The Characteristics Of Common Syndromes And Abdominal Syndrome In Type 2 Diabetes And Their Correlation Studies

Background:Type 2 diabetes is a chronic metabolic disease characterized by elevated blood glucose levels,which belongs to "wasting-thirst" in traditional Chinese medicine.With the acceleration of urbanization and the increasing of the elderly people in China,the prevalence of diabetes in China has increased significantly in recent years.Diabetes mellitus has become a frequent disease that endangers the health of our people and a heavy economic burden on countries,families and individuals.Chinese medicine is one of the effective means of preventing and treating diabetes.However,different doctors have different understandings of the pathogenesis of diabetes.Observing the characteristics of diabetes syndromes and pathogenesis has clinical significance in guiding clinical drug use.The "abdominal examination" is one of the diagnostic methods of traditional Chinese medicine,which can diagnose diseases,identify disease locations and pathogenesis,guide the use of drugs,observe the curative effect and prognosis.At the same time it can supplement other diagnosis methods.My tutor inherited the classics,and attach importance to the use of abdominal examination.And there are many descriptions of the characteristics of the abdominal syndromes with many diseases including "wasting-thirst" in Japanese books.Objective:By consulting relevant literature,the aim is to investigate the understanding of the causes and pathogenesis of diabetes in ancient and modern physicians,the theoretical origin and methods of "abdominal examination",and their clinical significance.And clinical studies on the correlation between diabetes and "abdominal syndromes" are conducted to study the characteristics of syndromes of diabetes and related abdominal syndromes,as well as their characteristics and regularities.According to the whole research,we hope to help diabetic patients to improve their blood glucose status and living conditions and delay the development of diabetic complications.At the same time,we expect to regain the attention of"abdominal examination" in clinical practice.Methods:Using the "Observation Form of Type 2 Diabetes TCM Syndrome elements" and the "Observation Form of Type 2 Diabetes abdominal Syndromes" to investigate and evaluate the TCM syndromes and abdominal Syndromes in patients with type 2 diabetes.And the study of the characteristics of the TCM syndromes and abdominal syndromes,as well as the correlation between them,was analyzed by statistical software named SPSS 20.0.Results:The study includes 85 cases with type 2 diabetes.? Men account for 55.3%,while women account for 44.7%.? Patients under 45 account for 5.9%,patients between 45 to 59 accounted for 37.6%,patients between 60 to 74 account for 40.0%,patients between 75 to 89 accounted for 16.5%,most of the diabetes patients were concentrated in the middle-aged and elderly people.? The average duration of the disease was 14.12 years.Nearly 70%of the patients had a course of more than 10 years,and nearly 90%of them were more than 5 years.Combined with the age of the patients,most of the patients were estimated to fall into the disease at their middle or old age.? The average BMI is 26.0.Overweight and obese patients account for the majority of diabetic patients.? The incidence rate of diabetic peripheral neuropathy is 84.5%,the diabetic retinopathy is 56.5%,and the diabetic nephropathy is the lowest.Diabetes is associated with hypertension,hyperlipidemia,and fatty liver.? The frequency of the occurrence of the common syndrome elements of diabetes in decreasing order:yin deficiency,qi deficiency,phlegm-dampness,blood stasis,yang deficiency,damp heat,heat,blood deficiency,qi stagnation,stagnated heat,and upper hyperactivity of liver yang.The integral arithmetic average value of each syndrome element in decreasing order:damp heat,upper hyperactivity of liver yang,heat,stagnated heat,phlegm-dampness,qi stagnation,yin deficiency,yang deficiency,qi deficiency,blood deficiency and blood stasis.? The probable trend of the frequency of the syndrome elements changing with the course of disease:Yin deficiency,qi deficiency and blood deficiency are more stable,and the former two are always at a relatively high level.The frequency of most excess syndromes are generally lower than most deficiency syndromes.Yang deficiency and the excess syndromes except blood stasis increase with the duration of the disease.However,in patients with a course of disease exceeding 20 years,the incidence of damp-heat,qi stagnation,and upper hyperactivity of liver yang decreased.The incidence of blood stasis is basically on the rise,and has been at a relatively high level.The rate of heat increases first and then decreases with the increasing of the disease duration.? The frequency of common abdominal syndromes in patients with diabetes mellitus in descending order:epigastric oppression,fullness and discomfort in chest and hypochondrium,middle core,and spasm of rectus abdominis.The frequency of abdominal tenderness in descending order:left lower abdomen,left side of umbilical,right lower abdomen,right side of umbilical,supra-umbilical,lower abdomen,subumbilical,left lower hypochondrium,and right lower hypochondrium.The order of the integral arithmetic average value of each abdominal tenderness is nearly the same as the frequency of common abdominal syndromes,except that the order of lower abdomen and subumbilical is reversed.? The relationship between syndrome elements of diabetes mellitus and abdominal tenderness is complicated:Tenderness in the left lower hypochondrium is more related to the symptoms of stagnated heat,phlegm-dampness,qi stagnation,blood stasis,and yang deficiency;Tenderness in the right lower hypochondrium is more related to the Symptoms of stagnated heat,phlegm-dampness,qi stagnation,yin deficiency and yang deficiency;supra-umbilical tenderness is mostly related to stagnated heat and phlegm-dampness;Subumbilical tenderness is only related to stagnated heat;The tenderness of left side of umbilical is mostly associated with yang deficiency,damp heat,qi deficiency and qi stagnation;The tenderness of right side of umbilical is mostly associated with damp heat,qi stagnation,stagnated heat,qi deficiency,yang deficiency,upper hyperactivity of liver yang and phlegm-dampness;There is a correlation between left lower abdominal tenderness and blood deficiency,yang deficiency,phlegm-dampness,stagnated heat,blood stasis,damp heat,qi stagnation;Lower abdominal tenderness and stagnated heat,upper hyperactivity of liver yang are related;Right lower abdominal tenderness is more associated with phlegm-dampness and blood deficiency.Conclusion:Yin deficiency and qi deficiency are the most common syndromes in type 2 diabetes,but their symptoms are relatively more mild and hidden than the excess syndromes.With the increasing of the disease duration,the excess syndromes decreases gradually and the deficiency syndromes gradually increases,but the phlegm-dampness and stagnated heat are on the rise,we thought it may be related to the deficiency of spleen and kidney and the pathological product stagnation.Blood stasis is common in diabetes,and it increases with the increase of the duration of the disease.It indicates that the diagnosis of blood stasis syndrome should be more comprehensive in clinical practice.It also point out that we should pay more attention to the blood stasis syndrome.The common abdominal syndromes in patients with type 2 diabetes mellitus are epigastric oppression,fullness and discomfort in chest and hypochondrium,middle core,and spasm of rectus abdominis,which reflect the common pathogenesis,such as phlegm-dampness,stagnated heat,qi stagnation,yin deficiency,qi deficiency and so on.There are complicated relationship between syndrome elements of diabetes mellitus and abdominal tenderness,which may reflect a variety of different pathogenesis features in each part of the abdomen.However,due to the fact that this study didn't have enough cases to count the nature of tenderness and pain,and accompanying symptoms,there are still deficiencies which need further researchs.So we cannot yet reach definitive conclusions.