasing in the order of phlegm-damp turbidity syndrome,yin deficiency and heat excess,qi and blood deficiency,yang deficiency and blood stasis,and the difference is statistically significant(P<0.05).This suggests that the average duration of diabetes in patients with type 2 diabetes and the disease transformation process from excess to deficiency in the classification of TCM syndrome types is the development trend of the syndrome of excess heat and yin deficiency to syndrome of deficiency of both qi and yin,and deficiency of both yin and yang.Yin deficiency syndrome,phlegm turbidity syndrome and dampness turbidity syndrome have a short onset time and are in the early stage of onset;Qi and blood deficiency syndrome is generally in the middle stage of onset,which is also the main course of type 2diabetes;Deficiency,yin damage and yang,stasis caused by deficiency,yang deficiency and blood stasis syndrome has the longest duration,so in most cases,it is the stage of severe related complications in the middle and late stages of type 2 diabetes;Different treatment methods are used according to the length of the reference disease course in the treatment of TCM syndrome differentiation.6.For the comparison of genetic history of T2 DM syndromes,there is no significant difference in the comparison of qi deficiency,blood deficiency,yin deficiency,yang deficiency,and damp turbidity(P>0.05);the genetic history of phlegm turbidity and blood stasis syndrome There was a significant difference in the comparison(P<0.05),so the genetic medical history had no significant significance for the analysis and differentiation of T2 DM syndrome types.7.For the comparison of hereditary medical history of T2 DM syndrome types,there were significant differences in the syndrome types of hypertension,coronary heart disease,chronic obstructive pulmonary disease and stroke in each basic medical history(P<0.05).8.In the comparison of urine routine and blood routine of each syndrome type,there is no significant difference between each syndrome type,which also shows that there is no significant relationship between abnormal blood and urine routine and the distribution of T2 DM syndrome types.9.Comparing the blood sugar of each syndrome type,glycosylated hemoglobin,fasting blood sugar,and two-hour postprandial blood sugar were significantly increased in Qi deficiency syndrome,fasting blood glucose was the highest in Yin deficiency syndrome,and lowest in dampness syndrome,at 7.27±1.51 mmol /L;blood glucose two hours after meals was the highest in blood stasis syndrome,at 10.95±2.68mmol/L;blood glucose two hours after meal was relatively low in yang deficiency syndrome,at10.01 ± 0.81mmol/L;Glycated hemoglobin,fasting blood glucose and two-hour postprandial blood glucose were compared among the syndrome types,and the differences were statistically significant(P<0.05).10.Serum creatinine accounted for the highest proportion in Qi deficiency syndrome,blood stasis syndrome and Yin deficiency syndrome,followed by121.67 ± 3.49,118.69 ± 3.91 and 115.69 ± 3.29;among cystatin,Yin deficiency syndrome and blood stasis syndrome accounted for the highest proportion,followed by 1.71±2.18 and 1.69±3.28;in the comparison of urea nitrogen,blood stasis syndrome and qi deficiency syndrome accounted for the highest proportions,accounting for 7.65±3.18 and 7.43±3.19;finally,in the comparison of urine trace protein,yin deficiency syndrome And blood stasis syndrome accounted for the highest proportion,followed by 181.28±18.27 and 179.33±11.29;11.The highest content of TG in type 2 diabetes patients is blood stasis syndrome,which is 1.83±2.91;the highest proportion in LDL-C is yin deficiency type(3.71±3.15);the highest proportion in HDL-C is blood deficiency Syndrome(0.81±0.75);the blood lipids of the following syndromes were significantly different(P<0.05).[Conclusion]1.Type 2 diabetes is more common with qi deficiency syndrome and blood deficiency syndrome,and most of them have blood stasis syndrome,which shows that in the whole development process of diabetes,qi and blood deficiency or blood stasis are the main types;the composition of type2 diabetes syndrome is complex,"Yin deficiency and dryness heat" can not fully summarize its pathogenesis characteristics.2.From the perspective of gender distribution,there is no significant difference in the incidence of type 2 diabetes between men and women.In male patients,the syndrome of yin deficiency,phlegm turbidity and blood stasis are more common,and in female patients,the syndrome of qi deficiency and blood deficiency is the most common.,Yang deficiency syndrome,damp turbidity syndrome accounted for more.From the perspective of age,the age of patients with yang deficiency syndrome and blood stasis syndrome is older than other syndrome types,suggesting that the natural age of diabetic patients is closely related to the overall trend of diabetes from Yin deficiency and heat to Qi and Yin deficiency and Yin and Yang deficiency.Correlation indicated that with the increase of age,the righteousness gradually weakened,and the deficiency of qi was the beginning of deficiency of yang.The long-term deficiency of qi would inevitably lead to the deficiency of yang,and the dynamic progression process of the etiology and pathogenesis of diabetes was basically consistent with the transformation process.3.There is no direct and obvious relationship between the genetic history and the distribution of T2 DM syndrome types.4.The blood stasis syndrome and qi deficiency and blood deficiency syndrome in T2 DM combined with hypertension,coronary heart disease greatly increased.5.Hematuria routine has no obvious relationship with the distribution of T2 DM TCM syndrome types.6.The detection of blood sugar is of great significance for the prevention and treatment of diabetes.In the comparison of blood sugar conditions,compared with other syndromes,it is necessary to focus on the blood sugar conditions of Qi deficiency syndrome,Yang deficiency syndrome and wet turbidity syndrome.7.The renal function of T2 DM patients with various syndromes has a certain degree of damage,and the detection of renal function should focus on prevention and attention for yin deficiency syndrome,blood stasis syndrome and qi deficiency syndrome.8.The blood lipids of T2 DM patients with various syndrome types are often increased,especially the blood stasis syndrome,suggesting that most of the T2 DM patients need lipid regulation,which is very necessary to reduce cardiovascular and cerebrovascular complications and improve the quality of life of patients. |
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