Study On The Characteristics Of TCM Syndrome And Treatment Of Prediabetes And The PRO Scale

Objective:This thesis relies on the Beijing Municipal Health Development Scientific Research Special Project "Prevention and Management of Diabetes Based on Precision Medicine"(Project Batch Number:First Issue 2016-1-4151).It consists of literature review,characteristics of pre-diabetes TCM syndromes and treatment,and PRO scale study.By sorting out and digging out clinical cases,explore the syndrome differentiation and pre-diabetes type,treatment and commonly used herbs.Form pre-diabetes PRO scale.Methods:(1)Literature review:To summarize and summarize the literature on TCM treatment of diabetes and PRO scale in the past 10 years,and review the research progress of TCM treatment and PRO scale at home and abroad.(2)Characteristics of TCM Syndrome Treatment in Pre-diabetes:The total number of patients with prediabetes from Guanganmen Hospital of China Academy of Chinese Medical Sciences,Shijitan Hospital Affiliated to Capital Medical University,Changping District Hospital of Beijing,Shunyi District Hospital of Beijing,Miyun District Hospital of Beijing,Pinggu District Hospital of Beijing 560 cases.Perform symptom,syndrome differentiation,medication information,physical and chemical indicators and other information on all cases,standardize the data,and enter the text into Microsoft office Excel to establish a database,use SPSS 23.0 software for pre-diabetes symptoms,tongue pulse,syndrome differentiation,drug analysis,and Follow up the patients who were treated with pure Chinese medicine using the network data platform.(3)PRO scale study:Set up a research team,based on the etiology and pathogenesis of pre-diabetes TCM and clinical manifestations,combined with international scale development norms,establish the theoretical framework of the pre-diabetes TCM PRO scale,which is produced through literature analysis,patient interviews,expert consultation,brainstorming Item pool,after initial screening,conduct cognitive test,and after modification,form a preliminary scale,and scientifically evaluate the scale from three aspects of validity,reliability,and feasibilityResult:(1)Literature review:Pre-diabetes belongs to the category of "spleen spleen" in traditional Chinese medicine.Its incidence is closely related to the spleen,liver and kidney,and blood stasis and phlegm are the main pathological factors.Non-drug treatment of traditional Chinese medicine is based on traditional physical therapy such as diet control,emotional regulation,sports therapy and acupuncture and massage;commonly used Chinese patent medicines such as Qi Yao Xiao Ke capsule,Shen Qi Jiang Tang granule,Tian Qi Jiang Tang capsule,Tang Mai Kang Granules,Jinqi Jiangtang tablets,Jinlida granules,Tangqianping granules,etc.;Traditional Chinese medicine decoctions are mainly based on syndrome differentiation and compound treatment.The existing curative effect evaluation methods include signs and symptoms,microscopic indicators,self-management compliance,etc.;The PRO scale developed early in foreign countries.The domestic PRO scale is divided into two parts:translation and revision of foreign scales and self-developed scales.Related scales have been established in multiple disciplines.The TCM scale includes disease scale and syndrome scale.Table,TCM body mass table,etc.,the TCM Chinese traditional medicine is consistent with the PRO scale,but the PRO scale for pre-diabetes is blank at this stage,and there is no evaluation standard for the efficacy of TCM-related pre-diabetes.(2)Characteristics of TCM Syndrome Treatment in Pre-diabetes:Statistical analysis of symptoms:67.68%dry mouth and polydipsia,60%obesity,38.21%tiredness,tired stool 33.75%,frequent urination 31.25%,27.32%fear of heat,24.64%abdominal distension,23.57%limb weight%,Frequent eating and hunger 14.82%,bitter mouth 9.64%,sweating 8.21%.Tongue vein statistics:light red tongue 53.37%,red tongue 22.99%,light dark tongue 15.63,white greasy moss 52.90%,thin white moss 29.46%,thin yellow moss 11.16%,string vein 62.28%,slip vein 43.08%.Syndrome statistics:38.36%of spleen deficiency and dampness syndrome,31.18%of dampness and heat accumulation of spleen syndrome,13.33%of liver and stomach stagnation of heat syndrome,8.82%of liver qi stagnation syndrome,8.59%of qi and yin deficiency syndrome,5.59%,spleen and kidney yang deficiency syndrome 2.72%.Chinese medicine statistics:Coptis chinensis 58.27%,Poria 54.72%,Pinellia 53.54%,Atractylodes macrocephalae 48.43%,Atractylodes macrocephala 44.09%,tangerine peel 44.09%,Scutellaria baicalensis 40.16%,Bupleurum 38.19%,Huoxiang 37.01%,Pueraria lobata 36.22%,Citrus aurantium 35.04%,White Cardamom 34.65%,Alisma 34.25%,Perrin 33.46%,Trichosanthin 32.68%,Adenophora 31.89%,Ophiopogon japonicus 30.31%.The cluster analysis of traditional Chinese medicine can be roughly divided into four categories:the first category:Coptis chinensis,Scutellaria baicalensis,Pinellia,Poria,Alisma,Atractylodes macrocephala,Citrus aurantium,Coix seed,dried ginger,Codonopsis,Atractylodes,Atractylodes chinense,Agastache rugosa,Agastache rugosa;The second category:Trichosanthin,Schisandra,Ophiopogon japonicus,Radix Ginseng,Radix Radix,Radix Astragali,Bamboo Ru,Gypsum,Anemarrhena,Radix,Radix Rehmanniae;Fructus Aurantii,Citrus trifoliate,Magnolia officinalis,Fructus Aurantii,White Peony,Bupleurum;fourth category:Alisma,paeonia,red peony,achyranthes,yam,angelica,rehmannia glutinosa.Univariate analysis showed that the treatment effectiveness was related to the use rate of traditional Chinese medicine and BMI.Regression analysis showed that the treatment effectiveness was related to the use rate of traditional Chinese medicine OR=0.002,P=0.022.Correlation analysis showed that the use rate of traditional Chinese medicine was related to the change value of blood glucose and blood lipid.,TCM symptom score and BMI change value were obviously positively correlated.(3)PRO scale study:The initial scale of this study included 49 items.After item screening and scientific testing,the final scale has 25 items,including 18 in the physiological field,4 in the psychological field,2 in the social field,and independent field 1 The scale is issued in electronic form,the recovery rate is 100%,and the time to complete the scale is within 7 minutes.The reliability of the overall scale is 0.878,and the reliability of the physiological field,psychological field,and social field are 0.805,0.803,and 0.452,respectively.The Spearman correlation coefficient was used to check the relevance of the items and their dimensions,and all the items passed the content validity;the structural validity evaluation showed that KMO=0.618,and the cumulative variance contribution rate of the factor analysis method was 73.285%Conclusion:(1)Literature review:Traditional Chinese medicine adopts the methods of prescription,prescription,medicine,acupuncture,massage,etc.,and has achieved good results in the prevention and treatment of pre-diabetes,and has formed a variety of syndrome differentiation methods.There are few and can not guide clinical scientific research well;the evaluation of the effect of pre-diabetes is not uniform,it is necessary to develop the pre-diabetes PRO scale to promote the standardization of clinical evaluation of diabetes.(2)Characteristics of TCM Syndrome Treatment in Pre-diabetes:The pre-diabetes symptoms are the most common symptoms of dry mouth,polydipsia,obesity,tiredness,sticky stools,and heavy limbs.Some patients have no clinical symptoms,only abnormal physical and chemical indicators.The syndrome differentiation in the early stage of diabetes is mainly based on spleen deficiency and dampness and dampness and heat accumulation,indicating that spleen deficiency is closely related to the onset of this disease.The analysis of the treatment drugs showed that the traditional Chinese medicines mainly consisted of Coptis chinensis,Poria,Pinellia,Alisma,Atractylodes,etc.,and the treatment method was mainly heat and dampness.The usage rate of traditional Chinese medicine has a certain effect on pre-diabetes.In regression analysis,it can be seen that the usage rate of traditional Chinese medicine is greater than 0.56,which can significantly improve the treatment effect of pre-diabetes.The utilization rate of traditional Chinese medicine is positively related to the metabolism of glucose and lipid,which may be related to the traditional Chinese medicine's ability to improve the internal environment of the body and regulate self-steady state.(3)PRO scale study:The scale has good reliability and validity,and can be used to evaluate the clinical efficacy of prediabetes.