The TCM Symptoms Research On Type 2 Diabetes Mellitus With Dyslipidemia

ObjectiveIn recent years, the incidence of diabetes is growing, and patients with dyslipidemia which is the majority. With the increasing incidence of diabetes, it only relys on the reasonable diagnosis and treatment of type 2 diabetes mellitus with dyslipidemia, to prevent or manage the cardiovascular complications effectively, and reduce the mortality of diabetic patients. As the standpoint of "first distinguishes the Yin and Yang, and then distinguishes the six meridians", the research has demonstrated type 2 diabetes mellitus with dyslipidemia of TCM symptoms characteristics. By comparision test between different symptoms of blood glucose, serum lipid, we can analyze and summarize the etiology and pathogenesis of type 2 diabetes mellitus with dyslipidemia, as well as provide the basis for clinical diagnosis and treatment.MethodsThe research divided into two parts, literature research and clinical research. First of all, from the point of traditional Chinese medicine, the literature research summarizes the etiology and pathogenesis of diabetic dyslipidemia, treatment based on symptoms differentiation. Then from the modern medicine of view, it sums up the epidemiological characteristics of type 2 diabetes mellitus with dyslipidemia, as well as the latest situation of pathogenesis and the modern medicine treatment. On the other hand, the clinical research has collected 170 cases of patients with type 2 diabetes mellitus with dyslipidemia, who had a hospitalization since September 2014 to December 2014 at the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine endocrinology. According with the inclusion criteria and the six-meridian syndrome differentiation in Treatise on Exogenous Febrile Diseases, we have divided the patients into five groups. Then we have recorded the general information in different TCM symptoms, such as age, duration, BMI, blood glucose, lipids and other clinical data ect. By SPSS21.0 software, we have analysed the clinical data and compare the differences between the index and correlation among different symptoms.ResultsAccording six-meridian symptoms differentiation, statistics has revealed that the Shaoyin accounts for 40%, while the Shaoyang accounts for 36.5%. The simultaneous occurrence of cold and heat accounts for 8.8%. The Taiyin accounts for 6.5% while the others accounts for 8,2%.On general aspects, there is no significant difference in duration and BMI (P>0.05). The average age of all patients is 50.77±10.12 years old. Among them, the Shaoyang are much younger than the Shaoyin (P<0.05). In glycemic indicators, there is no significant difference in glycosylated hemoglobin, fasting blood glucose, fasting insulin, fasting C-peptide (P>0.05). The patients in different symptoms with no obvious difference in postprandial glucose, but compared with the Shaoyin and the simultaneous occurrence of cold and heat, the P value is relatively closing to significant level of 0.05.In blood lipid indicators, there is no significant difference in TC, HDL-C, apoAl (P>0.05). In all patients with elevated TG, the largest proportion is the Shaoyang symptom group (41.18%).The average TG level of Shaoyang is much higher than the Shaoyin (P<0.05). In all patients with elevated LDL-C, the largest proportion is the Shaoyin symptoms group (52.24%).Both in LDL-C and apoB average level, the Shaoyin is higher than Shaoyang and Taiyin (P <0.05). The Taiyin’s apoB level is lower than the others (P<0.05).Among the all patients, the average level of HDL-C is 0.81±0.21mmol/L. The average level of apoAl is 1.08±0.81mmol/L. Both them are significantly lower than normal.ConclusionFrom the "first distinguishes the Yin and Yang, and then distinguishes the six meridians" perspective, yang deficiency was the basis pathogenesis of type 2 diabetes mellitus with dyslipidemia. The proportion of TCM symptoms is that:Shaoyin>Shaoyang>The simultaneous occurrence of cold and heat> Taiyin.There is no significant difference in duration and BMI, and Shaoyang is on the low level in age compared with Shaoyin. In glycemic indicators, there is no significant difference in glycosylated hemoglobin, fasting blood glucose. In terms of postprandial glucose, the average level of Shaoyang is higher than Shaoyin and the simultaneous occurrence of cold and heat, which one with the P value is relatively closing to 0.05.The research shows that the serum lipid levels of patents who suffered type 2 diabetes mellitus with dyslipidemia is accordant to the typical lipid spectrum change:elevated in TG, reduced in HDL-C, elevated or normal in LDL-C. Group of Shaoyang is higher than Shaoyin in TG, while Shaoyin is higher than Shaoyang and Taiyin in LDL-C and apoB. Taiyin has the most lower level in apoB than the other groups. There is no significant difference in TC, HDL-C and apoAl.It can be predicated that the characteristics of blood glucose and lipid, the patients who have diagnosed as type 2 diabetes mellitus with dyslipidemia, is related to insulin resistance of the different periods of type 2 diabetes. Be affected by insulin levels, the lipase activity had an impact on the lipid metabolism. From the "first distinguishes the Yin and Yang, and then distinguishes the six meridians" perspective, yang deficiency, as the basis pathogenesis, leading to dysfunction of the Pivot. As a result, the different symptoms has different lipid spectrum characteristics.