| Objective:By comparing the clinical data, indicators such as serum bilirubin and TCM syndromes of non-DN group, stage DNIII and DNIV of Type2diabetes. Looking for clinical features of DN. And explore the correlation between TCM syndromes and clinical indicators such as serum bilirubin.Finding out some valuable and objective evidence for the TCM syndromes differentiation and treatment of DN. To provide some ideas for the prevention and treatment of DN.Methods:First, we Collected85cases of patients with Type2diabetes which were divided into non-DN group, stage DNIII and DNIV group depending on urinary albumin excretion rate. Then Collected the clinical data, differentiated the TCM syndromes according to the symptoms, pulse and tongue condition. Analysis and compare the general data, the differences between the indicators such as serum bilirubin and the TCM syndromes distribution characteristics of three groups. The SPSS17.0statistical software is used. To explore the correlation between the TCM syndromes and the clinical indicators such as serum bilirubin.Results:(1)In85cases of Type2diabetes patients, ages60to74years younger elderly accounted for41.18%, the largest proportion. Male:female ratio is1.3:1, the prevalence of women is lower than men.(2)The blood pressure of stage DNIII and DNIV is higher than non-DN group, the systolic blood pressure difference is statistically significant (p<0.05, p<0.01). The difference of fasting blood glucose and glycosylated hemoglobin between the three groups is not statistically significant. CHO, TG and LDL compared, stage DNIII is higher than non-DN group, stage DNIV is higher than stage DNIII.The cholesterol of stage DNIV is significantly higher than that of non-DN group (p<0.01).The LDL-C of stage DNIV is higher than non-DN group (p<0.05).The difference of serum creatinine and blood urea nitrogen between the groups is statistically significant (P<0.05).Stage DNIV has a significantly higher serum creatinine than stage DNIII and non-DN group (P<0.01). Stage DNIV has a significantly higher urea nitrogen than non-DN group (P<0.01).The bilirubin of non-DN group is highest, followed by stage DNIII and DNIV. The difference of total bilirubin and indirect bilirubin between the three grougs is statistically significant (P<0.05).The total bilirubin of stage DNIV is lower than stage DNIII (P<0.05).The Indirect bilirubin Of stage DNIV is lower than non-DN group(P<0.05), significantly lower than stage DNIII (P<0.01).(3) WithUAERas dependent variable, and other indicators as independent variable for multiple linear stepwise regression analysis, the diastolic pressure and total bilirubin into the equation. The diastolic pressure is positively correlated with UAER and the total bilirubin is negatively correlated with UAER.(4)Qi and Yin deficiency and blood stasis is respectively the highest frequency appeared in deficiency syndromes and standard empirical syndromes; The frequency of occurrence of Qi and Yin deficiency, liver and kidney Yin deficiency in stage DNIII is higher than that in stage DNIV. The frequency of occurrence of spleen and kidney deficiency, Yin and yang deficiency in stage DNIV is higher than that in stage DNIII; The Yin and Yang deficiency has the longest duration of diabetes in deficiency syndromes, followed by liver and kidney Yin deficiency, spleen and kidney deficiency, Qi and yin deficiency; Phlegm syndrome has the longest duration of diabetes in standard empirical syndromes, followed by the Blood stasis, qi stagnation and dampness syndrome.(5)The fasting glucose levels of Qi stagnation syndrome is higher than blood stasis syndrome, phlegm and dampness syndrome(p<0.05). The glycosylated hemoglobin of Qi stagnation syndrome is higher than the other three standard empirical syndromes, difference with blood stasis and dampness syndrome is statistically significant(p<0.05). The serum creatinine and blood urea nitrogen of Yin and Yang deficiency are sequentially higher than that of spleen and kidney deficiency, qi and Yin deficiency, liver and kidney Yin deficiency. The difference of serum creatinine with liver and kidney Yin deficiency is significantly (p<0.01).The triglycerides of Phlegm syndrome is significantly higher than the non-phlegm syndrome (P<0.01).Direct bilirubin of qi and Yin deficiency is higher than liver and kidney Yin deficiency and spleen and kidney deficiency(P<0.01> P<0.05). The total bilirubin of qi stagnation syndrome is higher than the other three standard empirical syndromes, the difference with blood stasis and phlegm syndrome is statistically significant (P<0.05); The total bilirubin, direct bilirubin and indirect bilirubin of qi and Yin deficiency are the highest, followed by liver and kidney Yin deficiency, spleen And kidney deficiency, and qi stagnation syndrome also the highest, followed by dampness syndrome, blood stasis syndrome, phlegm syndrome.Conclusions:(1)Type2DN is more common in older people, the prevalence of women is lower than men.(2)The systolic blood pressure, total cholesterol and low density lipoprotein cholesterol of DN patients are higher than diabetic patients without DN. DN patients are Often accompanied by high blood pressure, lipid metabolic disorder, and be worse with the progression of disease.(3) Bilirubin levels decline with the progression of DN, and the reduce of total bilirubin levels may be a risk factor of DN; The rise of diastolic blood pressure is a risk factor of DN.(4)Qi and Yin deficiency is the most common deficiency syndrome and blood stasis syndrome is the most common standard empirical syndrome in type2DN; Disease may develop from qi and Yin deficiency, to liver and kidney Yin deficiency, spleen and kidney deficiency, to Yin and Yang deficiency. Phlegm syndrome, blood stasis syndrome appear earlier in the process of disease and exist for a long time, probably throughout the disease.(5)The increase of fasting blood glucose and glycosylated hemoglobin suggest that Qi Stagnation syndrome may exist. The increase of Serum creatinine and blood urea nitrogen indicate that DN develop in the direction of Yin and Yang syndrome, and the treatment should pay attention to tone up the Yin and Yang. The increase of triglycerides can serve as a reference of phlegm syndrome differentiation.The change trend of serum bilirubin prompt the evolution trend of TCM syndromes. |
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