Analysis Of TCM Syndrome And Medication Rule Of Type 2 Diabetes Mellitus Complicated With Hyperuricemia

Objective:In this study,the case data of patients with type 2 diabetes mellitus complicated with hyperuricemia were sorted out and analyzed,and their TCM syndromes and medication rules were summarized to provide reference for clinical diagnosis and treatment of this disease.Methods:Using the retrospective study method,229 patients with type 2 diabetes mellitus with hyperuricemia who were hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from September 2019 to September 2021 were selected according to the criteria of case inclusion.After standardizing the patient’s general information,four diagnosis information,diagnosis and Chinese medicine prescription,it was entered into Excel software to establish a database,and SPSS26.0 software was used for the statistics of high-frequency symptoms and signs to obtain the internal characteristics of syndromes such as the nature and location of the disease that might be involved,and the possible syndrome types.The TCM inheritance calculation platform(V3.0)was used to analyze the case data of patients and summarize the clinical characteristics of the disease and the use of Chinese medicine.Results:1.General information:(1)Gender and age:Among the 229 patients with T2DM combined with HUA included in this study,males were dominant,the male to female ratio was 1.54:1;the age was mainly distributed between 41-65 years old;with the increase of age,the percentage of women with T2DM combined with HUA showed an overall upward trend compared with men.(2)Associated diseases:there were 142 cases of hyperlipidemia(about 62.01%),129 cases of obesity(about 56.33%),91 cases of liver damage(about 39.74%),73 cases of fatty liver(about 31.88%),and 69 cases of hypertension(about 30.13%).2.Analysis of TCM syndromes:(1)There are 54 symptoms in total,and the top 10 frequencies of symptoms were as follows:Fatigue(15 6 times),thirst(13 6 times),poor sleep(111 times),dizziness(104 times),numbness at the extremities(9 5 times),blurred vision(8 5 times),chest tightness(7 9 times),palpidity(7 3 times),chills(60 times),and frequency of urination(5 7 times).(2)In terms of tongue image,the top 3 tongues included dark tongue quality(69 cases,accounting for 30.13%),red tongue quality(57 cases,accounting for 24.89%),and light tongue quality(23 cases,accounting for 10.04%);The top 3 lichens were moss yellow greasy(88 cases,accounting for 3 8.43%),moss thin white(66 cases,accounting for 28.82%),and moss white greasy(56 cases,accounting for 24.45%).(3)The pulse frequency was as follows:fine pulse(7 3 cases,accounting for 3 1.88%),pulse chord(72 cases,accounting for 3 1.44%),pulse slippage(71 cases,accounting for 31.00%),pulse astringency(70 cases,accounting for 3 0.57%),pulse sinking(36 cases,accounting for 15.72%),pulse number(32 cases,accounting for 13.97%),weak pulse(10 cases,accounting for 4.37%),and pulse(3 cases,accounting for 1.31%).(4)After cluster analysis of the symptoms,tongue images and pulses of 229 patients with T2DM and HUA,it was concluded that the disease factors that may be involved are:humid heat,yang deficiency,yin deficiency,qi stagnation,qi deficiency,blood stasis,phlegm dampness,and the disease symptoms include spleen,liver,kidney and heart.Through collation and analysis,it is concluded that the possible syndrome types are:spleen deficiency and wet type,humid heat connotation type,qi deficiency blood stasis type,and renal yang deficiency type.3.Medication pattern:(1)The cold drugs(1,424 times)were the most frequently used ones in the four qi systems of TCM,followed by the warm drugs(1,364 times),the rest were the neutral drugs(1,014 times),cold drugs(168 times)and heat drugs(107 times).(2)The most frequently used in the five flavors of traditionalChinese medicine was sweet medicine(223 8 times),while the others were bitter medicine(203 1 times),pungent medicine(1270 times),sour medicine(5 18 times)and salty medicine(178 times).(3)The meridian tropism and frequency of traditional Chinesemedicine were as follows:spleen meridian(2003 times),liver meridian(1912 times),lung meridian(1750 times),stomach meridian(1494 times),heart meridian(13 16 times),kidney meridian(1288 times),biliary meridian(642 times),large intestine meridian(500 times),bladder meridian(23 9 times),small intestine meridian(23 2 times),Sanjiao meridian(115 times),pericardial meridian(47 times).(4)The main effects and frequencies of traditional Chinesemedicine were:tonifying deficiency(826 times),clearing heat(773 times),inducing diuresis and draining dampness(5 50 times),activating blood and resolving stasis(494 times)and regulating qi(3 03 times).(5)A total of 186 TCM appeared in 229 prescriptions in thisstudy,of which 55 were used more than or greater than 24 times.The top 11 drugs were Radix Astragalus,Poria cocos,Coptis,rhizoma smilacis glabrae,dioscorea,salviae miltiorrhiza,atractylodes rhizome,plantain,ligusticum Chuanensis,atractylodes rhizome and scutellaria radix.(6)Through data analysis,3 5 medication patterns and 20 association rules were identified,involving a total of 11 Chinese medicinal s(same as(5)).Among them,radix astragalus,poria cocos,and coptis had the strongest relationship,and were the core drugs,while the other drugs had strong relationships with the three,such as dioscorea,rhizoma smilacis glabrae,plantain,and scutellaria radix with coptis,and ligusticum Chuanensis,salviae miltiorrhiza,atractylodes rhizome,and atractylodes rhizome with radix astragalus and poria cocos.Conclusions:1.In this study,T2DM patients with HUA are more male than female,and the onset age is 41-65 years old,often accompanied by hyperlipidemia,obesity,liver damage,fatty liver and hypertension.2.The pathogenic elements that may be involved in this study are:humid heat,yang deficiency,yin deficiency,qi stagnation,qi deficiency,blood stasis,phlegm dampness,and the disease factors include spleen,liver,kidney,and heart.Through collation and analysis,it is concluded that the possible syndrome types are:spleen deficiency and wet type,humid heat connotation type,qi deficiency blood stasis type,and renal yang deficiency type.3.In this study,most drugs are tonic,heat-clearing,diuresis and dampness-removing,blood-activating and stasis-removing,qi-regulating,etc.Most of them are cold and warm in nature,and the main drugs are sweet,bitter and pungent,which mainly belong to spleen meridian.Commonly used drugs include Radix astragalus,Poria cocos,Coptis,rhizoma smilacis glabrae,dioscorea,sal viae miltiorrhiza,atractylodes rhizome,plantain,ligusticum Chuanensis,atractylodes rhizome and scutellaria radix,among which Radix astragalus,poria cocos and Coptis have the strongest relationship and are the core drugs.