| ObjectiveThis research is conducted based on the acquisition and analysis of clinical data of 847 cases of type 2 diabetes in perimenopausal women collected from structured inpatient medical records system to find out the rule of type 2 diabetes in perimen-opausal women and provide clinical practice for the diagnosis and treatment of perimenopausal women diabetes.Methods1.Ldata collection:In this research,a retrospective study was used to collect clinical data from Guang’anmen Hospital from 2009 to 2014 using a structured medical records collection system.Through the compilation of structured query language,women aged 45 to 60 years old who met the inclusion criteria were selected.There are 847 cases of diabetes.2,data processing:Export the data meeting the standard to an Excel spreadsheet,including patient basic information,chief complaint,engraved illness,past history,personal history,marriage and childbearing history,family history,tongue,veins,moss,physical examination,test,diagnosis of Chinese and Western medicine,prescription,Chinese medicine and other modules.Record the missing data and standardize the writing and expression of the missing data on the initial case history,inpatient history,and first rounds of ward records.3.data analysis:(1)Use Excel spreadsheets for general statistics of different groups of basic data,including smoking and drinking history,family history,physical and chemical indicators,carved encephalitis,concurrent/comorbidities,symptoms,traditional Chinese medicine,herbs,etc.,and objectively explore the evolution rules.(2)Conducted association studies by using Spss modeler18 software,based on association rules,on perimenopausal women with type 2 diabetes according to whether menopause and duration of disease,to find out whether menopause or illness/symptoms-symptoms,menopause or illness-herbal medicine,menopause or disease course-Concurrency/comorbidity-relationships between syndromes.(3)Study the relationship between syndrome-physical and chemical indicators of perimenopausal diabetes by using the regression-analysis method.(4)Analyse the commonly used prescriptions,symptoms,physical and chemical indicators by suing Bayesian network system,and explore the characteristics and evolution rules of major Chinese medicine syndromes.Results1.Among the 847 diabetic women with perimenopausal women,59.29%had a family history of diabetes.BMI analysis showed that overweight menopausal patients with type 2 diabetes accounted for 46.46%of the total sample,obese people accounted for 18.11%,a total of 64.57%.Blood glucose and glycated hemoglobin increase with the prolongation of the course of the disease,and the rate of abnormal blood glucose in postmenopausal patients is high.31.07%of men who had already had menopausal blood glucose were significantly elevated and overweight,and obesity was 13.3%;2.3%were non-menopause and overweight,and 6.43%were obese.30.43%were overweight in the course of<1 year,5.43%were obese,42.59%were overweight in>1 year and<5 years,16.67%were obese,39.80%were overweight for>5 years,and 17.63%were obese.With the arrival of menopause,the proportion of obesity and overweight has increased;with the development of the disease,the proportion of obesity is getting higher and higher.Fasting blood glucose in postmenopausal patients was significantly elevated and abnormal levels of sex hormones accounted for 45.21%.Obvious abnormalities accounted for 22.74%;abnormal menopause accounted for 13.04%,and abnormal abnormalities accounted for 5.80%.Fasting blood glucose was significantly higher in the course of illness ≤ 1 year and abnormal levels of sex hormones accounted for 43.64%,significantly abnormalities accounted for 16.36%;abnormalities>1 year and≤ 5 years accounted for 44.30%,and significant abnormalities accounted for 18.99%;abnormalities>5 years.13.50%,significantly abnormal 20.8%.With the stop of fasting blood glucose and the level of sex hormones,the proportion of postmenopausal patients is high.With the prolonged course of the disease,fasting blood glucose levels are significantly higher and the proportion of abnormally high levels of sex hormones is higher.The use of regression analysis of physical and chemical indicators-the relationship between evidence:Yin deficiency heat Sheng certificate and physical and chemical indicators have nothing to do;yin and yang deficiency and C peptide;qi and Yin deficiency and total cholesterol,triglycerides,high-density lipoprotein Low-density lipoprotein,fasting insulin.The complications of perimenopausal diabetes mellitus are mainly hypertension,heart disease,cerebrovascular disease,blood lipid disorders,peripheral neuropathy,and with the extension of the duration of perimenopausal diabetes and stop of women’s menstruation,the propotion of a variety of complications has gradually increased.Perimenopausal diabetic patients with osteoporosis,before and after menopause are mainly based on deficiency of both qi and Yin,and the main evidence for the folder folder and clip moisture;non-menopause patients with Yin deficiency heat Sheng also occupied a certain percentage.Perimenopausal diabetes mellitus with breast hyperplasia,obesity and uterine fibroids,before and after menopause are based on the two main symptoms of Qi arid Yin deficiency,and the main evidence for the folder folder and clip wet.Perimenopausal diabetes patients with urinary tract infections were predominantly guilty of both qi and yin deficiency before and after menopause.The syndrome was mainly due to pincers and clips.The proportion of yin-deficiency heat syndrome in non-menopause patients was also large.The folder folder is also hotter than the menopausal patients.In addition to the above characteristics,the postmenopausal patients also have a higher proportion of the folder folder.2.Perimenopausal diabetes is mainly characterized by fatigue,dry mouth or throat,and excessive drinking.In addition to the above symptoms,the proportion of symptoms such as numbness and blurred vision is relatively high.The distribution of tongue,moss,and pulse is relatively concentrated:Tongue distribution is mainly concentrated in dark red tongue,dark tongue,red tongue,dark tongue,dark,pale red tongue,purple dark tongue;moss elephant with thin white moss,thin yellow moss,The greasy moss and the yellow greasy moss are the main species;the pulse is mainly composed of fine veins,stringy veins,and stringy veins.Perimenopausal diabetes in different periods of TCM syndromes are:Patients with a course of ≤1 year showed significantly more than the course of disease>5 years,which was 22.22%and 9.31%respectively.The proportion of patients with yin and yang deficiency the course of>5 years was gradually increased.The main types of syndromes are deficiency of qi and yin,deficiency of yin deficiency,and deficiency of yin and yang.The main types of syndromes are mainly clips,clips,and clips.And always runs through the entire course of the disease.There is no significant difference between the syndromes of menopause and non-menopause patients and the syndromes.3.Peri-menopausal women with type 2 diabetes mellitus combined with diagnosis and treatmentThe followings are concluded by correlation analysis and Bayesian network.1)Patients with a course of<1 year,mainly Yin deficiency heat Sheng-based,this type of syndrome mainly includes drink more,heart palpitations,shortness of breath,insomnia,irritability,anorexia,frequent urination and more.Tongue images are mainly dark red and light dark tongues;moss images are mainly thin white,thin yellow,and greasy;pulse patterns are mainly fine,string slippery,and stringy veins.Physical and chemical indicators:elevated glycosylated hemoglobin,elevated fasting blood glucose,and abnormal or abnormal estrogen levels.The BMI index is abnormal,with the majority of overweight patients.Concurrency/complications mainly include:hypertension,peripheral neuropathy,blood lipid disorders,urinary tract infections.Single medicine are mainly jaundice,Anemarrhena,Peach kernel,Pueraria,Millettia,Atractylodes;commonly used traditional Chinese medicine combination of drugs are mainly Schisandra-Ophiopogon-Angelica-Poria.You can use Ziyinqingre for the law,with Da Chai Hu Tang,Zhi Bai Di Tang,Bai Hu Tang and other prescriptions combined with other prescriptions.2)Patients with a course>1 year and<5 years are mainly dominated by deficiency of both qi and yin.This type of syndrome mainly consists of multiple drinks,multiple foods,excessive sweating,dizziness,thirst,shortness of breath,frequent urination,nocturia,and neck.Back pain,difficulty falling asleep.Tongue images:dark red,dark,red tongue-based;moss elephant:thin white,thin yellow,greasy moss mainly;pulse like:fine,string-based.Physical and chemical indicators:elevated glycosylated hemoglobin,elevated fasting blood glucose,abnormal/abnormal estrogen levels,and decreased 25-hydroxy vitamin D3.The BMI index is abnormal,with the majority of overweight patients.Concurrent/comorbidities:Hypertension,peripheral neuropathy,dyslipidemia,heart disease,urinary tract infections.The monospicillaties are Radix et Rhizoma,Radix Angelicae Sinensis,Salvia miltiorrhiza,Fructus Corni,Radix Astragali,Rhizoma Chuanxiong,Radix Paeoniae Alba,Rhizoma Coptidis,Phellodendron amurense and Radix Astragali;the commonly used traditional Chinese medicine combination drugs mainly include Schisandra chinensis-Ophiopogon japonicus-Danggui-Taikosan,followed by Danpi-Hawthorn Meat-Habitat-Poria,Salvia miltiorrhiza-Schisandra-Ophiopogon japonicus-heterophylla,Alisma-Danpi-Hawthorn meat-habitat,Salvia miltiorrhiza-Schisandra-Ophiopogon japonicus-heterophylla,Schisandra-Ophiopogon-Angelica-Taizishen and so on.It can be used for qi and nourishing yin as a method,and it can be added or subtracted with ginseng glutinous rice soup and Shenqidihuangtang.3)Patients with a disease course>5 years are mainly dominated by yin and yang deficiency.This syndrome is mainly characterized by shortness of breath,fatigue,excessive drinking,dry mouth and throat,dizziness,tinnitus,palpitations,chest tightness,blurred vision,limb numbness,and lower extremity.Swollen,backache,poor sleep,etc.Tongue:dark red,mainly dark;moss like thin white,thin yellow-based;pulse like thin,string slippery,string-based.Physical and chemical indicators:elevated fasting blood glucose,elevated glycosylated hemoglobin,abnormal levels of sex hormones/obvious abnormalities,and most of the abnormal levels of sex hormones.Abnormal BMI index,mostly overweight patients.Concurrent/comorbidities:urinary tract infection,peripheral neuropathy,hypertension,dyslipidemia,etc.In the menopause group with a history of>5 years,the single-use herbal medicines are mainly wolfberry,Chinese angelica,Ophiopogon japonicus,rehmannia,schisandra,red peony and hawthorn.Common Chinese herbal medicines include Schisandra chinensis-Ophiopogon japonicus-Radix Paeoniae Alba-Poria,Schisandra-Ophiopogon japonicus-Angelica-heterophylla,Schisandra-habitat-Ophiopogon japonicus-Radix Paeoniae Radix Peel-Hawthorn meat-Poria,etc.>5 years without menopause group:single-use medicinal herbs are Baizhu,Atractylodes macrocephala,tangerine peel,citrus aurantium,Bupleurum,Zhuzhu;commonly used traditional Chinese medicine combined drugs are Taizishen-Pteris-raw Astragalus,raw Astragalus-habitat-Prince Senate,habitat-Rehmannia-heterophylla,raw Astragalus-Schisandra-heterophylla,Rhizoma Chuanxiong-Radix Paeoniae-alum,astragalus-habitat-loquat.Can be yin and yang double complement method,with Jin Qi Shen Qi Wan,Shen Qi Tong Jia combined with other prescriptions.4)Perimenopausal women with diabetes mellitus syndrome have more clips,clips,clips wet in addition to the above rules.Therefore,herbal medicines that promote blood circulation and dissolve dampness are added to the group.ConclusionAnalysis and research based on association rules and Bayesian networks suggest that:1.The risk factors related to the onset of type 2 diabetes in perimenopausal women include BMI index and family history of diabetes.2.Physical and chemical indicators were related to abnormal levels of sex hormones,elevated levels of glycated hemoglobin,elevated fasting blood glucose,and decreased 25-hydroxy vitamin D3.3.The research on perimenopausal diabetes on menopause or not/disease course-symptoms,menopause or illness/disease-herbal,noremally based on symptom-based confirmation,and side-by-side testing,suggested the evolution of TCM syndromes in type 2 diabetes in perimenopausal women:From Yin deficiency heat Sheng,Qi and Yin deficiency gradually evolved into yin and yang deficiency,the main and the folder certificate is for blood stasis,sputum,wet.4.According to the inductive research and syndrome analysis of symptoms,the treatment of type 2 diabetes in perimenopausal women is mainly based on nourishing yin,clearing away heat,supplementing qi and nourishing yin,replenishing yin and yang,promoting blood circulation,and eliminating dampness and phlegm.5.The commonly used prescriptions for type 2 diabetes in perimenopausal menopause include Qiqimai Diwei Decoction,Shenqi Dihuang Decoction,Zhibai Dihuang Decoction,Liuwei Dihuang Pills,Jinkui Shenqi Pills,and Shengmai Yinyu,etc.;Yin Qi Yin and blood circulation of Shengmai Sanhe drink,etc.;Shuganqiqi Dachaihu soup,etc.;dampness Yu Pu Xia Tang soup;hypoglycemic Baihu Tang.6.According to the association analysis of menopause or disease/herb-herbs and Bayesian network analysis,traditional Chinese medicines for the course of each type of diabetes in perimenopausal women include qi herbs,taiwan ginseng,and yam;Phlegm medicine:Angelica,Dan,Chuanxiong,safflower,red peony;nourishing yin:Ophiopogon japonicus,habitat,rehmannia;yin and yang fill the hawthorn meat;habitat,Danpi can also heat and cooling blood and so on. |
PDF Full Text Request