| Objective By observing the correlation of TCM constitution distribution characteristics and blood glucose,blood lipid,related blood test indexes and risk factors(sex,age,living habit,BMI,etc.)of patients with hypertension and type 2 diabetes mellitus(T2DM)with constitutional type,the research project aimed to discuss the effects of TCM constitution distribution characteristics and cardiovascular risk factors of patients with hypertension and T2 DM on their constitutional types,provide a new thought for the intervention of this disease from the perspective of constitution,improve the level of TCM clinical diagnosis and treatment.Methods Patients were collected from the inpatient department and physical examination center of the First Affiliated Hospital of Henan University of Chinese Medicine.170 patients with hypertension and T2 DM were divided into observation group,while 150 healthy subjects were used as controls.The constitutional types of all patients were identified according to TCM Constitution Classification and Decision Table of China Association of Chinese Medicine Standards 2009.Also,we collect relevant clinical data,including general data such as age,sex,profession,previous history,smoking history,drinking history,food preference and hypertensive diabetes,as well as height,weight,blood pressure,fasting plasm glucose(FPG),serum cholesterol,triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),hypersensitive C-reactive protein(Hs CRP),homocysteine(HCY)and other physical and chemical examination indexes.The relationships between the above-mentioned indexes and various constitutional types were analyzed in overall and by group comparison.Results 1 A total of 170 cases(82 males and 88 females;mean age: 64.72±11.16 years old)were included into the case group,while a total of 150 cases(58 males and 92 females)were included into the normal control group;there were no statistically significant differences in sex,age,personal smoking history,personal drinking history and profession distributions between these two groups(P>0.05).Most of subjects in the control group preferred to bland diet,accounting for 66.7% of the control group.Most of patients with hypertension preferred to fat,greasy and spicy food,accounting for 61.8% of the control group.There were statistically significant differences in culinary preference between these two groups(P<0.05).2 Phlegm dampness,yin deficiency,blood stasis and dampness-heat were common TCM constitutions in the case group,accounting for 79.9% of the control group.Most of TCM constitutions in the control group were abnormal constitutions,while normal constitution only accounted for 2.4%.The proportion of normal constitution in the normal group was the highest,accounting for 20.7%.As shown in chi-square test,there were statistically significant differences in the distributions of normal constitution and abnormal constitutions between the two groups(P<0.05).3 Multivariate logistic regression analysis of the TCM constitutions of patients with hypertension and T2 DM showed that dampness-heat(OR=1.727,95%CI: 1.490-2.012),blood stasis(OR=1.078,95%CI: 1.010-1.149),yin deficiency(OR=1.045,95%CI: 1.015-1.075),phlegm dampness(OR=1.032,95%CI: 1.005-1.061)and normal constitution(OR=0.211,95%CI: 0.064-0.699)were constitution factors affecting the occurrence of primary hypertension and T2 DM.In conclusion,dampness-heat,blood stasis,yin deficiency and phlegm dampness were the major risk factors for the occurrence of primary hypertension and T2 DM,while normal constitution was the major protective factor for primary hypertension and T2 DM.4 There were differences between males and females in terms of factors affecting the TCM constitutions of patients with hypertension and T2 DM.The major constitution influencing factors of male patients with hypertension and T2 DM were dampness-heat(OR=7.408,95%CI: 1.742-13.935),phlegm dampness(OR=3.519,95%CI:1.465-8.453),yin deficiency(OR=1.500,95%CI:1.063-2.117)and normal constitution(OR=0.150,95%CI : 0.040-0.560).The major constitution influencing factors of male patients with hypertension and T2 DM were phlegm-dampness(OR=3.878,95%CI: 1.734-8.672),yin deficiency(OR=1.187,95%CI: 1.056-1.333),dampness-heat(OR=1.052,95%CI: 1.013-1.092),blood stasis(OR=1.051,95%CI : 1.013-1.090)and normal constitution(OR=0.201,95%CI: 0.051-0.794).5 The BMI,HCY,Hs CRP,CHOL,TG,HDL,LDL and FPG of the main five constitutional types(yin deficiency,normal constitution,phlegm-dampness,dampness-heat and blood stasis)were compared.The results showed the BMI of phlegm-dampness was the highest,and that of blood stasis was the lowest,there were statistically significant differences in BMI between the five constitutions(P<0.05).The BMI levels of normal constitution,dampness-heat and yin deficiency were compared,showing statistically significant differences(P<0.05);the HCY levels of the five constitutions were compared,showing statistically significant differences(P<0.05).The mean HCY level of the five constitutions was higher than the normal level,with the highest HCY level observed in yin deficiency and the lowest HCY level observed in normal constitution and dampness-heat.The HCY level of normal constitution,yin deficiency,dampness-heat were compared,showing statistically significant differences(P<0.05).There were statistically significant differences in Hs CRP level between the five constitutional types(P<0.05),and the Hs CRP level of yin deficiency was much higher than those of the other constitutional types.The Hs CRP level of normal constitution,yin deficiency,dampness-heat and blood stasis were compared,showing statistically significant differences(P<0.05).Among the common five constitutional types of patients with hypertension and T2 DM,the mean TC level of dampness-heat was higher than the normal level and its serum TC level was the highest,while the TC level of yin deficiency was the lowest,showing statistically significant differences(P<0.05).The TC level of normal constitution patients was compared with phlegm-dampness and dampness-heat,showing statistically significant differences(P<0.05).The TG level of yin deficiency was the highest and that of dampness-heat was the lowest,but there were no statistically significant differences between different groups(P=0.142> 0.05).The HDL-C level of phlegm-dampness was the lowest and those of yin deficiency and normal constitution were the highest,and there were statistically significant differences between different groups(P<0.05).The HDL-C levels of phlegm-dampness,dampness-heat and were compared with that of normal constitution,showing statistically significant differences(P<0.05).The LDL-C level of phlegm-dampness was the highest,and there were statistically significant differences(P<0.05).The LDL-C levels of phlegm-dampness and normal constitution were compared,showing statistically significant differences(P<0.05).The FPG levels of the five common constitutional types were compared.The results showed statistically significant differences between different groups(P<0.05).The FPG level of blood stasis was the highest,the FPG level of yin deficiency,phlegm-dampness,blood stasis and normal constitution were compared,showing statistically significant differences(P<0.05).Conclusion 1 There is correlation between culinary preference and hypertension and T2 DM.Food preference for fat,grease and spicy food is risk factor.2 There is correlation between TCM constitutions and hypertension and T2 DM.Dampness-heat,blood stasis,yin deficiency and phlegm-dampness are the risk constitution factors for hypertension and T2 DM and normal constitution was the protective constitution factor for hypertension and T2 DM.3 The risk constitution factors of male patients with hypertension and T2 DM were dampness-heat,blood stasis and yin deficiency,while those of female patients with hypertension and T2 DM were phlegm-dampness,yin deficiency,dampness-heat and blood stasis.4 Among patients with hypertension and T2 DM,the phlegm-dampness population had the highest BMI.5 Among patients with hypertension and T2 DM,the yin deficiency population had the highest HCY and Hs CRP levels.6 Among patients with hypertension and T2 DM,the dampness-heat population had the highest TC level,the phlegm-dampness population had the highest HDL-C level and the lowest LDC-C level,and dampness-heat and phlegm-dampness are associated with abnormal blood lipid metabolism.7 Among patients with hypertension and T2 DM,the blood stasis population had the highest FPG level. |
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