Study On The Traditional Chinese Medicine Syndrome Rule Of Type 2 Diabetic Nephropathy

ObjectiveThrough the analyses of data collected from type 2 diabetic nephropathy patients in a large comprehensive hospital of Chinese medicine,between January 2003 to December 2014,to discover the diagnosis and treatment rules of diabetic nephropathy,and contribute to the epidemiology,standardized clinical diagnosis of traditional Chinese and western medicine,and the promotion and development of TCM syndrome differentiation standardization.MethodsData from patients with diagnoses of type 2 diabetic nephropathy in Guangdong Province Traditional Chinese Medical Hospital between January 2003 and December 2014 were included in this study.Information included the year of hospitalization,age,gender,duration of hospitalization,times of hospitalization,department,admission conditions,mode of payment,total cost,accommodation fee,western medicine fee,Chinese medicine fee,radiation fees,laboratory fees,medical fees,inspection fees,the name of TCM diseases,the diagnosis of TCM,the main diagnosis of Western medicine,the minor disease diagnosis of Western medicine was used.Excel 2010 was used to build database,standardize terminology and data cleaning.Frequency analysis,t test,chi square test,correlation analysis,cluster analysis,single linear regression analysis,multiple linear regression analysis,data mining technology and multivariate statistical methods were used for patients' demographic information,hospitalization expenses,incidence characteristics,syndrome pattern,syndrome element rule and rules of combined diseases,using SPSS 17.0 and Excel 2010.Result1.Basic information.In total 3350 effective cases,1739 cases(51.91%)of male,and 1611 cases(48.09%)of female were included in the study.The oldest age of patients was 90,and the youngest was 21 years old,overall average age was 67±17.There were 2187 patients aged 50-75,accounting for 65.28% of the total number.2.Hospital expenses.2.1 The fee for medicine have the greatest contribution to the total cost of hospitalization,and the second is the fee for diagnosis and treatment,followed by the cost of laboratory and accommodation,the least was radiation fee,among all patients with type 2 diabetic nephropathy included in this study.The maximum hospitalization expense is 187074.44 yuan,the minimum is 1197.00 yuan,and the mean value is 13101.33 + 9819.34 yuan.In general,the hospitalization cost has not obvious change with the change of year.The cost of hospitalization is mainly produced in endocrinology,nephrology,surgery and cardiology.Single linear regression analysis and multiple linear regression analysis found that the duration of hospitalization,years of hospitalization,age and number of diseases had the statistical significant impact on hospitalization expenses.2.2 Patients with type 2 diabetic nephropathy showed an upward trend in total fee of medicine.Hospitalization medicine costs are mainly produced in endocrinology,nephrology,surgery and interventional therapy.Single linear regression analysis and multiple linear regression analysis found that duration of hospitalization,years of hospitalization and the number of time of hospitalization had the statistical significant impact on hospitalization medicine expenses.2.3 The cost of examination for patients with type 2 diabetic nephropathy is mainly in endocrinology,nephrology and cardiology.Single linear regression analysis and multiple linear regression analysis found that hospitalization year,age,duration of hospitalization and number of diagnosed diseases had a great impact on the cost of examination.3.TCM diagnosis of patients.The common syndromes of type 2 diabetic nephropathy are deficiency of qi and Yin and damp and heat stasis,deficiency of qi and Yin and blood stasis,deficiency of qi and Yin,deficiency of qi,deficiency of qi and Yin,deficiency of qi and Yin and dampness and turbid stasis.Most common syndrome element is qi deficiency,following by blood stasis,Yin deficiency,dampness,spleen,kidney,heat,phlegm,water stop,Yang deficiency.The most common form of syndrome element combinations are three syndrome elements,four syndrome elements and five syndrome elements.Qi deficiency,blood stasis,Yin deficiency and dampness contain the strongest relationship,within these,blood stasis is related to water stop,dampness,phlegm and heat,qi deficiency is related to Yin deficiency,heat and blood stasis.The syndrome elements of disease are mainly in the spleen and kidney,indicating that the common traditional Chinese medical pathological products of diabetic nephropathy are blood stasis,dampness,heat,phlegm and water stop,and theses syndrome elements are mainly related to spleen,kidney,stomach and liver.4.Diagnosis of western medicine.Common diabetic complications in type 2 diabetic nephropathy patients are neurological complications,and eye complications;Common non-diabetic complications are hypertension,hyperlipidaemia,cataract,renal failure,atherosclerosis,fatty liver,hyperuricemia.Conclusion1.The etiology and pathogenesis of type 2 diabetic nephropathy.The type 2 diabetic nephropathy is a disease of asthenia in origin with syndrome in superficiality,the asthenia in origin is mainly shown as qi deficiency and Yin deficiency,while the main syndrome of blood stasis,followed by wet,heat,phlegm and water stop.The syndrome is mainly in kidney,but also involved the spleen and stomach and liver.The deficiency of qi and Yin is the basic pathogenesis of type 2 diabetic nephropathy,and blood stasis is the primary syndrome of it.2.The pathogenesis of type 2 diabetic nephropathy.Patients with type 2 diabetic nephropathy mainly occur in middle and old age group(50-75),and mostly are male.The majority of diabetic nephropathy patients were in endocrinology(74.6%),followed by nephropathy(15.5%),which was related to nephropathy.3.Characteristics of health economics in hospitalization expenses of type 2 diabetic nephropathy.Shorten the duration of hospitalization,optimize the health care system,strengthen education,prevention and control of complication disease,can inhibit excessive examination,reduce the abuse of examination,reduce excessive drug use,reduce the gross cost of hospitalization to a certain extent,it can also optimize allocation of medical resources,improve the economic benefit.4.Type 2 diabetic nephropathy syndrome.Deficiency of qi and Yin and damp and heat stasis,followed by deficiency of qi and Yin and blood stasis,deficiency of qi and Yin,deficiency of qi,deficiency of qi and Yin,deficiency of qi and Yin and dampness and turbid stasis were the most common syndrome of Type 2 diabetic nephropathy,which indicated that qi and Yin deficiency is an important pathogenesis of diabetic nephropathy.Qi deficiency,blood stasis,Yin deficiency,dampness,heat,phlegm,water stop,Yang deficiency are the core elements of diabetic nephropathy syndrome elements,these syndrome elements mainly concentrated in the spleen and kidney.These shows that diabetic nephropathy is caused by congenital damage and acquired loss of nourishment.5.Type 2 diabetic nephropathy complicated by disease.Common diabetic complications in type 2 diabetic nephropathy patients are neurological complications,and eye complications;Common non-diabetic complications are hypertension,hyperlipidaemia,cataract,renal failure,atherosclerosis,fatty liver,hyperuricemia,most of which are related to lipid metabolism.