Study On The Distribution Of TCM Syndrome And Medication Rules Of Type 2 Diabetes Mellitus With Hypothyroidism

Objective : Based on Traditional Chinese Medicine Inheritance Computing Platform System(V3.0),we calculated the type 2 diabetes mellitus(T2DM)combined with hypothyroidism(OH)in the affiliated hospital of Shandong University of Traditional Chinese Medicine.In order to investigate the distribution characteristics and medication pattern of the TCM evidence types,and to provide reference for the treatment of T2 DM combined with OH in Chinese medicine.Methods:Clinical data of patients with type 2 diabetes mellitus combined with hypothyroidism who were hospitalized at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2016 to October 2022 were collected.The TCM Inheritance Computing Platform System(V3.0)was used to statistically analyze the patients’ basic information,TCM syndrome types,medication frequency and frequency,as well as the four Qi and five flavor of traditional Chinese medicine,attribution,association rule analysis and systematic clustering analysis.The results of the statistical analysis were summarized.Results:1.A total of 384 patients were included in this study,including 215 females and 169 males,with an average age of 67.49 years old.Mainly concentrated in onset between the ages of 51 and 80,with an average age of 67.49 years.There were 213 patients with OH onset later than T2 DM.2.The distribution of main syndromes were as follows:Qi and Yin deficiency syndrome(38.3%)>Yin and Yang deficiency syndrome(21.4%)>Phlegm(Dampness)-Heat syndrome(15.6%)>Liver and Kidney Yin deficiency syndrome(14.6%)>excessive Heat impairing Body fluid syndrome(10.1%).The concurrent syndromes were as follows:concurrent syndrome of blood stasis(36.5%)>concurrent syndrome of phlegm turbidity(16.1%).3.Among the 384 traditional Chinese medicine prescriptions included,there were a total of 267 TCMs,with a total usage frequency of 5246.There were 27 drugs with high frequency(≥60 times of use),with a total frequency of 57.99%.The top 10 in order of frequency were Astragalus(262),Poria(218),Licorice(206),Angelica(180),Atractylodes Macrocephala(168),Yam(164),Salvia miltiorrhiza(130),Rehmannia(128),Dogwood(116)and Pueraria(114).4.A total of 18 types of drugs were obtained by classifying the efficacy of 247 TCM.The main medicines for treating T2 DM combined with hypothyroidism were tonic medicines,heat-clearing medicines,blood-activating and stasis-removing medicines,and diuresis-dampening medicines,among which qi-tonifying medicines(53.12%)were the most used,mainly Astragalus.5.The four qi of the medicine were mainly warm(37.63%),cold(29.97%)and flat(24.40%),accounting for 91.99% of the total.The five flavors of the medicine were mainly sweet(42.16%%),bitter(28.30%)and acrid(19.63%),accounting for 90.09% of the total.The meridians of the medicine were mainly spleen meridian(19.29%),liver meridian(16.28%),lung meridian(15.85%),accounting for 51.42% of the total.6.The herbal combinations were concentrated in Astragalus-Angelicae,Glycyrrhiza-Atractylodes Macrocephala,Astragalus-Radix Rehmanniae Praeparata,etc.The drug association rules were based on Atractylodes Macrocephala,Radix Rehmanniae Praeparata→Astragalus.7.Based on the k-means algorithm and regression simulation analysis,the core formula rule is obtained,and four core combinations are obtained,as follows:Atractylodes Macrocephala,Poria,Glycyrrhiza,Astragalus,Pericarpium and Pinellia ternate were used 91 times;Astragalus,Atractylodes Macrocephala,Yam,Rehmannia,licorice and Ophiopogon were used 101 times;Astragalus,Angelicae,Yam,Radix Rehmanniae Praeparata,Poria and Cornus were used 123 times;Glycyrrhiza,Poria,Astragalus,Yam,Dried ginger,Monkshood and Radix Rehmanniae Praeparata were used69 times.Conclusion:1.The main syndroms of type 2 diabetes combined with hypothyroidism are Qi and Yin deficiency syndrome,Yin and Yang deficiency syndrome,often accompanied by blood stasis.2.Astragalus,Poria,Licorice,Angelica,Atractyloides atractyloides,Yam and Salvia miltiorrhiza were the core drugs for the treatment of type 2 diabetes mellitus complicated with hypothyroidism,and the main drugs were tonic medicines.3.The medicinal properties and flavor of treating type 2 diabetes mellitus with hypothyroidism are mainly warm and sweet,and the meridians of the medicine are spleen meridian,liver meridian and lung meridian.4.In the clinical treatment of type 2 diabetes mellitus combined with hypothyroidism,the general treatment is based on tonifying the deficiency and strengthening the body,and at the same time removing pathogens.The rational combination of medicinal properties,flavors and meridians is used to achieve a comprehensive regulation of the Qi,Blood,Yin and Yang of zangfu organs and treat both symptoms and root causes.