Study On The Correlation Between Intestinal Flora And TCM Syndromes In Patients With Type 2 Diabetes

ObjectivesExplore the distribution of intestinal microflora in patients with type 2 diabetes and its correlation with blood glucose;explore the correlation between T2DM intestinal flora and TCM syndrome types.MethodsIn this study,242 T2DM patients in the Department of endocrinology of Oriental Hospital of Beijing University of traditional Chinese medicine from June 2019 to November 2019 were selected by quota,and a questionnaire composed of closed questions was filled out to conduct a cross-sectional study.By using spss22.0 to analyze the data from "Case Report Form",to study the correlation between intestinal flora and blood glucose related biochemical indicators;using the simplified measurement method in syndrome differentiation,factor analysis extraction of common factors for syndrome differentiation,to explore the pathogenesis of TCM in T2DM patients;according to the combination of syndrome factors in T2DM patients to get T2DM patients The correlation between intestinal microflora and TCM syndrome types was analyzed by logistic regression.Results1.The distribution of intestinal flora inT2DMG-bacilli were the highest,followed by G+bacilli and G+cocci,and G"cocci and fungi were the least(P<0.05).Bacilli are higher than cocci,and G-bacteria are higher than G+bacteria(P<0.05).2.Correlation between intestinal flora and blood glucose and other biochemical indicators in patients with T2DMThe proportion of G-bacilli was negatively correlated with HOMA-?(r=-0.128,P<0.05).The proportion of G-bacilli was positively correlated with HbA1c(r=0.129,P<0.05).G-bacilli were positively correlated with TBIL,DBIL,IBIL(r=-0.278,r=-0.276,r=-0.269.P<0.01).The proportion of G-bacilli in the patients with abnormal bile acid was lower than that in the patients with normal bile acid(P<0.05).The BA was positively correlated with HOMA-?(r=0.203,P<0.01).The BA was negatively correlated with HbA1c(r=-0.148,P<0.05).3.Syndrome,TCM syndrome type and the correlation between intestinal flora and TCM syndrome type of T2DM patientsIn this study,the disease location factors were yang deficiency,yin deficiency,qi deficiency,blood deficiency,essence deficiency,damp evil,fluid-retention,phlegm,blood stasis,qi stagnation,heat syndrome.The disease location factors were kidney,heart,spleen,lung,stomach,liver,main and collateral channels,mind.The syndrome types in turn were stomach heat yin deficiency syndrome,kidney essence deficiency syndrome,liver stagnation syndrome,heart lung qi deficiency syndrome,of mind yin deficiency syndrome,spleen deficiency syndrome,yang deficiency lead to stasis blocking main and collateral channels syndrome,phlegm turbidity obstructive lung syndrome,heart vessel stasis syndrome,heart kidney yang deficiency syndrome,spleen qi deficiency syndrome,kidney(yang)deficiency syndrome,middle heater dampness stagnation syndrome.The increase of G+cocci in intestinal flora can reduce the incidence of stagnation of liver qi(P<0.05).The increase of G+cocci in intestinal flora can increase the incidence of dampness stagnation and charring(P<0.01).ConclusionThe change of intestinal microflora in T2DM patients,especially the increase of G-bacilli ratio,may cause the rise of bilirubin,the decrease of bile acid,the decrease of ? cell function,and the abnormality of blood glucose,which may be the one of the reasons for the occurrence and development of T2DM.It provides a new way to study T2DM from the perspective of the relationship between intestinal microflora and biochemical indicators.It is believed that the deficiency of the five internal organs is the basis,and the inclusion of sputum,stasis,heat,and stagnation is the basic pathogenesis of the development of Xiaoke disease,which provides a theoretical basis for the TCM syndrome differentiation and treatment of diabetes.The increase of G+cocci in intestinal flora can reduce the incidence of stagnation of liver qi and increase the incidence of dampness stagnation and charring,which provides theoretical support for enriching the correlation between objective indicators and syndrome types of TCM from the perspective of intestinal flora.