| Objective:To study the relationship between syndrome differentiation of TCM and the bone mineral density(BMD)of diferent parts,the plasma level of hs-CRP,TNF-αand the other correlative index in type 2 diabetes mellitus. Methods:According to diagnostic criterion of western medicine and criterion of exclucive case,75cases T2DM were selected and classified into Yin deficiency and excess heat syndrome(YDEHS),Dump Heat syndrome(DHS) , Stagnated blood syndrome(SBS),Both Qi and Yin deficiency syndrom(BQYS),the both Yin and Yang deficiency with phlegm and blood stasis syndrom(BYYPBSS),And 15 cases of healthy people were selected as the normal control group(NCG).The 5 diferent types of TCM of T2DM were compared with each other by bone mineral density(BMD) of lumbar vertebrae 1～4,left femur neck,left forearm(radius 33%) and whole body,hs-CRP,TNF-αand the other correlative index,and then were compared with the normal group,observing the change of index to sduty the relationship. Results:(1)Comparison of the six groups'BMD:①the serum level of the average BMD of whole body of 6 groups was as follows: BYYPBSS﹤SBS﹤BQYS﹤YDEHS﹤DHS﹤NCG; the level of BMD of SBS,BYYPBSS,YDEHS and BQYS were lower than NCG,the diference was very significant,(P<0.01);the level of BMD of DHS were lower than NCG,(P<0.05);the level of BMD of DHS and YDEHS were higher than SBS,(P<0.05); the level of BMD of DHS and YDEHS were higher than BYYPBSS,(P<0.05).②the serum level of the average BMD of left femur neck of 6 groups was as follows: SBS﹤BYYPBSS﹤ BQYS﹤YDEHS﹤DHS﹤NCG; the level of BMD of SBS and BYYPBSS were lower than NCG,the diference was very significant,(P<0.01);the level of BMD of BQYS was lower than NCG,(P<0.05); the level of BMD of DHS and YDEHS were lower than NCG,the diference was not significant,(P>0.05);the level of BMD of SBS and BYYPBSS were lower than DHS,(P<0.05).③the serum level of the average BMD of lumbar vertebrae 1～4 of 6 groups was as follows: SBS﹤BYYPBSS﹤BQYS﹤YDEHS﹤DHS﹤NCG; the level of BMD of SBS,BQYS and BYYPBSS were lower than NCG,the diference was very significant,(P<0.01); the level of BMD of YDEHS and DHS were lower than NCG,(P<0.05).④the serum level of the average BMD of left forearm (radius 33%)of 6 groups was as follows: BYYPBSS﹤SBS﹤DHS﹤YDEHS﹤BQYS﹤NCG; the level of BMD of SBS , BQYS and BYYPBSS were lower than NCG, the diference was very significant(P<0.01), the level of BMD of YDEHS and DHS were lower than NCG,, (P<0.05).(2)Comparison of the six groups'hs-CRP:the serum level of hs-CRP of 6 groups was as follows:SBS﹥DHS﹥BYYPBSS﹥YDEHS﹥BQYS﹥NCG,the level of hs-CRP of SBS , DHS, BYYPBSS,YDEHS and BQYS were higher than NCG,the diference was very significant(P<0.01),the level of hs-CRP of SBS and DHS were higher than YDEHS(P<0.01),the level of hs-CRP of BQYS was higher than SBS and DHS, (P<0.01), BYYPBSS was higher than BQYS,(P<0.05).(3)Comparison of the six groups'TNF-α:the serum level of TNF-αof 6 groups was as follows:SBS﹥DHS﹥BYYPBSS﹥BQYS﹥YDEHS﹥NCG,the level of TNF-αof SBS,DHS,BYYPBSS, YDEHS and BQYS were higher than NCG,the diference was very significant,(P<0.01);the level of TNF-αof SBS,DHS and BYYPBSS were higher than YDEHS,the diference was very significant,(P<0.01);the level of TNF-αof DHS was higher than BQYS and YDEHS,(P<0.01), the level of TNF-αof SBS was higher than BYYPBSS and BQYS(P<0.01); BYYPBSS was higher than BQYS,(P<0.05).(4)Comparison of the six groups'BMI:the serum level of BMI of 6 groups was as follows: DHS﹥BQYS﹥YDEHS﹥BYYPBSS﹥SBS﹥NCG;the level of BMI of DHS were higher than NCG,the diference was very significant,(P<0.01); the level of BMI of SBS , BQYS,YDEHS and BYYPBSS were higher than NCG,but the diference was not significant,(P>0.05); the level of BMIof DHS was higher than SBS,BQYS,YDEHS and BYYPBSS,the diference was very significant,(P<0.01);The diference between SBS,BQYS,YDEHS and BYYPBSS were not significant,(P>0.05). (5)Comparison of the six groups'HbA1c:the serum level of HbA1c of 6 groups was as follows: SBS﹥DHS﹥BQYS﹥YDEHS﹥BYYPBSS﹥NCG,the level of HbA1c of SBS,DHS,BQYS, YDEHS and BYYPBSS were higher than NCG,the diference was very significan,(P<0.01); the level of HbA1c of SBS,DHS and BQYS were higher than YDEHS,the diference was very significant,(P<0.01); the level of HbA1c of SBS,DHS and BQYS were higher than BYYPBSS,the diference was very significant,(P<0.01);The diference between SBS , DHS and BQYS were not significant,(P>0.05);The diference between YDEHS and BYYPBSS were not significant,(P>0.05).(6)The levels of BMD were negatively correlated with TNF-αand HbA1c. The levels of BMD did not correlate with BMI and hs-CRP.(7)The levels of BMD of SBS and BYYPBSS were negatively correlated with TNF-α.The levels of left forearm's BMD of DHS did not correlate with TNF-α,but The levels of other parts'BMD of DHS were positively correlated with TNF-α. The levels of BMD of SBS were negatively correlated with HbA1c. The levels of left femur neck's BMD of DHS did not correlate with HbA1c,but The levels of other parts'BMD of DHS were positively correlated with HbA1c. The levels of lumbar vertebrae 1～4's BMD of BQYS and YDEHS were negatively correlated with TNF-α,but The levels of other parts'BMD of BQYS and YDEHS did not correlate with TNF-α.The levels of lumbar vertebrae 1～4's BMD of YDEHS were negatively correlated with HbA1c,but The levels of other parts'BMD of YDEHS did not correlate with HbA1c.The levels of left forearm's BMD of BYYPBSS were negatively correlated with HbA1c,but The levels of other parts'BMD of BYYPBSS did not correlate with HbA1c. The levels of BMD of BQYS did not correlate with HbA1c.Conclusion:(1)The relationship between syndrome differentiation of TCM and bone mineral density of different parts with T2DM is clear. It can guide the clinical dialectic and early intervention,prevention and treatment of diabetic osteoporosis It can reflect the thought of"preventive treatment of disease"of TCM. (2)The relationship between syndrome differentiation of TCM and TNF-α,hs-CRP,HbA1c with T2DM is clear.they may offer microcosmic objective reference to syndrome differentiation of TCM of T2DM.(3)BMI can serve as a reference index in microcosmic objective reference to syndrome differentiation of TCM in the Moist Heat deficiency syndrome of T2DM. ( 4 )Hyperglycemia was one of the common risk factors of T2DM.
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