Correlation Between TCM Syndromes,Mean Platelet Volume Divided Platelet Count,Plasma Fibrinogen In Type 2 Diabetes Mellitus And Metabolic-Associated Fatty Liver Disease

Objective:Metabolic Dysfunction-associated Fatty Liver of Type 2 Diabetes Mellitus(T2DM)was collected Distribution of TCM syndrome types in patients with Disease,MAFLD,And the correlation among clinical indicators such as mean platelet volume(MPV),platelet count(PC)and fibrinogen(FIB)between different syndrome types,To provide objective theoretical basis for TCM prevention and treatment of T2DM with MAFLD.Methods:A total of 355 patients who were hospitalized in the Department of Endocrinology of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January to December 2022 and met the requirements of this study were collected.According to the TCM syndrome dialectical standard formulated in this study,the patients were divided into two groups.The general data of patients such as name,gender,age,body mass index(BMI),duration of diabetes were collected,and laboratory physical and chemical indicators such as MPV,PC,FIB were collected.Excel database was established to input and manage the data,and SPSS 26.0 statistical analysis software was used to explore the distribution of TCM syndrome types and their correlation with various research indicators.Results:1.In this study,355 patients with T2DM combined with MAFLD had TCM syndrome distribution characteristics:There were 99 cases(27.9%)of phlegm-stasis interjunction,89cases(25.1%)of spleen deficiency and turbidity-phlegm,68 cases(19.2%)of liver depression and spleen deficiency,54 cases(15.2%)of dampness-heat accumulation and formation,45cases(12.7%)of spleen and kidney deficiency,mainly of phlegm-stasis interjunction and spleen deficiency and turbidity-phlegm.2.In this study,the proportion of males(56.6%)was higher than that of females(43.4%).There were 234 patients(64.9%)with BMI≥24kg/m~2,and most of them were overweight.The mean age and course of disease in the liver-qi and spleen-deficiency syndrome group were the youngest,while the mean age and course of disease in the spleen-kidney deficiency syndrome group were the longest,and the differences among the groups were statistically significant(P<0.05);The results of multiple logistic regression indicated that age was negatively correlated with syndrome of phlegm-stasis interjunction,syndrome of spleen deficiency and phlegm turbidities,syndrome of liver depression and spleen deficiency and syndrome of damp-heat accumulation.The course of disease is negatively related to the syndrome of liver depression and spleen deficiency and the syndrome of dampness-heat accumulation.3.In this study,the MPV/PC and FIB levels were the highest in the phlegm-stasis Hujie syndrome group,and the differences were statistically significant compared with spleen-deficiency phlegm-turbidity syndrome,liver-stagnation and spleen-deficiency syndrome,damp-heat accumulation syndrome and spleen-kidney deficiency syndrome(P<0.05).The results of multiple logistic regression indicated that MPV/PC was positively correlated with the syndrome of phlegm-stasis interjunction,spleen deficiency phlegm-turbidities,and FIB was positively correlated with the syndrome of phlegm-stasis interjunction.4.In this study,the FC-P level of spleen-kidney deficiency syndrome group was the lowest,and the difference was statistically significant compared with the syndrome of phlegm-stasis interjunction,the syndrome of spleen deficiency phlegm turbidities,and the syndrome of dampness-heat accumulation(P<0.05).The results of multiple logistic regression indicated that FC-P was negatively correlated with the syndrome of dampness-heat accumulation.There was no significant difference between the levels of FBG,FINS,HOMA-IR and Hb Alc(P>0.05).5.In this study,the levels of ALT and AST in damp-heat accumulation syndrome group and phlegm-stasis interjunction syndrome group were higher,and the differences were statistically significant compared with spleen deficiency phlegm turbidness syndrome,liver depression and spleen deficiency syndrome,spleen and kidney deficiency syndrome(P<0.05).Logistic regression analysis indicated that ALT was positively correlated with syndrome of damp-heat accumulation,AST was positively correlated with syndrome of damp-heat accumulation,syndrome of spleen deficiency and phlegm turbidities,and syndrome of liver depression and spleen deficiency.6.In this study,the level of TG was higher in the syndrome group of mutual accumulation of phlegm and blood stasis and the syndrome group of spleen deficiency and phlegm turbidity,and the difference was statistically significant compared with the syndrome of liver stagnation and spleen deficiency,damp heat accumulation and spleen and kidney deficiency(P<0.05).Logistic regression analysis showed that TG was positively correlated with mutual accumulation of phlegm and blood stasis,spleen deficiency and phlegm turbidity,and damp-heat accumulation,and TC was positively correlated with mutual accumulation of phlegm and blood stasis,spleen deficiency and phlegm turbidity,liver stagnation and spleen deficiency.There was no significant difference in HDL-C and LDL-C levels among the three syndrome types(P>0.05).Conclusion:1.The distribution of TCM syndromes in T2DM patients with MAFLD is mainly phlegm-stasis interjunction syndrome,spleen deficiency phlegm turbidness syndrome.2.There is a correlation between MPV/PC,FIB and TCM syndrome types,and the changes of their levels can provide a reference for TCM syndrome differentiation and diagnosis of disease conditions.3.There is a correlation between MPV/PC,FIB and TCM syndrome types,There are statistically significant differences in BMI,MPV,PC,FC-P,ALT,AST,TC,TG,diabetes duration and age among different TCM syndrome types of T2DM with MAFLD,which can be used as a reference basis for TCM syndrome differentiation of T2DM with MAFLD.In clinical practice,we should pay attention to the dynamic observation of the above indicators and treat them combined with TCM syndrome differentiation.