Correlation Between Gastrointestinal Adverse Reactions And TCM Syndromes Of Liraglutide In Overweight/Obese Type2 Diabetes

Object: The main purpose of this study is to study the correlation between the probability of gastrointestinal adverse reactions and TCM syndrome types in overweight / obese patients with type 2 diabetes treated with lialutide,so as to provide a relevant basis for TCM syndrome differentiation to treat the gastrointestinal adverse reactions of rilarutide.Through the theoretical system of traditional Chinese medicine to guide clinical drug use,save medical resources and increase patients' compliance.Expand the idea of using western medicine under the guidance of the theoretical system of traditional Chinese medicine.Method: From June 2018 to December 2019,overweight / obese patients with type 2diabetes who were treated with liraluptide in the Department of Endocrinology,affiliated Hospital of Chengdu University of TCM were selected through inclusion criteria,exclusion criteria,elimination and shedding criteria.153 subjects were finally determined,the data of four TCM diagnoses of the patients were collected,and TCM syndrome differentiation was carried out according to the TCM syndrome standard.All patients were divided into qi-yin deficiency group,damp-heat trapped spleen group,yang deficiency cold coagulation group and blood stasis blocking collaterals group.The name,sex,age,hospitalization number,starting time and contact information of the patients were recorded,and the data of BMI,FPG,2h PG,Hb A1 c,TG,TC,LDL-C and HDL-C and glycosylated hemoglobin were collected.All subjects were given diabetes-related knowledge education,diet and exercise treatment,and each group was gradually given liralutide 0.6mg to 1.8 mg,subcutaneously injected before breakfast,once a day.The cases of gastrointestinal adverse reactions during the trial were observed and counted.The patient's BMI was recorded again four weeks later.The collected data were analyzed by statistical software SPSS25.0.Result:(1)the incidence of gastrointestinal adverse reactions among the groups was26.7% in Qi-Yin deficiency group,64.5% in damp-heat trapped spleen group,34.1%in Yang deficiency and cold coagulation group,46.9% in blood stasis group,and the difference have statistically significant(p < 0.05).It can be considered that dampness-heat trapping spleen syndrome is the most prone to gastrointestinal adverse reactions among the four groups of TCM syndrome.(2)After treatment with Lilaluptide,the BMI of all TCM syndrome groups decreased,and the decreasing degree of BMI among the groups was as follows:damp-heat trapped spleen group > deficiency of both qi and yin group,yang deficiency cold coagulation group,blood stasis blocking collaterals group,there was statistical significance(p < 0 05).(3)The incidence of gastrointestinal adverse reactions was not related to the baseline conditions of BMI,FPG,2h PG,Hb A1 c,TG,TC,LDL-C and HDL-C,and the difference was not statistically significant.Conclusion:(1)The incidence of gastrointestinal adverse reactions in the treatment of overweight / obese type 2 diabetes mellitus was the highest in the syndrome of damp-heat trapped in the spleen,followed by the syndrome of deficiency of both qi and yin,yang deficiency and cold coagulation,and blood stasis blocking collaterals.The weight loss effect of rilarutide in patients with overweight / obese type 2 diabetes is the best in the syndrome of damp-heat trapping the spleen,and the other syndrome types are the same,which can be used to guide the clinical use of liralutide;(2)The occurrence of gastrointestinal adverse reactions of lialutide was not related to the baseline levels of BMI,FPG,2h PG,Hb A1 c,TG,TC,LDL-C and HDL-C;(3)According to the theoretical analysis of traditional Chinese medicine,the traditional Chinese medicine properties of Lilaru peptide may be bitter and cold,belonging to the spleen,stomach and intestinal meridians.