| Objective:Observe the conventional indexes and adiponectin(APN), homocysteine(HCY) levels of type 2 diabetes mellitus (T2DM) with and non-with phlegm syndromes(PS) and blood stasis syndromes (BSS), in order to reveal the objective law of T2DM with PS,BSS, to analysis the pathological role of serum APN and HCY in chronic vascular complications within patients of T2DM,to provide the laboratory basis for objective differentiation in TCM, Also to provide a theoretical basis for Chinese medicine prevention and treatment.Methods:1 Pations and groups:collected patients with T2DM 112 cases in line with the requirement during 2009.11-2010.9 in the First Clinical School of Zhengzhou University, and differentiated them into PS group of 43 cases,BSS group of 30 cases and non-PBSS group of 39 cases according the standards of TCM. Set normal control group of 35 cases.2 Observation items: General items:sex, age, disease duration, weight, height, body mass index, symptom inquiry, tongue, pulseBiochemistry items:fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), Serum insulin (FINS), insulin resistance index (HOMA-IR).Experimental item:detected adiponectin by the way of ELISA and homocysteine by the way of HPLC.Results:1 General items analysis:Gender comparison was no significant difference among the groups (P> 0.05). About age comparison, the difference was statistically significant between BSS group and PS group,non-PBSS group (P<0.05). Course of disease of BSS was significant longer than ones of PS group and non-PBSS (P <0.01).2 About body mass index, PS group were significant higher than BSS group non-PBSS group and normal control group (P<0.01). Compared of fasting blood glucose, PS group and BSS group was higher than the non-PBSS group, but the difference was not statistically significant (P> 0.05). HbAlc% between PS group and BSS group was not statistically significant (P> 0.05), but was significant higher than the that of non-PBSS (P<0.05). About HOMA-IR, PS group>BSS group> non-PBSS group,and the difference were statistically significant (P<0.01 P< 0.05).3 Compared TG, group of PS and BSS were higher than non-PBSS group and normal control group (P<0.01, P<0.05); the difference between PS group and BSS group was not statistically significant (P> 0.05). TC and LDL-c was no significant difference among PS group,BSS group and non-PBSS group (P> 0.05). HDL-c of PS group was significant lower than any other groups(P<0.01).4 HCY between PS group and BSS group was not statistically significant difference (P> 0.05), but were significant higher than the other groups (P<0.05). APN of PS,BSS gruops were significant lower than one of normal control group (P<0.01),and APN of PS was also significant lower than those of BSS, non-PBSS groups (P<0.01). 5 With the 21 cases,23 cases and 11 cases of chronic vascular complications of BSS,PS,non-PBSS groups,the incidence rates were 70%,53.49%and 28.21% respectively; and were significant different (P<0.05).6 To differentiation PS and BSS groups by extreme heat with yin asthenia syndrome,deficiency of both vital energy and yin syndrome,deficiency of both yin and yang syndrome, the distribution rate of the PS group among the 3 syndromes above is 6.67%,36.67%,56.67% respectively; the distribution rate of the BSS group among the 3 syndromes above is 39.53%,51.16%,9.31% respectively.7 HCY were statistically significant difference between with and non-with vascular complications,so as APN (P< 0.05).Conclusion:1 There are common pathophysiological basis between phlegm syndromes,blood stasis syndromes and chronic vascular complications of T2DM2 Adiponectin, homocysteine can be used as reference of phlegm syndromes,blood stasis syndrome and vascular complications.3 Phlegm and blood stasis accompany with the whole process of T2DM, the treatment of dissipating phlegm and activating blood circulation is important. |
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