Study On The Distribution Of Chinese Medicine Syndrome Elements In Elderly Patients With Metabolic Syndrome

Objective:The aim of this study is to explore the distribution of TCM evidence in metabolic syndrome(MS)in the elderly,to improve the TCM evidence system for MS in the elderly,and to provide a theoretical basis for improving the standardisation and objectivity of clinical evidence in MS in the elderly.Methods:A total of 180 elderly patients with MS who visited the outpatient and inpatient department of the Department of Cardiology,the First Affiliated Hospital of Heilongjiang University of traditional Chinese medicine from November 2021 to December 2022 were collected,including 8 cases meeting the exclusion criteria,and 172 cases were finally included.The"questionnaire of syndrome differentiation factors of elderly patients with metabolic syndrome" and "questionnaire of general conditions" were formulated,and the diagnosis and statistical analysis of syndrome factors were carried out according to the "syndrome differentiation of syndrome factors",so as to summarize the disease location and disease distribution law of the disease.Results:1.General information:172 cases were finally included,including 93 females and 79 males,with an average age of 71.53 ± 5.78 years.According to the frequency,the abnormal components of MS in the elderly were hypertension>high Tg>low HDL-C>hyperglycemia>abdominal obesity.The combination of hypertension+hyperglycemia+dyslipidemia accounted for the highest proportion,27.33%.2.Distribution pattern of TCM elements2.1 Syndrome element distribution:the disease location syndrome elements were kidney(55.23%),spleen(39.53%),liver(27.33%),heart(9.30%),stomach(5.81%),gallbladder(2.33%),lung(1.74%),and mind(0.58%).The pathogenic factors were phlegm(58.72%),blood stasis(45.35%),Qi deficiency(38.95%),dampness(36.63%),yin deficiency(34.88%),heat(26.74%),Yang deficiency(25.58%),yang hyperactivity(18.60%),blood deficiency(6.40%),Qi Stagnation(2.33%),dryness(1.16%),fluid deficiency(0.58%),and dynamic wind(0.58%).2.2 Syndrome element combination:the distribution of disease location combination is mainly double disease location(45.93%),the others are single disease location(35.47%),zero disease location(13.95%),three disease location and above(4.65%).In the two disease sites,spleen+kidney accounted for the highest proportion(21.51%);Among the three disease sites and above,kidney+spleen+heart accounted for the highest proportion(2.33%).In the distribution of disease combination,the three diseases were the most(38.95%),and the others were double disease(23.26%),four disease(22.67%),single disease(8.72%),five disease and above(6.40%).Phlegm+blood stasis accounted for the most(8.72%)of the dual disease syndrome elements;Among the three diseases,Qi deficiency+Yin deficiency+blood stasis was the most(7.56%);Among the four diseases,phlegm+blood stasis+Qi deficiency+dampness accounted for the most(6.98%);There were 11 cases with five or more diseases.3.Correlation analysis of TCM syndrome elements with lifestyle and dietary behaviorThere was a statistically significant difference between damp and heat in the distribution of drinking history(P>0.05);There were statistical differences in the distribution of qi deficiency and phlegm in sedentary and sedentary patients(P<0.05);The spleen and sputum showed statistically significant differences in the distribution of appetite for fat and sweet food(P<0.05);There were statistical differences in the distribution of Insomnia between kidney and Qi deficiency(P<0.05);There was no statistical difference in the distribution of smoking history among different syndrome elements(P<0.05).4.Cluster analysisThe common TCM Syndromes of MS in the elderly include spleen and kidney yang deficiency syndrome,liver yang hyperactivity syndrome,dampness heat stagnation syndrome,phlegm and blood stasis syndrome,and Qi and yin deficiency syndrome.Conclusion:1.In elderly MS patients,the pathogenic elements are mainly kidney,spleen and liver,and the pathogenic elements are mainly phlegm,blood stasis,qi deficiency,dampness,yin deficiency,heat,yang deficiency and hyperactivity.Among the combinations of pathogenic elements,Spleen+Kidney is the most common,followed by Liver+Kidney;among the combinations of pathogenic elements,Phlegm+Blood Stasis is the most common,followed by Qi Deficiency+Yin Deficiency+Blood Stasis.2.Different syndrome elements(frequency>10%)in elderly patients with MS have certain correlation in drinking history,sedentary lifestyle,eating fat and sweet taste and insomnia.3.The common TCM Syndromes of MS in the elderly include spleen and kidney yang deficiency syndrome,liver yang hyperactivity syndrome,dampness heat stagnation syndrome,phlegm and blood stasis syndrome,and Qi and yin deficiency syndrome.