Summary Of Zhao Jinxi's Experience In Distinguishing And Treating Shaoyang Constitution Type 2 Diabetes Based On Data Minin

Background:Type 2 diabetes mellitus(T2DM)accounts for more than 90%of the diabetic population in China,and its chronic complications have become an important cause of blindness,disability and death.Professor Jinxi Zhao has been engaged in the clinical scientific research of diabetes and its complications for a long time,and has accumulated rich experience in the prevention and treatment of T2DM.In clinic,he emphasizes the "trinity"diagnosis and treatment mode of distinguishing constitution,disease and syndrome differentiation.It is of great significance to study the relationship between physique and symptoms,syndromes and medication of patients with T2DM,and to summarize and analyze experts’ experience in selecting prescriptions and medication.Objective:To summarize Professor Jinxi Zhao’s clinical experience in treating T2DM with shaoyang constitution,so as to deeply understand the trinity diagnosis and treatment mode of constitution,disease and syndrome differentiation,and to understand the relationship between constitution,disease and syndrome,so as to provide reference for the prevention and treatment of T2DM with traditional Chinese medicine.Methods:From September 2020 to December 2021,the medical record database of T2DM patients with Shaoyang constitution who were treated by Professor Jinxi Zhao was established,and the clinical manifestations,tongue picture,pulse condition,Chinese medicine name and other data were standardized in Microsoft office Excel 2016.The ancient and modern medical record cloud platform(V2.3.5)was used to further standardize the data,and the frequency of age,sex,constitution type,syndrome and medication was analyzed,and the relationship between constitution and syndrome,symptoms and medication was analyzed.Using IBM SPSS Statistics 26.0,the high-frequency drugs were systematically clustered and visualized.Results:A total of 124 patients with T2DM with shaoyang constitution were included in this study.Among them,60 cases were male and 64 cases were female,ranging in age from 30 to 80.Among the subtypes of shaoyang constitution,shaoyang B patients are the most,accounting for 54.84%of the total number;Shaoyang A patients are the least,accounting for only 5.64%.The common symptoms of T2DM patients with shaoyang constitution are bitter mouth,dry eyes,dry mouth and dreaminess.The common tongue images are dark red tongue with cloudy edges;The common pulse condition is pulse string.Specific to the three subtypes,the constitution of shaoyang A is often characterized by melancholy mood,loose stool,cold limbs,fatigue,red tongue tip,thready pulse,etc.,the constitution of shaoyang B is often characterized by bitter mouth,dry eyes,dry mouth,fatigue,dreaminess,dark red tongue,thready pulse,etc.,and the constitution of shaoyang C is often characterized by bitter mouth,dry eyes,dry mouth,dry stool and dreaminess.Among T2DM patients with shaoyang constitution,blood stasis is the most common syndrome,followed by stagnation of heat,yin deficiency and qi stagnation.Specifically,there are three subtypes,such as qi stagnation syndrome,blood stasis syndrome,qi deficiency syndrome and stagnation of heat in Shaoyang A constitution,blood stasis syndrome,stagnation of heat syndrome,yin deficiency syndrome and qi stagnation syndrome in Shaoyang B constitution,and stagnation of heat syndrome,blood stasis syndrome,yin deficiency syndrome and stagnation of heat syndrome in Shaoyang C constitution.In the prescription of T2DM patients with shaoyang constitution,the commonly used drugs are Bupleurum,Scutellariae Radix,Salvia Miltiorrhiza Radix,Pueraria lobata,Pinellia Preparata,Radix Paeoniae Alba,Glycyrrhiza uralensis,Pericarpium Citri Tangerinae,Coptidis Rhizoma,Bombyx mori,Prunella vulgaris,Litchi Seed,Cortex Lycii,and Herba et Gemma Agrimoniae,etc.,with the most cold nature,bitter taste,sweet taste and pungent taste,and the meridian tropism belongs to liver meridian and spleen and stomach meridian,with the efficacy of clearing heat and eliminating dampness Specifically,the drugs used in the three subtypes are Bupleurum,Salvia Miltiorrhiza,Radix Puerariae,Radix Paeoniae Alba,Glycyrrhrizae Radix,Herba et Gemma Agrimoniae,Cortex Lycii,Scutellariae Radix,Litchi Semen,Bombyx Mori,Rhizoma Pinelliae Preparata,Cortex Cinnamomi,etc.,and Bupleurum,Scutellariae Radix,Salvia Miltiorrhiza Radix,Rhizoma Pinelliae Preparata,Radix Puerariae,Radix Paeoniae Alba,Pericarpium Citri Tangerinae,Radix Glycyrrhizae,Rhizoma Coptidis,Bombyx In the correlation analysis between symptoms and medication,bitter taste is closely related to Bupleurum,Scutellaria baicalensis,Rhizoma Pinelliae Preparata,Radix Paeoniae Alba,Radix Glycyrrhizae and Prunellae Spica,dry eyes are closely related to Bupleurum,Scutellaria baicalensis,Prunellae Spica,Radix Salviae Miltiorrhizae,Radix Puerariae and Radix Paeoniae Alba,dry mouth is closely related to Bupleurum,Scutellariae Radix,Rhizoma Pinelliae Preparata,Pericarpium Citri Tangerinae and Radix Glycyrrhizae,dreaminess is closely related to Bupleurum,Scutellariae Radix,Rhizoma Pinelliae Preparata and Pericarpium In the correlation analysis of physique subtypes and symptoms,Shaoyang A physique is closely related to depression,Shaoyang B physique is closely related to dry mouth,dreaminess,fatigue,dry stool,chest tightness,depression,abdominal distension and so on,and Shaoyang C physique is closely related to bitter mouth,dry eyes,dry mouth,dry stool,impatience and irritability,and defecation for several days.In the correlation analysis of constitution subtypes and syndromes,shaoyang A constitution is closely related to qi stagnation syndrome,shaoyang B constitution is closely related to blood stasis syndrome,yin deficiency syndrome,qi stagnation syndrome and phlegm-heat syndrome,and shaoyang C constitution is closely related to stagnation heat syndrome,blood stasis syndrome,yin deficiency syndrome and heat stagnation syndrome.In the correlation analysis between constitution subtypes and medication,Shaoyang A constitution is closely related to Bupleurum,Salvia Miltiorrhiza,Radix Puerariae,Radix Paeoniae Alba,Radix Glycyrrhizae,Semen litchi,Cortex Lycii,Herba et Gemma Agrimoniae,Bombyx Mori,Cortex Cinnamomi,etc.,while Shaoyang B constitution is closely related to Bupleurum,Pericarpium Citri Tangerinae,Rhizoma Coptidis,Radix Glehniae,Radix Acanthopanacis Senticosi,Rhizoma Anemarrhenae,Radix Linderae,Herba Taxilli,Radix Dipsaci,Os Draconis The results of cluster analysis show that the commonly used drug combinations for treating T2DM with shaoyang constitution mainly include:Os Draconis,Concha Ostreae,Semen Ziziphi Spinosae and Radix Acanthopanacis Senticosi;Rhizoma Pinelliae Preparata,Pericarpium Citri Tangerinae and Poria;Lindera root,Lily and Endothelium Corneum Gigeriae Galli;Mulberry leaf,chrysanthemum,selfheal,bupleurum root,scutellaria root and glehnia root;Herba Taxilli,Radix Dipsaci,Rhizoma Cibotii,Fructus Chaenomelis,Radix Achyranthis Bidentatae,Radix Cyathulae and Caulis Spatholobi;Coptidis Rhizoma,Cinnamomum cassia;Litchi seed,Lycium barbarum bark,hairyvein agrimony,silkworm excrement,Euonymus japonicus feather,Radix Rehmanniae,Radix Scrophulariae and Corni Fructus;Saviae Miltiorrhizae Radix,Radix Puerariae.Conclusion:① Among the different subtypes of T2DM with shaoyang constitution,shaoyang type B and shaoyang type C are the most,and shaoyang type A is rare.Patients with different physical subtypes have their own characteristics in clinical manifestations,syndromes and medication.② Among the syndromes of T2DM patients with shaoyang constitution,deficiency syndrome is more common in Yin deficiency syndrome,while excess syndrome is more common in blood stasis syndrome and stagnation heat syndrome.③Professor Jinxi Zhao’s treatment of T2DM with shaoyang constitution emphasizes the prevention of pathogenesis,differentiation of prescriptions and syndromes,and selection of effective drugs,with clearing away stagnation and heat,promoting blood circulation and removing blood stasis,benefiting qi and nourishing yin as the main treatment methods.In clinical specific treatment,it is important to add and subtract drugs in combination with patients’ physique and actual clinical manifestations,and give full play to the advantages of individualized prevention and treatment of traditional Chinese medicine.