| Background:Type 2 diabetes mellitus,T2DM is an endocrine and metabolic disease characterized by disorders of glucose and fat metabolism,and elevated plasma glucose levels.It is also related with physical and mental disorder.In modern society,life is fast-paced and stressful,and the impact of emotions on diseases is particularly prominent.Traditional Chinese medicine believes that "liver controlling conveyance and dispersion",and the liver is closely related to emotional regulation.More and more doctors pay attention to the emotional problems of diabetic patients and find that liver qi stagnation syndrome accounts for a higher proportion in diabetes,especially in the early stages.It is also related to the occurrence and development of the complications closely.More and more attention is paid to the relationship between syndrome of liver qi stagnation and the development of diabetes.At present,the diagnosis of diabetic liver qi stagnation syndrome often depends on the subjective feelings of patients.Some patients are reluctant to disclose their emotional status,lack objective symptoms and signs with greater reference value,which make identifying syndromes difficult.Abdominal examination is a form of diagnosis that has gradually developed in the life and medical treatment of our country.It has been abundantly recorded in Inner Canon of Huangdi and Classic of Questioning.My supervisor Professor Zhao Jinxi attaches great importance to the use of abdominal diagnosis.He believes that abdominal examination is an important part of the diagnosis of Treatise on Cold Pathogenic Diseases,and it has a clear guiding effect on clinical syndrome differentiation.The abdominal examination can objectively and directly judge the patient's syndrome and physical fitness,and evaluate the pathological changes of viscera,yin and yang,qi and blood.Many "abdominal syndromes"are more directly related to "prescription syndromes",which can directly guide the clinical prescription of medication,which is more objective and easier to operate than tongue diagnosis and pulse diagnosis.As living standards improve,more and more obese people suffer from type 2 diabetesObjective:To summarize the common abdominal syndromes of type 2 diabetes with syndromes of liver qi stagnation,and explore the inherent relationship between different abdominal syndromes,clinical symptoms,TCM syndromes.And to excavate typical abdominal syndromes of type 2 diabetes with syndrome of liver qi stagnation.To improve the accuracy of clinical syndrome differentiation in type 2 diabetes;As the abdominal evidence obtained from the abdominal examination can reflect the pathogenesis of the disease,summarizing the characteristics of abdominal syndrome and its correlation with TCM syndromes can further guide the clinical treatment of diabetes liver qi stagnation syndrome.The current research on abdominal diagnosis is still in its infancy.It is mainly based on literature research and relatively few clinical studies.There is no related research on abdominal diagnosis of type 2 diabetes specific syndromes.This study can supplement research gaps in related fields.Methods:This study investigated patients with type 2 diabetes in the outpatient and inpatient of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine.Using the " observation form of Type 2 Diabetes TCM syndrome elements ",and the "observation form of Type 2 Diabetes abdominal syndromes " to Record basic information,general conditions,clinical symptoms,abdominal syndromes.Enter data and perform statistical analysis.Results:90 patients with type 2 diabetes mellitus with syndrome of liver qi stagnation were included in this study.The results are as follows:? In the course of disease,the average course of disease was 11.46 years,28.9%of patients had a course of less than 5 years,and 36.7%of patients had a course of 15 years or more.these age groups are more than others;?The frequency of the combined syndromes:blood stasis>qi deficiency>stagnated heat>upper hyper activity of liver yang>phlegm dampness>yin deficiency>yang deficiency>blood deficiency>damp heat>heat.The average score of the syndrome elements:damp heat>stagnated heat>qi stagnation>upper hyper activity of liver yang>phlegm dampness>yang deficiency>yin deficiency>blood deficiency>blood stasis;?The frequency of symptoms related to the syndrome of liver qi stagnation:mood depression>pulse string>irritability>insomnia>bitter in the mouth>chest tightness and sigh>abdominal fullness>turbid foam near the tongue>foreign body sensation in the throat>chest and hypochondrium fullness.In terms of diet,Those who do not like cold food are more than those who like cold food,and those with poor or vigorous appetite are rare.In terms of stool abnormality,the frequency of the stool is:poor stools>dry stools>thin stools>viscous stools;?abdominal examination of the whole abdomen:There are relatively many obese people.The proportion of those who are warm in the whole abdomen is similar to those who are cold in some areas.For abdominal strength,weak when pressed lightly but strong when pressed lightly is most common.?Common abdominal syndromes in chest and abdomen and their correlations:The frequency of abdomen syndromes:epigastric oppression and tension>fullness and discomfort in chest and hypochondrium>tension in rectus abdominis>bellyache>epigastric oppression.Fullness and discomfort in chest and hypochondrium,epigastric oppression are related to the severity of syndrome of liver qi stagnation.Epigastric oppression and tension,Hard heart,bellyache,fullness and discomfort in chest and hypochondrium,full chest pain,Epigastric cold is related to insomnia.?Umbilical abdominal syndromes:the proportion of the navels shape is straight " |" shape>triangle>horizontal "one" shape>irregular shape>round.More common in mid-size navels and small-size navels,big-size are rare.In terms of depth,shallow navels are more;?Correlation between umbilical abdominal syndrome and syndrome:small-size navel is positively correlated with Qi deficiency scores and Yang deficiency scores;?Correlation between umbilical shape and symptoms:The round navel is negatively related to poor stool;the horizontal "—"-shaped navel is significantly positively related to dry stool and poor stool,and has a significant negative correlation with thin stool;the vertical " | "-shaped navel is significantly negatively correlated with dry stool,negatively correlated with poor stool,and significantly positively correlated with thin stool.Triangular shaped navel is significantly positively related to dry stool and positively related to poor stool.Conclusions:? T2DM patients with a disease course of less than 5 years and more than 15 years have relatively frequent syndrome of liver qi stagnation.Qi stagnation is an important factor in the onset of illness,and chronic diseases are often associated with qi stagnation;?Combining syndromes are complicated.Excess syndromes are are often associated with blood stasis,stagnated heat and upper hyper activity of liver yang,and the symptoms of blood stasis are relatively faint.Heat and damp heat are rare.Deficiency syndrome is common with qi deficiency and yin deficiency,and the symptoms are relatively mild;?Common abdominal syndromes of type 2 diabetes with syndrome of liver qi stagnation include:epigastric oppression and tension,fullness and discomfort in chest and hypochondrium,tension in rectus abdominis,bellyache,epigastric oppression.Fullness and discomfort in chest and hypochondrium,epigastric oppression are are related to the scores of the syndrome of liver qi stagnation,which can be used as a typical abdominal syndrome for diagnosis and evaluation;?In abdominal syndromes,epigastric oppression and tension,Hard heart,bellyache,fullness and discomfort in chest and hypochondrium,full chest pain,Epigastric cold is related to insomnia,they can reflect the patient's sleep condition.In the treatment,we should pay attention to regulating the qi of spleen and stomach,and treat the liver and spleen together.?Navel size is related to scores of qi deficiency and yang deficiency.People with small-size navel tend to have qi deficiency and yang deficiency,while mid-size navel indicates that qi is still sufficient.It can be used to judge the condition of qi,blood and organs;?The shape of the navel can reflect the pathological changes of the belt vessel,which are related to abnormal stool.The horizontal "—"-shaped navel and triangular shaped navel are prone to constipation,suggesting that the belt vessel are too tightly constrained.The vertical "|"-shaped navel is prone to diarrhea,suggesting that the belt vessel are less constrained.People with round navels often have normal stools,suggesting the function of belt vessel is normal. |
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