The Discussion On The Characteristics Of TCM Diagnosis And Treatment Of Type 2 Diabetes Mellitus Complicated With Hyperuricemia Based On Structured TCM Hospitalization Data

Objective:To explore the characteristics of TCM diagnosis and treatment of type 2 diabetes mellitus with hyperuricemia based on the clinical data of "diabetes structured TCM medical record collection system".Method:1Data acquisition:Based on the "diabetes structured TCM inpatient record collection system",we collected 410 cases of diabetes combined with hyperuricemia disease,built data warehouse through data storage and processing.Screening by writing SQL statements,summarizing the inpatient records which meet the inclusion criteria and dividing it into 11 data tables to summarize,fill out the missing data based on paper medical records,and check the samples with random samples.2 Data quality control:In the process of sorting out the data information,it is arranged by the special person through the unified standard and standard terminology.Make sure the information is comprehensive,true,objective and accurate.3Data processing:the data is normalized by man-machine combination.The principle of data preprocessing is the symptoms and disease names of traditional Chinese medicine and Western medicine are generally regulated or replaced according to the current national standards and industry standards.Under special circumstances,the experts consensus or suggestion is adopted to standardize or replace without causing ambiguity.4Data mining analysis:(1)descriptive statistics using SPSS21.0 statistical analysis software for general data,qualitative data using frequency and proportion expression,combined statistical indicators using variable number of cross classification table.(2)Concluding the rule of diabetes and hyperuricemia syndrome from the common symptoms of the cases.Confirming the syndrome of diabetes mellitus by computer discriminant analysis and verifying the objectivity.(3)Study the frequency of the commonly used drugs in each period,research the compatibility of the commonly used single flavored drugs and the medicine,three flavors and four flavors,and the common clinical compound.Using the association rules in the Clementine data mining platform to study the law of traditional Chinese medicine.(4)Calculate the frequency of the symptoms of each period.Study the relationship between syndrome and physical、chemical indicators and symptoms by combining the common prescriptions and physical and chemical indexes.Summarize the characteristics of TCM diagnosis and treatment of type 2 diabetes mellitus with hyperuricemia.Results:1related factors of diseaseMiddle age is the most frequent age of the disease,and the male ratio is significantly higher.The incidence of obesity is 64.49%.With high blood pressure,the proportion of diabetic peripheral neuropathy is higher.The ratio of glycosylated hemoglobin and hypertriglyceridemia is close to 80%in physical and chemical indexes,and more than 50%of the patients accompanied with other abnormal lipid metabolism.This shows that age,sex,BMI,hypertension,family history of diabetes,high blood sugar and high blood lipid are all the risk factors affecting the incidence of hyperuricemia in type 2 diabetes,and the incidence of diabetic peripheral neuropathy is closely related to the disease.2 Joint analysis of multiple indicators2.1 General situation comparison:In the early course of disease,hyperlipidemia and hypertension are all the highest,coronary heart disease,cerebral infarction,renal insufficiency,diabetic peripheral neuropathy,diabetic retinopathy and diabetic nephropathy are the highest in the late course of disease,indicating that the early basic pathological changes of type 2 diabetes combined hyperuricemia is prominent,with the development of the course of disease,the complications of large vessels and microvessels appeared gradually.2.2tongue and pulse condition:The tongue coating is mainly with red tongue,dark red tongue and light dark tongue.Moss elephants are thin yellow fur,white greasy fur and Bo Baitai.The pulse is based on the slippery veins,the fine veins and the veins.Early pulse of tongue coating indicates obvious heat,accompanied by dampness syndrome and fever.In the middle of the disease,the tongue is the pulse,the tongue is light and dark,the pulse is thin,and the Qi deficiency and stasis syndrome appear,and the late tongue vein syndrome shows Qi deficiency,Yang deficiency and stasis syndrome,and the phlegm and syndrome are more obvious.2.3 Chinese medicine and prescription:The number of effective people is 3727,the total of drugs is 253.The early use of traditional Chinese medicine in type 2 diabetes with hyperuricemia is Scutellaria,Cypress,Bupleurum,Atractylodes,Tuckahoe,Mushroom,Silkworm and so on.The early traditional Chinese medicine is mainly to clear the heat and the dampness.Medium term medication is Poria,Salvia miltiorrhiza,fried Atractylodes macrocephala,tangerine peel,Radix heterophylla,Radix Astragali and so on.Late use of Radix rehmanniae,Fructus Corni,Yam,Codonopsis pilosula,Poria,Salvia miltiorrhiza and Earthworm increased proportionally.According to the law of the square,the total number of effective persons is 740,and 65 altogether.Early Da Chaihu Decoction,Four Miao pills and Zhi Bai Dihuang Decoction used more,clearing heat and dampness,clearing liver stomach stagnation heat.Commonly used prescriptions include supplementing Qi and nourishing Yin,activating blood circulation to dissipate blood stasis,reducing infiltration and dampness,and supplementing Qi and warming Yang.3 Based on regression analysis,the relationship between syndrome and index shows that Yin deficiency heat syndrome is related to high density lipoprotein and glycosylated hemoglobin.Liver stomach stagnation syndrome is related to triglyceride and glycosylated hemoglobin.Qi Yin deficiency and blood stasis syndrome are related to high density lipoprotein and serum creatinine.The spleen deficiency stomach heat syndrome is related to triglyceride.Yin deficiency and blood stasis syndrome are related to total cholesterol and low density lipoprotein.4 Through data mining and human-machine interaction,the characteristics of TCM diagnosis and treatment of type 2 diabetes mellitus combined with hyperuricemia are summarized as follows:4.1 In the early stages of Type 2 diabetes combined with hyperuricaemia:If there is a lot of thirst and thirst,much food is easy to eat,the stool is dry,the tongue is red and dry,the moss is yellow,the pulse number or the string is fine or fine,the blood uric acid is obviously high with the increase of glycated hemoglobin,the triglyceride is elevated,and it is Yin deficiency heat,which can be given to the decoction of Rehmannia glutinosa,Four Miao pills and White Tiger decoction.At the same time,if accompanied by dry mouth,stomachs,abdominal distention,irritability,blurred vision,red tongue,yellow or yellow moss,pulse chords or chords,increased triglyceride,total cholesterol,glycosylated hemoglobin,the liver and stomach heat syndrome,can be given the Da Chaihu Decoction.If there is an obvious weakness,blurred visual substance,dizziness,chest tightness,numbness of limbs,insomnia,dark red tongue,thin white tongue,thin vein,high diastolic pressure,high triglyceride,a manifestation of Qi and Yin deficiency and blood stasis,can be given to Xiaoke drink,Shenqi Dihuang soup,and Tao Hongsiwu soup.The course of the disease is Scutellaria,Cypress,Bupleurum,Tuckahoe,Atractylodes,Arrowhead and Anemarrhena,Detoxification and Detoxification.The main medicine is Bupleurum chinensis + Scutellaria baicalensis,Atractylodes + Yellow cypress,Tuckahoe +Mountain mushroom,Tuckahoe + Silkworm sand and so on.The three or four flavors are Qing Dynasty +Fructus aurantii Immaturus + Scutellaria,Atractylodes + Yellow cypress + Tuckahoe + Mountain mushroom and so on.4.2Type 2 diabetes combined with hyperuricemia in the middle of hyperuricemia:If you are accompanied by dizziness,chest tightness,insomnia,numbness,pain in the limbs,frequency of urination,dark red tongue,thin white tongue,thin vein,high triglyceride,low density lipoprotein and deficiency of Qi and Yin,it can be given to Xiaoke,Shenqi ground yellow soup,and Tao Hongsiwu soup.If there is a dry mouth,five heart trouble,night sweat,dizziness,chest tightness,numbness of limbs,poor sleep,dry stool,dark red tongue,little moss,fine vein chords,high total cholesterol and low density lipoprotein,it is a syndrome of yin deficiency and blood stasis,which can be given with Xiaoke Yin,Shenqi Dihuang soup and peach red four material soup.If there is a dry mouth and not drink,the heart is full of stuffy,nausea,stool dry and heavy,can be accompanied by dizziness,sputum,numbness of limbs,sleep poor,tongue light fat or dark red,moss white or white greasy,pulse or chord slippery,with triglyceride increase,urine microalbumin rising,spleen deficiency stomach heat syndrome,may give the spleen deficiency stomach heat syndrome,can give the Banxia diarrhea.The heart soup is added and reduced.The main medium-term disease course was Ophiopogon japonicus,radix salviae miltiorrhizae,Radix Ophiopogon and tangerine peel.The drug was mainly Radix Ophiopogon plus Astragalus membranaceus,Radix Astragalus and Radix Astragali,Radix Paeoniae Alba and Ophiopogon japonicus.The three or four drugs are mainly Astragalus membranaceus+ Radix Salviae Miltiorrhizae + Ophiopogon japonicus,citrus peony + Radix Paeoniae miltiorrhiza + Poria cocos.4.3 Type 2 diabetes combined with hyperuricaemia in the later period:If it is weak,palpitation,palpitation,chest tightness,numbness,pain,cold and loose stool,dark red tongue,dark or dark,moss white,vein fine chord,fine slippery,accompanied by low density lipoprotein and kidney pellet rate filtration decline to Qi deficiency and blood stasis syndrome,Give Yang Yang five soup,Xiaoke drink,Tao Hongsiwu soup addition and subtraction.If the symptoms such as chest tightness,chest pain,numbness of limbs,pain,hair cool,dry or loose stool and so on,the tongue is dark red,dim or dark,white and greasy,fine veins,thin and slippery,accompanied by elevated glycated hemoglobin,elevated blood creatinine and a stagnation of phlegm with two deficiency of Qi and Yin,and the addition and subtraction of Xiaoke Yin,Tao Hongsiwu soup and Er Chen soup.If there is dry mouth and dry throat,chest tightness,waist and knee soft,body hair cool,limbs swollen,night urine frequency,palpitation,loose stool,thin tongue,fat body,pulse sinking,with urine microalbumin high and blood creatinine two deficiency syndrome,can be given to the Golden Chamber kidney qi pill and six flavored Rehmannia glutinous soup.The drug used to produce Astragalus,Ophiopogon,peach kernel,roasted Atractylodes,Radix Astragalus,Codonopsis,and Radix Astragali and tuckahoe,and Astragalus membranaceus +Tuckahoe,and Radix Astragali + Radix Astragalus + Yam,Radix Astragalus,Astragalus membranaceus +Tuckahoe + Danshen and Salvia miltiorrhiza,are the main three or four drugs.5 Conclusion5.1 Related factors:Age,Sex,BMI,combined hypertension,family history of diabetes,high blood sugar and high blood lipid are all the risk factors for the incidence of hyperuricemia in type 2 diabetes.The pathogenesis of diabetic peripheral neuropathy is closely related to this disease.5.2The symptom of 2 diabetes with hyperuricemia are dry mouth,multiple drinks,fatigue,abdominal distention,frequent urination,dizziness,poor sleep,numbness of limbs and pain in the limbs.The main tongue is red,dark red and dark.The moss are mainly thin yellow moss and white and greasy moss.The pulse is based on the slippery vein,the fine slippery and the pulse sink.5.3The main syndromes 2 diabetes mellitus and hyperuricemia is Yin deficiency heat syndrome,liver and stomach heat,Qi and Yin deficiency and blood stasis.The early physical and chemical indexes are mainly accompanied by glycosylated hemoglobin,abnormal metabolism of blood lipid and diastolic pressure,while the middle physical and chemical indexes are in the middle of the middle period.At the same time,dyslipidemia and elevated urinary albumin are the main disorder.Later,Qi deficiency and blood stasis,Qi and yin deficiency and phlegm clip stasis,yin and yang two deficiency are the main factors.The physical and chemical indexes are accompanied by abnormal lipid metabolism,high urinary albumin and elevated serum creatinine.5.4The main treatment of type 2 diabetes with hyperuricemia is to remove heat,nourishing yin and reducing fire,nourishing qi and nourishing Yin,activating blood and removing stasis.The main drugs are Scutellaria baicalensis,Cypress,Tuckahoe,Mushroom,Silkworm,Atractylodes,Peach kernel,Salvia miltiorrhiza,Radix Ginseng,Orange peel,astragalus,Codonopsis pilosula.The selected prescription mainly are Xiaoke Yin,Shenqi Dihuang Decoction,Da Chaihu Decoction,Four Miao pills,Zhi Bai Dihuang soup,Tao Hongsiwu soup,Banxia Xiexin soup and the Golden Chamber kidney qi pill.