Analysis Of TCM Syndrom Types And Related Factors In Overweight And Obesity Patients

Objective:In this study,we collected and collated information on general conditions,laboratory indicators and TCM evidence patterns of overweight obese patients,analysed the correlation between BMI levels and laboratory indicators of overweight obese patients,and explored the distribution of TCM evidence patterns of overweight obese patients and the correlation between them and metabolic indicators,so as to provide an objective basis for the identification and treatment of clinical overweight obese patients.Methods: The clinical data of 124 overweight and obese patients who attended the outpatient clinic of the Department of Endocrinology of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine between December 1,2021 and December 31,2022 and met the criteria for nadir were collected,including gender,age,history of smoking,history of alcohol consumption,family history,height,weight,waist circumference,TSH,(25(D)OH),ALT,AST,GGT,ALP,TG,TC,LDL-C,HDL-C,UA,FBG,TIFNS and TCM evidence pattern data.According to their body mass index,they were divided into four groups: overweight group,mild obesity group,moderate obesity group and severe obesity group.The correlation between BMI levels and laboratory indices of the four groups of overweight and obese patients was analysed,as well as the correlation between Chinese medicine evidence patterns and metabolic indices of overweight and obese patients.This study used Excel for data collection and SPSS 26.0 statistical software for analysis of the data.Result:1.General data:A total of 124 overweight and obese patients were included in this study,71 males and 53 females;34 in the overweight group,38 in the mild obesity group,30 in the moderate obesity group and 22 in the severe obesity group.There were no statistically significant differences in gender,age,height,smoking history,drinking history and family history among overweight and obese patients in different BMI groups(P>0.05);there were statistically significant differences in weight and waist circumference among overweight and obese patients in different BMI groups(P<0.05).2.Laboratory indicators:(1)TSH Indicator:There was no statistically significant difference between the different BMI groups and TSH(p>0.05),There was no correlation between BMI levels and TSH in 124 overweight and obese patients(p>0.05).(2)25(OH)D Indicator:There was a statistically significant difference(p<0.01)between the different BMI groups compared with 25(OH)D,The overweight group had higher 25(OH)D levels than the mild,moderate and severe obesity groups;the mild obesity group had higher 25(OH)D levels than the moderate and severe obesity groups;and the moderate obesity group had higher 25(OH)D levels than the severe obesity group.BMI levels were negatively correlated with 25(OH)D levels in 124 overweight and obese patients(p<0.01).(3)Liver Function Indicators:Statistically significant differences between different BMI groups and ALT and AST(p<0.01);On ALT levels:higher in the moderately and severely obese groups than in the overweight group;higher in the severely obese group than in the mildly obese group;On AST levels: the moderately and severely obese group had higher AST levels than the overweight group;There was no statistically significant difference in GGT and ALP on different BMI subgroups(P > 0.05);the BMI levels of 124 overweight and obese patients were positively correlated with ALT and AST levels(ALT:P<0.01,AST:P<0.01),but not with GGT and ALP(GGT:P>0.05,AST:P>0.05).(4)Uric acid indicator:There was a statistically significant difference between the different BMI groups compared to UA(p < 0.01),UA levels were significantly higher in the moderate and severe obesity groups than in the overweight and mild obesity groups;BMI levels were positively correlated with UA levels in 124 overweight a(p < 0.01),ALT levels were higher in gastrointestinal damp-heat and phlegm-stasis evidence than in spleen-kidney-yang deficiency and spleen-deficiency-damp obstruction evidence;there was no statistically significant difference in AST,GGT and ALP levels among the 4 groups of TCM evidence(P > 0.05).uric acid indicator:there was no statistically significant difference in the level of UA between the four groups of TCM evidence(P > 0.05).UA levels are highest in evidence of dampness and heat in the stomach and intestines,second highest in evidence of phlegm and stasis,and lowest in evidence of Yang deficiency in the spleen and kidneys.Lipid metabolic indexes: The differences in TG,TC and LDL-C levels between the four groups of overweight and obese TCM evidence were statistically significant(P < 0.05).In terms of TG levels: TG levels are higher in gastrointestinal damp-heat evidence than in spleen-kidney yang deficiency and spleen-deficiency-damp obstruction evidence;In terms of TC levels: TC levels in the Spleen Deficiency and Dampness Blocking Certificate and Gastrointestinal Dampness and Heat Certificate were higher than those in the Spleen and Kidney Yang Deficiency Certificate group and the Phlegm and Blood Stasis Interconnection Certificate group;In terms of LDL-C levels: LDL-C levels were higher in evidence of spleen deficiency and dampness than in evidence of gastrointestinal dampness and heat and evidence of spleen-kidney yang deficiency;LDL-C levels were higher in evidence of phlegm and stasis than in evidence of spleen-kidney yang deficiency;the difference in HDL-C was not statistically significant in the four groups of TCM evidence(p>0.05).Blood glucose,insulin indicators:no statistically significant differences in FBG levels among the four groups of TCM evidence in overweight obese patients(P > 0.05);the differences in FINS and HOMA-IR levels among the four groups of TCM evidence were statistically significant(p < 0.01),on the level of FINS: the level of FINS on the evidence of spleen deficiency and dampness obstruction was higher than that on the evidence of gastrointestinal damp-heat,spleen-kidney yang deficiency and phlegm-stasis interconnection;the level of FINS on the evidence of gastrointestinal damp-heat was higher than that on the evidence of spleen-kidney yang deficiency;in terms of HOMA-IR levels: HOMA-IR levels were higher in evidence of spleen deficiency and dampness than in evidence of damp-heat in the stomach and intestines,evidence of spleen-kidney yang deficiency,and evidence of phlegm-stasis interconnection.Conclusion:1.The 124 overweight and obese patients in this study were more male than female and their BMI levels were not related to gender,age,history of smoking,alcohol consumption or family history;2.In this study,the BMI level of 124 overweight and obese patients was negatively correlated with 25(OH)D,positively correlated with ALT,AST,UA,TG,TC,LDL-C,FBG,FINS and HOMA-IR levels,and had no correlation with normal TSH level,GGT,ALP and HDL-C levels;3.In this study,among the 124 TCM syndromes of overweight and obesity,spleen deficiency and dampness-blocking syndrome was the most,followed by gastrointestinal dampness-heat syndrome,phlegm-stasis interjunction syndrome,and spleen-kidney Yang deficiency syndrome were the least;4.In this study,patients with Spleen and Kidney Yang deficiency evidence were the oldest.The elevated ALT and TG levels were mainly seen in Gastrointestinal Damp-Heat evidence and Phlegm-Stasis Interconnection evidence,while the elevated FINS,HOMA-IR,TC and LDL-C were mainly seen in Spleen Deficiency and Dampness Blockage evidence.