The TCM Syndrome Analysis Of Overweight Diabetic Nephropathy And Fueling Diabetic Nephropathy

ObjectiveDiabetic Nephropathy is the leading causes of kidney failure for Diabetes patients, and the incidence of DN is increasing. So more and more clinicians pay attention to this desease. However, the abnormal lipid metabolism which is caused by overweight and obesity can further promote the progress of Diabetic Nephropathy. In the early stages of Diabetic Nephropathy, strict control of blood glucose,blood pressure and blood lipid is the effetive way to prevent the development of Diabetic Nephropathy.Modern treatment such as:lifestyle changes which including weight control, diabetic diet, smoking cessation and athletic sports;control of blood glucose,blood pressure and blood lipid and dialyse or transplantation can’t stop disease progression. Although they have obtained certain clinical curative effect, there are still limitations and side effects that cannot be ignored. As traditional Chinese medicine get more and more attention,, we should increase the proportion of traditional Chinese medicine in the future treatment of DN. But nowdays, the unified specification standards of syndrome differentiation and treatment in overweight and obesity Diabetic Nephropathy is still blank.PurposeThis study collected the related dates of overweight and obesity Diabetic Nephropathy patients through the retrospective investigation, and the mainly dates included the basic information, TCM four diagnostic data. All dates are collected for researching and exploring the distributed regularity of TCM symptoms, defining the syndrome differentiation and treatment of overweight and obesity Diabetic Nephropathy, and providing the useful basis for the clinical treatment of DN.MethodsA cross-sectional survey research method was used in this study. Firstly, we designed a TCM symptom information collection table, according the large number of literature investigation, clinical characteristics and accompanying symptoms of the overweight and fueling Diabetic Nephropathy, and guidance of our tutor. Secondly, we filled in the questionnaire through collecting related information of the overweight and fueling Diabetic Nephropathy inpatient’s during November 2012-January 2015 in Guangdong Province TCM Hospital. And then, we established the information database in accordance with requirements statistics, and finished the data entry and check. Finally, we summarized and classifyed the syndrome of overweight and fueling DN using factor analysis and cluster analysis method of SPSS17.0 software.Results1.The statistical analysis of 201 cases overweight and fueling Diabetic Nephropathy patients showed that the main clinical symptoms included dry mouth drink more, depression, blurred vision, body pain, limb edema, nocturia, bubble urine, etc. And the more common tongue picture were dark red, light and dark tongue, yellow greasy moss, white greasy moss, moss thin white, the more common type of pulse were thready and slippery pulse, string pulse.2. After dimension reduction processing of 15 TCM symptoms and 13 tongue pulse condition using factor analysis,20 common factor were extracted. Combining with clinical practice and under the guidance of our tutor, clustering analysis of the 20 common factor concluded 4 kinds of TCM syndrome classification:the hot and humid,phlegm and blood stasis type, the lack of heat phlegm wet type, heart kidney deficiency type, qi deficiency and blood stasis wet type.3. According to the factor score, we classifyed the patients into 4 groups:46 cases (22.89%) in the hot and humid, phlegm and blood stasis type,105 cases (52.23%) in the the lack of heat phlegm wet type,22 cases (10.95%) in the heart kidney deficiency type,28 cases (13.93%) in the qi deficiency and blood stasis type wet. Thus mainly TCM syndromes of the overweight and obesity Diabetic Nephropathy patients were the hot and humid, phlegm and blood stasis type and the lack of heat phlegm wet type.ConelusionThe most common clinical symptoms of the overweight and obesity Diabetic Nephropathy patients included dry and drinking more, weakness, blurred vision, limbs pain and edema. The most common conditions of the tongue and the pulse were dark red tongue, light and dark tongue, yellow or white greasy fur, thin and white fur, thready and slippery pulse and small and wiry pulse. The study summed up 4 TCM syndrome differentiations:stagnant dampness-heat type, the lack of heat phlegm wet type, heart kidney deficiency type and qi deficiency and blood stasis type wet. Among the four types, The proportion of the the lack of heat phlegm wet type is the highest percentage, and the hot and humid, phlegm and blood stasis type is the second. Both accounted for more than seventy percent, which suggested that patients with this disease, more is given priority to with hot and humid. We have preliminarily obtained the regularity of TCM syndrome, which provided the basis for the treatment and dignosis for the overweight and obesity Diabetic Nephropathy, and made a beneficial attempt for the standardization study of TCM syndrome.