| ObjectedBy collecting the information of TCM diagnosis and general situation of patients with type2 diabetes mellitus complicated with hyperuricemia,the distribution law of TCM syndrome of type 2 diabetes mellitus complicated with hyperuricemia was explored.MethodsIn this study,a single center and cross-sectional study was conducted.Patients with type 2diabetes mellitus and hyperuricemia hospitalized in the Department of Endocrinology and metabolism in First Hospital Affiliated to Tianjin Medical University from January 2021 to January 2022 were selected as the subjects.According to the inclusion and exclusion criteria,229 patients were selected,filled in the information and general situation of four diagnosis of traditional Chinese medicine with reference to syndrome element dialectics,and entered into excel table to calculate and refine the disease location and disease nature syndrome elements of each patient,and classify the syndrome types of Traditional Chinese Medicine.The four diagnostic information was extracted by factor analysis,and the common factor was extracted by clustering analysis and the basic theory of Chinese medicine.The results of two kinds of results were compared with those of TCM.The TCM syndrome characteristics of hyperuricemia in the final type 2 diabetes were obtained.The TCM syndrome elements,syndrome types,age,duration,gender,history of smoking and drinking,BMI,and BMI were analyzed by means of quantitative description,Fisher accuracy test,chi-square test and Cochran-Armitage trend test.The correlation of insulin use,blood uric acid,glycosylated hemoglobin and color Doppler ultrasound of metatarsophalangeal joint was analyzed by spss25.0 and sas9.4 carry out relevant statistical operations.Results1 General data:the male to female ratio of T2DM patients with HUA was 2.01:1,mostly male.The average BMI index was 28.77±4.28kg/m2.The frequencies of normal(18.5～23.9kg/m~2),overweight(24～27.9kg/m~2)and obesity≥28kg/m~2 were 25,75 and 129respectively,mostly obesity.Complications:32 with gout history,18 with kidney stones,8with gout and kidney stones,159 with fatty liver,146 with hypertension,176 with hyperlipidemia,55 with coronary heart disease and 37 with cerebral infarction.The duration of diabetes:the average duration of disease was 9.55+8.52 years.According to 1years,2～5 years,6～10 years,11～19 years,and 20 years,20 were classified into 60,36,42,48 and 43.2 Distribution of syndrome elements:disease location syndrome elements:kidney 101>liver 82>spleen 62>heart 48>lung 14;There were 108 of phlegm dampness>97 of heat>33of water stagnation>17 of blood stasis>11 of qi stagnation in solid disease syndrome,169of yin deficiency>100 of Yang deficiency>42 of qi deficiency>41 of blood deficiency in virtual disease syndrome;At the age of 18～40,the course of disease≤1 year is mainly concentrated in the spleen,at the age of 41～50,the course of disease≤2～5 years is mainly concentrated in the liver,and at the age of≥51,the course of disease≥6 years is mainly concentrated in the kidney.The distribution rate of spleen syndrome elements decreases with the increase of age and course of disease,and the distribution of kidney syndrome elements increases with the development of age and course of disease,which is statistically significant.When the age is 18～60 years old and the course of disease is≤1 year and≥6 years,the majority is phlegm dampness syndrome element,the majority is heat syndrome element when the age is 61～70 years old and the course of disease is 2～5 years,and the majority is water stagnation syndrome element when the age is≥71 years old.In the distribution of deficiency syndrome elements,yin deficiency syndrome elements are mainly in each age and course of disease,the distribution of phlegm dampness syndrome element and heat syndrome element decreases with the increase of age and course of disease,and the distribution of blood deficiency syndrome element and Yang deficiency syndrome element increases with the increase of age and course of disease,Shuiting syndrome element increased with age.Phlegm dampness syndrome element and heat syndrome element are more distributed in patients who do not use insulin,while water retention syndrome element and yang deficiency syndrome element are more distributed in patients who use insulin,and the distribution rate of Yang deficiency syndrome element increases with the increase of insulin use time,which are statistically different.3 Type of syndrome:type 2 diabetes mellitus combined with hyperuricemia can be divided into 6 types,namely,51 of spleen deficiency and Dampness Retention syndrome,37 of yin deficiency and fire fire syndrome,37 of yin deficiency and dampness heat syndrome,26 of yin deficiency syndrome,23 of Yang deficiency and water stagnation syndrome,53 of yin yang deficiency syndrome.At the age of 18～40,when the course of disease is≤1 year and 6～10years,the syndrome type is mainly spleen deficiency and dampness excess syndrome;at the age of 41～50 and the course of disease is 2～5 years,the syndrome type is mainly Yin deficiency and dampness heat syndrome;at the age of≥51 and the course of disease is≥11years,the syndrome type is mainly Yin and yang deficiency syndrome.The distribution rate of spleen deficiency dampness excess syndrome and yin deficiency damp heat syndrome decreased with the increase of age and course of disease,the distribution rate of Yang deficiency water stop syndrome and yin-yang deficiency syndrome increased with the increase of age and course of disease,and the distribution rate of Yin blood deficiency syndrome increased with the increase of age,which was statistically significant.When insulin is not used,the syndrome types are mainly spleen deficiency dampness excess syndrome,yin deficiency fire excess syndrome and yin deficiency damp heat syndrome.After insulin is used,the syndrome types are mainly yin-yang deficiency syndrome and yang deficiency water stop syndrome,and the distribution rate of Yang deficiency water stop syndrome increases with the increase of insulin use time.The syndrome type of BMI at 18.5～23.9kg/m~2is concentrated in Yin deficiency and fire hyperactivity syndrome,which decreases with the increase of BMI index.When BMI at23.9～28kg/m~2,the syndrome type is concentrated in Yin and yang deficiency syndrome,when BMI≥28kg/m~2,the syndrome type is concentrated in spleen deficiency and dampness excess syndrome,and yin deficiency and dampness heat syndrome increase with the increase of BMI index,which has statistical significance.There is no statistical difference between the distribution of syndrome types and the history of tobacco and alcohol.Based on frequency statistics,the history of smokeless wine is mainly yin-yang deficiency syndrome,and the history of tobacco and alcohol is mainly Yin deficiency damp heat syndrome and spleen deficiency damp heat syndrome.The gender distribution of Yin-Yang deficiency syndrome is statistically different,and the distribution rate of men is higher than that of women.When glycosylated hemoglobin≤7%and serum uric acid≤480μmol/L,the distribution of spleen deficiency and dampness excess syndrome is most;When glycosylated hemoglobin>7%and serum uric acid>480μmol/L,yin-yang deficiency syndrome is the main syndrome,and the distribution rate of Yin-Yang deficiency syndrome increases with the increase of glycosylated hemoglobin,which is statistically significant.The correlation between syndrome type and color Doppler ultrasound of toe metatarsal joint was analyzed in 87 patients with T2DM complicated with Hua.The results showed that there was no significant statistical significance between syndrome type and the formation of gout.Conclusions1 Type 2 diabetes mellitus complicated with hyperuricemia is mostly male and obese.2 Type 2 diabetes mellitus with hyperuricemia,viscera and viscera in five viscera are closely related to kidney,liver and spleen.Early in the spleen,early in the liver,in the middle and later stages of the kidney,with the increase of age and progression of disease,there is a trend from spleen to liver to kidney.Type 2 diabetes mellitus complicated with hyperuricemia is mainly composed of deficiency and excess syndrome and deficiency syndrome.The basic pathogenesis is Yin deficiency,which can be related to Yang deficiency,blood deficiency and Qi deficiency.The pathological products are mainly phlegm dampness and heat,which may involve water stop and blood stasis.The phlegm dampness and heat syndrome elements obviously decrease with age and course of disease,while those of water stop,blood deficiency and yang deficiency indicate the aggravation of the condition and the poor prognosis of the three.3 Type 2 diabetes combined with hyperuricemia can be divided into 6 syndromes,namely spleen deficiency and dampness excess syndrome,yin deficiency and fire heat syndrome,yin deficiency and dampness heat syndrome,Yin blood deficiency syndrome,Yang deficiency water stop syndrome,yin and yang deficiency syndrome two.Mainly spleen deficiency and dampness excess syndrome and yin-yang deficiency syndrome.In the early stage of the disease,spleen deficiency dampness excess syndrome,yin deficiency dampness heat syndrome and yin deficiency fire hyperactivity syndrome are more common.In the later stage,yin and yang deficiency syndrome,Yang deficiency water stop syndrome and Yin blood deficiency syndrome are the main syndromes.4 The distribution of spleen deficiency dampness excess syndrome and yin deficiency dampness heat syndrome increased with the increase of BMI index,and yin deficiency Huowang syndrome decreased with the increase of BMI index.The distribution of Yin-Yang deficiency syndrome is related to gender and glycosylated hemoglobin.There is no correlation between blood uric acid,smoking and alcohol history,color Doppler ultrasound of metatarsophalangeal joint and the distribution of syndrome types. |
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