Study On The Influence Of The Multi Factor Analysis Of T2DM With OSAS In Patients With Respiratory Impairment And The Role Of Phlegm And Qi Deficiency Of TCM

Objective:1. To study the risk factors influencing the severity of type 2 diabetes mellitus(T2DM) in patients with obstructive sleep apnea syndrome(OSAS).2. To study the effect of phlegm and Qi deficiency on the degree of T2DM in patients with OSAS by using the syndrome element theory.Methods:This study selected patients with T2DM in 135 cases who visited the Hospital Department of Endocrinology from March 2015 to February 2016 and finally agreed to completion of the night of sleep monitoring. They were divided into groups based on AHI (Apnea Hypopnea Index):non OSAS group (AHI<5), mild OSAS group (5≤AHI<15), moderate OSAS group (15≤AHI≤30) and severe OSAS group (AHI>30). To collect all the demographic data of the patients, clinical indicators of Western medicine, and to analyze the distribution characteristics of the above indicators and their correlation with AHI by using the statistical software. TO collect the four diagnostic information which were provided by the university of TCM syndrome research base, and to count Syndrome differentiation of phlegm and Qi deficiency syndrome with TCM syndrome differentiation system software. Finally, the distribution characteristics of the four groups and their relationship with AHI were analyzed by statistical software.Results:1.There were 43 patients with no OSAS in 135 patients with T2DM and 92 patients of the final diagnosis of OSAS, accounting for 68.1% of them. There were mild OSAS 43 cases (46.7%), moderate OSAS 21 cases (22.8%) and severe OSAS 28 cases (30.4%) among them.2. Compare of the clinical data, phlegm and Qi deficiency syndrome elements scores of each group:Compared with no, mild, moderate OSAS groups, severe OSAS group in BMI, waist hip ratio, neck circumference, C peptide and phlegm syndrome element scores increased significantly, and HbAlc decreased significantly (P<0.05 or P<0.01).But there were no significant difference the above objectives in the other three groups (P>0.05). In moderate and severe OSAS group UA level was significantly higher than that of no or mild OSAS group (P<0.05 or P<0.01). There was no significant difference in the age, sex, duration of diabetes between the groups (P>0.05).3. Correlation analysis with AHI:After controlling for BMI, waist to hip ratio, neck circumference and other obesity factors,AHI was negatively correlated with HbAlc(r=-0.260, P<0.05), positively correlated with UA and phlegm syndrome element scores(r=0.219、0.190, P<0.05),and systolic blood pressure, diastolic blood pressure, TC, TG, C peptide, Qi deficiency prime integral relevance were not obvious (P> 0.05).4.Multiple linear regression analysis of AHI:BMI, HbAlc, UA, phlegm syndrome elements score are the important factors of AHI, linear regression equation y=-14.031+0.994*BMI-1.708*HbAlc+0.075*phlegm syndrome elements score+0.031*UA.Conclusion:1. Prevalence of OSAS in patients with type 2 diabetes in hospital was very high, it was up to 68.1% in the hospital, of which moderate and severe OSAS accounted for 53.3%.2. BMI, HbAlc and UA were the important factors that affect the degree of OSAS respiratory disturbance in patients with T2DM;wherein, UA, BMI were positively correlated, HbA1c negatively related to to the degree of respiratory obstruction, and the relationship between HbA1c and UA was independent of obesity.3. The higher phlegm syndrome elements scores, the more severe the T2DM combined with OSAS, and the effect is independent of obesity. Phlegm syndrome can be used as a risk factor for Chinese medicine to judge T2DM combined with OSAS.4. In the present study, no correlation was found between the deficiency of qi deficiency syndrome and the degree of T2DM combined with OSAS.