Research On The Characteristics Of TCM Syndrome Elements Of The Progression From Diabetes To Diabetic Nephropathy Based On The Theory Of "deficiency And Stagnation Of Qi"

ObjectiveCombined with data mining and cross-sectional investigation,the distribution and differences of demographic,laboratory examinations and traditional Chinese medicine symptom elements between patients with diabetic kidney disease(DKD)and patients with only diabetes point 0 when they were first investigated,and the characteristics of TCM syndromes,physical and chemical indexes and demography of diabetic nephropathy patients were preliminarily understood.Then,the follow-up of diabetic nephropathy patients at 12 months was analyzed.Distribution of TCM syndromes and physicochemical indicators,from the perspective of vertical development,analysis of the evolution of disease syndromes,explore the characteristics of TCM syndromes of diabetic nephropathy"deficiency of Qi retention,more deficiency and more excess".Finally,through the Logistic model,analyze the significa nt factors of single factor research,and explore the characteristics of TCM syndromes and physicochemical indicators of diabetic nephropathy.To provide ideas for the prevention and treatment of diabetic nephropathy by integrated traditional Chinese and Western medicine.Method1.Collected from Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,Oriental Hospital of Beijing University of Traditional Chinese Medicine,Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine,Guang’ anmen Hospital of Chinese Academy of Traditional Chinese Medicine,Wangjing Hospital of Chinese Academy of Traditional Chinese Medicine,Xiyuan Hospital of Chinese Academy of Traditional Chinese Medicine,First Hospital of Peking University,People’s Hospital of Peking University,Sino-Japanese Friendship Hospital,Beijing Integrated Traditional Chinese and Western Medicine Hospital,we collected 364 patients with diabetes and 457 patients with DKD.After entering the data,a database is formed,and data analysis is carried out on this basis.2.IBM SPSS STATISTICS 25.0 was used for data statistical analysis,and_test was used for counting data;independent sample t test or variance analysis was used for metrological data which conformed to normal distribution and satisfied homogeneity of variance;LSD test or Dunnet-t test was used for those who conformed to normal distribution but whose variance was not homogeneous;those who did not conform to normal distribution used order to convert to normal distribution before calculating.Rank sum test is used for those whose skewed distribution is still abnormal after transformation.Multivariate logistic regression analysis was used to analyze the correlation between TCM syndromes and laboratory indicators.TCM syndromes characteristics of diabetic nephropathy were analyzed.2Result1.A cross-sectional survey was conducted at 0 points in DKD and DM patients.General data:821 patients were included,364 patients with DM,174 males(47.8%),190 females(52.2%)and more females than males(P<0.001);285 males(62.4%)and 172 females(36.7%)were included in DKD patients,and the number of males was more than females;the majority of them were between 60 and 70 years old.There were significant differences between DKD group and DM group in drinking history,smoking history,hypertension history,hyperuricemia history and cerebral infarction history.In terms of living habits,DKD patients were more likely to eat sweets and fruits,drink milk,eat more eggs per week and eat more meat per day than DM patients.In terms of exercise,DKD patients had more moderate intensity activities for more than half an hour per day than DM patients,while DM patients consumed more legumes and legumes than DKD patients.The investigation of TCM syndrome elements showed that the proportion and degree of syndrome elements in DKD patients at 0 o’clock were higher than those in DM patients,and the proportion and degree of disease location syndrome elements in DKD patients were higher than those in DM patients,such as Qi deficiency,blood deficiency,Yang deficiency,water-dampness,dampness-heat,blood stasis and phlegm turbidity.In terms of laboratory indicators,fasting blood glucose,triglyceride,creatinine,urea nitrogen,serum uric acid,potassium,calcium,phosphorus and 24-hour urinary protein,ACR,urinary microalbumin,serum albumin and total protein levels in DKD patients were higher than those in DM patients,and the difference was statistically significant.2.Evolution of syndrome elements in patients with DKD after one year.Compared with 0:00,the proportion and degree of Yang deficiency syndrome,Yin deficiency syndrome,damp-heat syndrome,blood stasis syndrome and Qi deficiency syndrome in DKD patients increased significantly 12 months later.In the aspect of disease location,the degree and proportion of liver and kidney syndrome elements also increased,and the proportion and degree of heart disease syndrome elements were significantly higher than those in the group,the difference was statistically significant.3.Based on statistical knowledge and professional knowledge,the meaningful indicators of the above studies were selected and evaluated.Logistic regression model was used to analyze them:gender,age,smoking time,drinking time,history of hypertension,systolic pressure,diastolic pressure,waist-hip ratio,fasting blood glucose,triglyceride level,serum creatinine,urea nitrogen,serum uric acid,serum potassium,phosphorus,calcium and albumin.The independent risk factors of diabetic nephropathy were blood urea nitrogen,potassium ion level,albumin,total protein,triglyceride,systolic pressure,smoking time and yang deficiency syndrome.Conclusion1.The overall pathogenesis of diabetes mellitus and its complications is characterized by deficiency leading to excess and stagnation of qi.In different stages of disease,the TCM syndrome elements and location of deficiency and stagnation are different.In the stage of diabetes mellitus,patients are mainly Yin deficiency,Qi deficiency,heat excess and dampness-heat,accompanied by blood stasis syndrome.In the stage of diabetic nephropathy,besides Qi deficiency and Yin deficiency syndrome,they are more Yin-deficient with the passage of time.The complex situation of Yang deficiency and phlegm and blood stasis blocking each other is not obvious.The basic location of the disease is liver and kidney,involving the heart and spleen.2.The pathogenesis of diabetic nephropathy can better embody the pathogenesis theory of"deficiency of Qi retention".With the passage of time,the degree of deficiency syndrome elements of diabetic nephropathy patients is deeper.At the same time,the marked syndrome elements of diabetic nephropathy appear various,mutually glued,complex and difficult to understand.It is precisely because of the deficiency,deficiency of Qi retention,the more deficiency,the more solid,the more deficient.3.Blood urea nitrogen,potassium ion level,albumin,total protein,triglyceride,systolic blood pressure,smoking time and yang deficiency syndrome are independent risk factors for diabetic nephropathy,and are also the characteristics of TCM syndrome elements and physical and chemical indicators.