Study On The Relationship Between Phlegm And Blood Stasis Pathological Elements And Complications Of Type2Diabetes Mellitus

Objective:Using the syndrome element theory to explore the relationship between phlegm and blood stasis pathological factors and complications of type2diabetes,and to dicuss the correlation between the change of clinical index and pathology of phlegm and blood stasis.Methods:Collecting360type2diabeties patients which were divided into five groups based on diabetic complications:group0without complication,group1with a kind of complication,group2with two kinds of complications, group3with three kinds of complications, group4with four kinds of complications. Using the syndrome element theory to explore the distribution characteristics of phlegm and blood stasis pathological factors in five groups,and to analyse correlation between the observation indexes and phlegm and blood stasis pathological factors.Result:1Distribution characteristics of phlegm and blood stasis pathological integral:Phlegm and blood stasis pathological score rise with increasing morbidity,there was different statistically significant which compared between the five groups (P<0.01).2The effection of the level of phlegm, stasis pathology to diabetic complications:2.1The frequency of complications species have significant differences in different degree with blood stasis blood stasis pathology: with pathology severity, without complication, with1complication in the proportion dropped significantly, with more than2kinds of complications, the proportion increased significantly (P<0.01or P<0.05).2.2The frequency of complications species have significant differences in different phlegm pathological degree: pathological degree aggravate, without complication was decreased, with more than3kinds of complications, the proportion increased significantly (P<0.01or P<0.05).3Correlation analysis of phlegm, blood stasis and pathological score and clinical indexes: BMI, blood stasis and phlegm pathological integral were positively correlated with sputum pathological scores (r=0.317,0.384, P<0.01), CPS was negatively correlated with sputum pathological scores (r=-0.340, P<0.01); HbAlC, mALB, FIB, pathological score and blood stasis phlegm pathological score were positively correlated with blood stasis pathological integral (r=0.422,0.363,0.577,0.384, P<0.01). 4Multiple linear regression analysis of phlegm and blood stasis pathological score:blood stasis pathological score, the number of complications, body mass index and C peptide were important factors that affected the phlegm pathological integral, linear regression equation y=6.084+0.204*blood stasis pathological score+4.076*the number of complications+3.169*body mass index-7.321*C peptide; the number of complications, phlegm pathological score, fibrinogen, HbAlC was important factors that affected the blood stasis pathological integral, linear regression equation y=-71.031+14.093*the number of complications+0.221*sputum pathological integral+14.473*fibrinogen+4.276*HbAlC.5Analysis of ROC curve of phlegm, blood stasis pathological integral to predict complications of type2diabetes:Blood Stasis pathological integral ROC curve area is0.782(P<0.01), with the largest Youden index point to critical point, determine the69points was the best critical point on ROC curve and pathological score; and the ROC curve of sputum pathological scores was0.631(P<0.01).Conclusion:1Phlegm, blood stasis and pathological integral could be risen with the increasing complications of type2diabetes.2With the phlegm, stasis pathology aggravated, the number of type2diabetes complications increased.3BMI, the number of complications, blood stasis pathological score and C peptide were important factors that affected the phlegm pathological integral; wherein, body mass index, blood stasis and phlegm pathological integral were positively correlated, C peptide negatively related to sputum pathological integral.4HbAlC, the number of complications, FIB and sputum pathological score were important factors that affected blood stasis pathological integral, and HbAlC, UA, FIB, blood stasis, phlegm pathological score were positively correlated with pathological integral.5Blood stasis pathological score for69points could be used as a preliminary screening for complications of type2diabetes.