Syndrome Differentiation Of Six Channels In Type 2 Diabetes Mellitus Complicated With Anxiety And Depression And Correlation Analysis Of Quality Of Life

ObjectiveThe purpose of this paper is to explore the characteristics of six meridian syndromes of T2DM patients with anxiety and depression,summarize the distribution rules,and provide new ideas for the different,iation and treatment of traditional Chinese medicine.The prevalence of anxiety and depression in patients with type 2 diabetes mellitus was counted,and attention should be paid to their mental health status so that clinicians could attach more importance to the mental state of patients with type 2 diabetes mellitus and provide basis for the prevention and treatment of diabetes mellitus.Besides,To analyze the quality of life of patients·with type 2 diabetes mellitus and its related influencing factors,so as to provide theoretical basis for improving the quality of life of patients with type 2 diabetes mellitus.MethodsA cross-sectional survey was conducted to study type 2 diabetes patients admitted to the outpatient clinic of professor Saimei Li,a famous doctor from lingnan university of traditional Chinese medicine in guangzhou from March 2018 to February 2019.We collected the basic information(sex,age,marital status,educational level,professional type,economic condition,sleep duration,eating habits,exercise frequency,history of tobacco and alcohol),clinical data(family history and chronic complications,duration of diabetes,blood sugar monitoring,hypoglycemic events,treatment,BMI,waist hip ratio,four diagnostic data),biochemical indicators such as FBG,2hPG,HbAlc,FINS?Islet functiong?IR index,blood lipids,blood uric acid,and score them on the Self-Rating Anxiety,Self-Rating Depression Scale and diabetes Specific Quality of Life.According to the scores of anxiety and depression scale,the patients were divided into emotional disorder group(including simple anxiety,simple depression,anxiety and depression)andnormal group.Based on the theory of syndrome differentiation of Six Meridians,the patients with type 2 diabetes rnellitus complicated with anxiety and depression were divided into syndrome differentiation type,the probability of each syndrome type was counted,and the distribution pattern of the six channels was explored.Then,to compare the basie information,clinical data,biochemical indicators and quality of life(four dimensions)between patients with type 2 diabetes with mood disorder and normal mood group.By statistical method,the differences and correlations among general data,clinical biochemical indexes and quality of life of different mood disorders(simple anxiety,simple depression,anxiety and depression)were compared.In addition,the influencing factors of quality of life of patients with type 2 diabetes mellitus was analyzed.Results1.The prevalence of anxiety and depression in T2DM patients is high,and the co-morbidity of anxiety and depression is the highest,followed by simple depression and simple anxiety.2.T2DM had a large difference in the total score of quality of life,which was higher in the physiological and psychological dimensions.3.The six syndromes of T2DM combined with anxiety and depression were mainly yangming taiyin syndrome(34.3%)>shaoyang syndrome(20%)>shaoyang taiyin syndrome(12.4%).Single meridians were followed by shaoyang syndrome(20%)>jueyin syndrome(11.4%)>taiyang,yangming and shaoyin syndrome(3%each)>taiyin syndrome(1.9%).Among the two meridians,yangming taiyin syndrome(34.3%)>shaoyang taiyin syndrome(12.4%)>taiyang shaoyang syndrome(9.5%)>shaoyang jueyin syndrome(1%).There was only one case of three meridians,which was yangming shaoyang taiyin syndrome.4.Yangming taiyin syndrome was the most common syndrome of the six meridians in the groups of simple anxiety and simple depression.In anxiety and depression group,shaoyang syndrome and yangming taiyin syndrome were the most common syndrome types.5.Comparison of differences between the two groups:In terms of basic data,the T2DM group and the mood disorder group had differences in marital status,occupational type,educational level,economic status,smoking and alcohol history,and sleep duration.There were no differences in sex,age,diet habits and exercise frequency.About clinical data,there were differences in course of disease,complications,treatment methods,hypoglycemic events,BMI,waist-hip ratio between the two groups,and no differences in family history and self-monitoring.There were differences in 2hPG,FBG,HbAlc,islet function and serum uric acid between normal emotional group and emotional disorder group in T2DM,but no differences in FINS,IR index,TC,TG,HDL-C and LDL-C among physical and chemical indicators.There were statistical differences between the two groups in DSQL total score and four dimensions.6.Comparison of differences among the three groups:Anxiety,depression,anxiety and depression group had no differences in gender,marriage,occupation type,smoking and alcohol history,and diet habit,family history of DM and DM complications,blood sugar monitoring,age,economic and cultural level,sleep duratioin,exercise frequency,Course of the disease,hypoglycemic events,waist-to-hip ratio,BMI index,FBG,2hPG and FINS,IR index,islet function,HDL-C,TC,LDL-C,blood uric acid and Social relation dimension.There were statistical differences in treatment,HbAlc,TG,physiological dimension,and treatment dimension and the difference came from simple depression group and the anxiety-depression group.In terms of DSQL total score and psychological dimension,the differences came from simple anxiety group and simple depression group,simple depression group and the anxiety-depression group.7.There was a strong positive correlation between DSQL total score and SAS,moderate correlation and SDS,and weak correlation between DSQL total score and history of tobacco and alcohol,course of disease,complications,treatment,hypoglycemia events,waist-to-hip ratio,FBG,2hPG,HbAlc and TG.Meanwhile,there was a very weak positive correlation between DSQL and marital status,dietary habits,BMI and TC.The total score of DSQL had a weak negative correlation with economic status,sleep time and islet function,and a very weak negative correlation with education level.8.The optimal scale regression of the factors influencing DSQL indicated that SAS and SDS were the main factors influencing the total score of DSQL,followed by FBG,marital status,economic status,history of tobacco and alcohol,and sleep duration.ConclusionThere is a high prevalence in emotional disorders in type 2 diabetes mellitus,mainly anxiety and depression comorbidity and simple depression.Therefore,early screening for anxiety and depression can be carried out,and psychological counseling or drug treatment can be given according to patients' conditions in order to improve the quality of life of patients.The secondary factors for the quality of life of T2DM are FBG,marital status,economic status,smoking and alcohol history,and sleep duration.In the clinical diagnosis and treatment,we need to pay attention to other factors at the same time,so as to provide theoretical basis for the comprehensive management of diabetes and the improvement of the quality of life of diabetic patients.In terms of traditional Chinese medicine,type 2 diabetes mellitus complicated with mood disorder is mainly characterized by the syndrome differentiation of six meridians with two diseases,which can be started from yangming taiyin syndrome and shaoyang taiyin syndrome,while the diseases of single meridians can be differentiated from shaoyang and jueyin syndrome.In addition,there is no clear conclusion about the relationship between diabetes mellitus and anxiety and depression in the current studies on diabetic mood disorder at home and abroad,and further research is needed.