| Objective:Study on the distribution characteristics of TCM syndrome types in patients with type 2 diabetes complicated with chronic heart failure,analyzing the relationship between TCM syndrome types and relevant laboratory indicators in type 2 diabetes complicated with heart failure,exploring the distribution pattern of TCM syndrome types in this disease,and providing objective basis for clinical differentiation and treatment.Methods:From January 2014 to January 2023,a total of 228 elderly patients with a diagnosis of diabetes complicated with heart failure were selected from Beijing University of Traditional Chinese Medicine Dongfang Hospital as the research subjects.Western medicine diagnostic standards for elderly diabetes combined with heart failure were used to select appropriate cases for inclusion and exclusion criteria,and traditional Chinese medicine syndrome differentiation was conducted under the guidance of a deputy chief physician according to the combination of the main and accompanying symptoms based on the Clinical Guidelines for New Chinese Medicine.General information such as age,gender,history of diabetes,hypertension,complications of diabetes,traditional Chinese medicine syndrome,fasting blood glucose,glycosylated hemoglobin,BNP,troponin I,blood biochemistry,and heart function grade of all 228 patients were collected.All data were entered into the Excel system and analyzed using SPSS 27.0.Based on the statistical results,the distribution characteristics of traditional Chinese medicine syndrome types in elderly diabetic patients with chronic heart failure and their correlation with laboratory indicators were explored.Results:1.A total of 228 elderly patients with diabetes and heart failure were included,including 115 males(50.44%)and 113 females(49.56%).Qi deficiency,blood stasis,water retention syndrome accounted for 36.28%,Qi deficiency,blood stasis syndrome accounted for 15.35%,Qi-Yin deficiency and phlegm-blood stasis obstructing syndrome accounted for 14.04%,Qi-Yin deficiency and blood stasis obstructing syndrome accounted for 11.84%,and Yang deficiency and water retention syndrome accounted for 21.49%.2.Age:The age differences among the five syndrome types of patients were statistically significant.The mean age of patients with Yang deficiency,blood stasis and water retention syndrome was higher than that of patients with Qi-Yin deficiency,blood stasis obstructing syndrome and Qi deficiency,blood stasis,water retention syndrome,and the difference was statistically significant(P<0.05).3.Diabetes history:The differences in diabetes history among patients with the five syndrome types were statistically significant.The diabetes history of patients with Yang deficiency,blood stasis and water retention syndrome was higher than that of patients with Qi deficiency,blood stasis and water retention syndrome,and Qi deficiency,blood stasis syndrome.The diabetes history of patients with Qi deficiency,blood stasis,water retention syndrome was higher than that of patients with Qi deficiency,blood stasis syndrome,and the difference was statistically significant(P<0.05).4.Glycemic index:1)Glycated hemoglobin levels:The differences in glycated hemoglobin levels among the five syndrome types were statistically significant.The glycated hemoglobin levels of patients with Qi-Yin deficiency and blood stasis obstructing syndrome were significantly higher than those of patients with Yang deficiency,blood stasis and water retention syndrome,and Qi deficiency,blood stasis and water retention syndrome,and the difference was statistically significant.2)Fasting blood glucose:The differences in fasting blood glucose among the five syndrome types were statistically significant(P<0.05).The fasting blood glucose levels of patients with Qi-Yin deficiency and blood stasis obstructing syndrome were significantly higher than those of patients with Qi deficiency,blood stasis syndrome,Qi deficiency,blood stasis and water retention syndrome,and Yang deficiency,blood stasis and water retention syndrome,and the difference was statistically significant(P<0.05).5.Cardiac index:1)Myocardial calcium protein I:The differences among the five syndrome types were statistically significant(P<0.05).The myocardial calcium protein levels of patients with Qi-Yin deficiency and phlegm-blood stasis obstructing syndrome were significantly higher than those of patients with Yang deficiency,blood stasis and water retention syndrome,and Qi deficiency,blood stasis syndrome,and the difference was statistically significant(P<0.05).2)BNP:The differences among the five syndrome types were statistically significant(P<0.05).The BNP levels of patients with Yang deficiency,blood stasis and water retention syndrome were significantly higher than those of patients with other syndrome types(P<0.05).6.Lipid metabolism index:1)Triglycerides:The differences among the five syndrome types were statistically significant(P<0.05).The triglyceride levels of patients with Qi-Yin deficiency and phlegm-blood stasis obstructing syndrome were higher than those of patients with Yang deficiency,blood stasis and water retention syndrome,and Qi deficiency,blood stasis syndrome,and the difference was statistically significant(P<0.05).2)Low-density lipoprotein:The differences among the five syndrome types were statistically significant(P<0.05).The low-density lipoprotein levels of patients with Qi-Yin deficiency and phlegm-blood stasis obstructing syndrome were significantly higher than those of patients with other syndrome types,and the difference was statistically significant(P<0.05).3)Total cholesterol:The differences among the five syndrome types were statistically significant(P<0.05).The total cholesterol levels of patients with Qi-Yin deficiency and blood stasis obstructing syndrome were significantly higher than those of patients with other syndrome types,and the difference was statistically significant(P<0.05).7.Hemostatic function index:D-dimer:The differences among the five syndrome types were statistically significant(P=0.000<0.05).The D-dimer levels of patients with Qi-Yin deficiency and phlegm-blood stasis obstructing syndrome were significantly higher than those of patients with other syndrome types,and the difference was statistically significant(P=0.000<0.05).8.Gender,history of hypertension,creatinine,homocysteine,and prothrombin time did not differ significantly among the five syndrome types of patients.Conclusions:Qi deficiency,blood stasis,and water retention syndrome are commonly seen in elderly diabetes patients with heart failure,followed by qi and yin deficiency,phlegm-stasis obstruction syndrome,yang deficiency and water retention syndrome,qi deficiency and blood stasis syndrome,and qi and yin deficiency with blood stasis syndrome.With increasing age,yang deficiency and water retention syndrome are more likely to occur.Glycosylated hemoglobin,fasting blood glucose,myosin calcium protein I,BNP,LDL,HDL,triglycerides,and D-dimer are closely related to the syndrome differentiation of elderly diabetic patients with heart failure and can be used as objective evidence for clinical diagnosis of type 2 diabetes with heart failure. |
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