Study On Distribution Of TCM Syndromes And Related Factors In Patients With Diabetes Mellitus And Carotid Artery Endometriosis

Purpose:To detect the relationship between the carotid artery intima-media thickness and the ankle brachial index in patients with type 2 diabetes mellitus,and to research the distribution regularity of TCM Syndromes in type 2 diabetes mellitus with carotid intimal thickening or plaque formation.Method:A total of 150 subjects were enrolled into this study,who admitted consecutively to Endocrinology department of affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September 2014 to March 2015.All patients underwent a detailed medical history enquiry,height and weight were measured. The fast blood samples were colleted to determine the levels of blood glucose, glycosylated hemoglobin, total cholesterol, low density lipoprotein,C-reactive protein,serum uric acid.Carotid ultrasound examinations and doppler blood flow survey meter were performed to assess for the carotid intima-media thickness and ankle-brachial index.Patients were divided into 3 groups according to their carotid ultrasound : normal IMT group(A,n=38,the average age was 46.74±9.63 years),IMT thickning group(B,n=56,the average age was 56.21±10.57 years),IMT thickening with plaque group(C,n=56,the average age was 60.82±9.20 years).Group comparison and correlation test were carried out among groups.TCM syndrome differentiation was refered to 《Guidelines for TCM Diabetes Prevention and Treatment 》.Results: 1.There were significant differences in the age, course of disease among the three groups(P<0.05). It was difference in BMI betweeen group A and the other two groups. 2.Group A was mainly deficiency of both qi and yin(55.3%),group B and C were mainly Qi and Yin deficiency with blood stasis syndrome(respectively 42.9% and 69.6%).The incidence of abnormal IMT in each syndromes :deficiency syndrome of both liver and kidney yin 82%,deficiency of both qi and yin52%,Qi and Yin deficiency with blood stasis syndrome 95%,phlegm-heat syndrome 52%.Composition of TCM Syndrome in patients with abnormal IMT:phlegm-heat syndrome accounted for 12.5%,:deficiency syndrome of both liver and kidney yin accounted for 10.71% ,deficiency of both qi and yin accounted for 20.54%,,Qi and Yin deficiency with blood stasis syndrome accounted for 56.25%。 3.In terms of smoking history, group A was statistically different from the other groups significantly;In terms of history of hypertension,group A had significant difference compared with group C alone(P <0.01). 4.There was no significant difference among the subgroups for FPG and Hb A1c;A significant difference with respect to TC, LDL-C、CRP was found between group A and C; There were significant differences in LDL-C、CRP and UA between group A and B; In respect of ABI,group C showed significant difference when compared with Group A and B. 5.Pearson correlation analysis showed that age, duration of disease, BMI,TC, LDL-C, CRP,UA,history of hypertension and smoking were positively correlated with IMT; ABI was negatively correlated with IMT;but Hb A1 C, FPG had no correlation with IMT;According to the result of multiple linear regression analysis:age, course of disease, smoking history,CRP, BMI,UA and ABI were correlated with IMT,in other words,they were main affecting factors of IMT.Conclusion: 1. Age, course of disease, smoking history,CRP,BMI,UAand ABI were the main affecting factors of the carotid artery intima media thickness. 2.ABI can reflect the degree of carotid atherosclerosis, ABI was inversely related to IMT. 3. ABI can be used as predictors for the development of cardiovascular disease in patients with type 2 diabetes mellitus.4.Qi and Yin deficiency with blood stasis syndrome was dominated in patients with abnormal IMT,followed by,deficiency of both qi and yin,deficiency syndrome of both liver and kidney yin,phlegm-heat syndrome.