Analysis Of TCM Syndromes And Related Factors Of T2DM Complicated With Permanent Atrial Fibrillation

Objective:To analyze the correlation between general data,laboratory tests,cardiac color Doppler ultrasound and combined diseases in T2 DM patients with permanent atrial fibrillation and without permanent atrial fibrillation under TCM syndrome differentiation classification,so as to provide syndrome differentiation ideas and clinical indicators for clinical diagnosis and treatment of T2 DM patients with permanent atrial fibrillation.Methods:A total of 728 T2 DM patients were enrolled in this retrospective study.According to the presence or absence of permanent atrial fibrillation,they were divided into T2 DM with permanent atrial fibrillation group and T2 DM without permanent atrial fibrillation group.The general condition,laboratory examination,comorbidities,symptoms,signs and other information of the patients were collected,and the syndrome type of the patients was determined according to the traditional Chinese medicine industry standard of the People’s Republic of China,"the diagnostic efficacy standard of TCM Internal Medicine Syndrome"(ZY/T001.1-94).SPSS25.0 software was used to analyze the relevant data between the two groups.Results:(1)Comparison of general dataAmong the 728 patients,the ratio of female to male was 1.1:1.There was no significant difference in gender between T2 DM with permanent atrial fibrillation group and T2 DM without permanent atrial fibrillation group(P>0.05).Compared with T2 DM without permanent atrial fibrillation group,T2 DM with permanent atrial fibrillation group had a higher proportion of males,an older age,a longer course of disease,and a higher proportion of patients with hypertension,coronary heart disease,and heart failure(P<0.05).(2)Comparison of laboratory indexesCompared with T2 DM without permanent atrial fibrillation group,the values of glycosylated hemoglobin,triglyceride,high density lipoprotein,low density lipoprotein and total cholesterol in T2 DM with permanent atrial fibrillation group were higher,and the uric acid value was lower,which was statistically significant(P<0.05).There was no significant difference in fasting blood glucose,total bilirubin,PT-INR and APTT between the two groups(P>0.05).(3)Comparison of cardiac ultrasoundCompared with T2 DM without permanent atrial fibrillation group,T2 DM with permanent atrial fibrillation group had a significantly higher left atrial anteroposterior diameter and a significantly lower EF(P<0.05).(4)Comparison of syndrome and syndrome typeThe distribution of syndrome types in T2 DM with permanent atrial fibrillation group was as follows: kidney Yin deficiency(34.4%)> stomach dryness and fluid injury(32.6%)> dryness and heat injury to lung(20.1%)>Yin and Yang deficiency(12.9%).The distribution of syndrome types in T2 DM without permanent atrial fibrillation group was as follows: kidneyyin deficiency(32.1%)>stomach dryness and fluid injury(26.9%)>dryness and heat injury to lung(25.5%)>Yin and Yang deficiency(15.5%).The probability of each syndrome type combined with atrial fibrillation was statistically significant.The frequency of kidney Yin deficiency syndrome combined with atrial fibrillation was higher than that of other syndrome types,and the difference was statistically significant(P<0.05).Symptoms of T2 DM with permanent atrial fibrillation group: chest tightness(45.5%)> fatigue(42.7%)> palpitation(40.9%)> poor sleep(37.9%)>dry mouth(33.5%).Symptoms of T2 DM without permanent atrial fibrillation group: fatigue(46.5%)> dry mouth(41.0%)> chest tightness(39.1%)>palpitation(36.2%)> limb numbness(34.7%).The tongue manifestations of T2 DM with permanent atrial fibrillation were as follows: Tongue texture: dark tongue(36.5%)> dark purple tongue(28.0%)> light red tongue(16.0%);Tongue coating: thin white coating(26.0%)> yellow greasy coating(17.9%)> white greasy coating(12.9%).In the non-permanent atrial fibrillation group,tongue texture: red tongue(30.6%)> dark tongue(23.2%)> light red tongue(17.7%);Tongue coating:yellow coating(32.1%)> thin white coating(23.6%)> yellow greasy coating(17.3%).The pulse manifestations of T2 DM with permanent atrial fibrillation were as follows: pulse jie dai(28.8%)> pulse sinking(21.2%)> pulse slippery(13.6%).The pulse of the non-permanent atrial fibrillation group was: pulse chord(27.3%)> pulse chord number(14.4%)> pulse depth(10.0%).(5)Comparison of factors among syndrome typesComorbidities(hypertension,coronary heart disease,heart failure),triglyceride,low density lipoprotein,total cholesterol in the type 2diabetes mellitus with permanent atrial fibrillation group were statistically significant(P<0.05).There was no significant difference in age,course of disease,glycosylated hemoglobin,high density lipoprotein,uric acid,left atrial anterior and posterior diameter,EF among different syndrome types in type 2 diabetes with permanent atrial fibrillation group(P>0.05).Conclusion(1)Compared with the non-permanent atrial fibrillation group,the T2 DM with permanent atrial fibrillation group had a higher proportion of males,an older age,a longer disease duration,and a higher proportion of hypertension,coronary heart disease,and heart failure.(2)Compared with the T2 DM group without permanent atrial fibrillation,the T2 DM group with permanent atrial fibrillation had higher values of glycosylated hemoglobin,triglyceride,low density lipoprotein,total cholesterol,left atrial anterior and posterior diameter,EF;and lower uric acid,high density lipoprotein.(3)Kidney Yin deficiency syndrome is more common in T2 DM patients with permanent atrial fibrillation.Kidney Yin deficiency syndrome is more likely to be associated with atrial fibrillation than other syndrome types.(4)Triglyceride,low density lipoprotein and total cholesterol were correlated with the occurrence of various syndrome types in T2 DM patients with permanent atrial fibrillation.