Study On The TCM Syndrome And Treatment Rules Of Gout Combined With Diabete

Purpose:To explore the distribution characteristics and medication rules of TCM Syndromes of gout combined with diabetes,and to provide the diagnosis and treatment standard for the quality control center of Liaoning rheumatic disease specialist,so as to provide reference for clinical prescriptions.Material and method:the hospitalized data of patients with gout combined with diabetes mellitus in rheumatology department of Liaoning University of Traditional Chinese Medicine Affiliated Hospital from January 2016 to November 2021 were retrospectively analyzed,and the cases were screened and summarized strictly according to the inclusion criteria and exclusion criteria.The collected data were analyzed by using Excel,SPSS 25.0 and traditional Chinese Medicine Inheritance auxiliary platform(v2.5).To summarize the distribution characteristics of syndromes in gout combined with diabetes,and explore the law of clinical medication.result:1.105 cases were collected in this study,the ratio of male to female was 10.67:1,the average age was 58.30 ± 14.73 years,and the median course of disease was 24(4114)months.2.Syndrome distribution(in order of proportion): dampness heat obstruction syndrome(68.57%)> dampness heat obstruction and blood stasis syndrome(23.81%)> Phlegm Blood stasis obstruction syndrome(5.71%)> cold dampness obstruction syndrome(0.95%)= spleen deficiency dampness obstruction syndrome(0.95%)> blood stasis heat obstruction syndrome(0%).3.the SUA of patients with gout combined with diabetes was 475.12±135.26umol/L,the median of CRP was 11.12(2.18,50.78)mg/L,the median of SCr was 85(72105)umol/L,FPG median was 7.7(6.6,10.09)mmol/L,systolic blood pressure was 137.86±19.09 mm Hg,diastolic blood pressure was 137.86(137.86,10.09)mm Hg.4.The median CRP of damp heat obstruction and blood stasis syndrome is 43.62mg/L,and the median CRP of damp heat obstruction and blood stasis syndrome is 19.2mg/L.The CRP of damp heat obstruction and blood stasis syndrome is higher than that of damp heat obstruction syndrome(P<0.05).5.105 prescriptions were collected in this study,involving 136 traditional Chinese medicines,1334 times of medication frequency and 16 categories of drugs.Among them,32 traditional Chinese medicines were used more than 10 times,accounting for 80.51% of the drug use frequency.The drug categories are heat clearing drugs,diuretic and dampness permeability drugs,blood activating and blood stasis removing drugs and deficiency tonifying drugs.Cold drugs were used most frequently.The medicine is mainly sweet,bitter and pungent.Drugs belonging to the liver meridian are used most frequently,followed by drugs from the kidney meridian,stomach meridian and spleen meridian.6.Analyze the association rules of the collected drugs,set the number of support as 42(the total number of prescriptions is 105,and the support is 40%),and the confidence is 0.8.A total of 30 data are obtained,including 7 kinds of drugs,including 17 groups of two drug combinations,11 groups of three drug combinations and 2 groups of four drug combinations,of which the highest frequency is Phellodendron chinense and Achyranthes bidentata,62 times,and the core drugs are Phellodendron chinense,Achyranthes bidentata,Atractylodes rhizome Alisma orientalis,Poria cocos,coix seed and cassia root.Set support 21(total number of prescriptions is 105.At this time,the support is 20%),the confidence is 0.9,and 18 association rules are obtained.The confidence of phellodendron,Achyranthes bidentata,coix seed-> Atractylodes macrocephala is the highest,which is 1.7.Analyze the prescription rule of the collected drugs under the entropy clustering algorithm,set the correlation degree to 8(the most relevant 8 drugs),and the punishment degree to 2(at least twice in all the collected prescriptions),and obtain the potential drug combination and drug correlation degree.There are 47 pairs of drugs with correlation coefficient > 0.05.Six groups of potential drug combinations can be evolved based on system entropy clustering algorithm.Potential drug pairs can be obtained by using the unsupervised entropy clustering algorithm of traditional Chinese Medicine Inheritance auxiliary platform software.The system forms three groups of new prescriptions according to these drug pairs,They are:(1)radix paeoniae rubra,Achyranthes bidentata,Alisma orientalis and cassia twig;(2)Flat storage,plantain,tangerine peel,Shiwei,ginger;(3)Notopterygium notopterygium,Ligusticum chuanxiong,Angelica sinensis,Herba Artemisiae,honeysuckle vine,Polygonum cuspidatum,Fangfeng,Duhuo.Conclusion:1.Damp heat obstruction syndrome and damp heat obstruction with blood stasis syndrome are more frequent.2.The increase of CRP in damp heat obstruction and blood stasis syndrome is more obvious than that in damp heat obstruction syndrome.3.The drugs used in clinical treatment of gout complicated with diabetes are mainly heat clearing drugs,diuresis and dampness removing drugs,blood activating and stasis removing drugs and tonifying drugs.The drugs are cold drugs,sweet,bitter and bitter drugs,and the drugs used in liver meridian are the most frequently.4.The analysis shows that the core drugs of the disease are Phellodendron amurense,Achyranthes bidentata,Atractylodes rhizome,Alisma orientalis,tuckahoe,coix seed and cassia root.The treatment principle of the disease is "clearing heat and dampness,promoting blood circulation and removing blood stasis,dispelling wind and removing arthralgia"5.The commonly used drug combinations are Phellodendron chinense,Achyranthes bidentata,coix seed and Atractylodes rhizome,which are the components of Simiao pill.6.The potential new prescriptions are:(1)radix paeoniae rubra,Achyranthes bidentata,Alisma orientalis and cassia twig;(2)Flat storage,plantain,tangerine peel,Shiwei,ginger;(3)Notopterygium notopterygium,Ligusticum chuanxiong,Angelica sinensis,Herba Artemisiae,honeysuckle vine,Polygonum cuspidatum,Fangfeng,Duhuo.