Correlation Between TCM Constitution And Risk Factors Of Diabetes In Diabetic Nephropathy

Objective: Through the acquisition of information on the age,height,weight,living habits,signs and medication contraindications of patients with stage III and IV diabetes mellitus,the results of TCM constitutional classification of patients with stage III and IV diabetic nephropathy were analyzed to further explore the constitution of TCM.Correlation between typing and risk factors for diabetic nephropathy.It provides more theoretical basis for the application of TCM constitution in clinical work,thus providing new ideas for the prevention and treatment of diabetic nephropathy.Methods: 1.After obtaining the patient’s consent,we evaluated 201 patients who met the inclusion criteria and exclusion criteria with TCM physique scale,and obtain data on patient profiles and related clinical risk factor,including: name,age,gender,Family genetic disease,height,weight,body mass index(BMI),duration of diabetes,history of tobacco and alcohol,blood lipid index,urinary kidney function index,renal function index,blood pressure,glycosylated hemoglobin.2.Statistical analysis: the data of relevant risk factors and the distribution characteristics of TCM constitution types were described by median(quartile)and composition ratio.Non-parametric test was used for comparison between groups.The correlation of risk factors was analyzed by binary multivariate logistic regression analysis.Statistical analysis of the data was performed using SPSS 24.0.Results: 1.Among the 201 patients with stage III and IV diabetic nephropathy,127(63.18%)were male and 74(36.82%)were female;the middle-aged and elderly patients accounted for the highest proportion,of which 65(32.34%)were 45-59 years old.The number of patients aged 60-74 years was 60(29.85%);the number of patients with a disease duration of less than 10 years was 80,accounting for 39.80%;the overall height range was 1.50-1.84 m,and the median was 1.70m;for the 40-120 kg,the median was 72.5kg;the overall BMI ranged from 16.23 to 37 kg/m2,and the median was 25.92 kg/m2.2.The distribution of TCM constitution: 34 persons with yang-deficiency(16.92%),yin-deficiency has 29 people(14.43%),qi-deficiency has 51 people(25.37%),10 people with wet-heat-deficiency(4.97%),34 people with phlegm-dampness(16.92%),7 people with qiyu-deficiency(3.48%),special quality has 9 people(4.48%),blood stasis constitution has 8 people(3.98%),peaceful-physique has 19 people(9.45%).3.There were significant differences between DN patients of different stages and course of disease in different constitutions of TCM(P=0.001).4.Yang-deficiency is positively correlated with DN stage and serum creatinine level;Yin-deficiency is positively correlated with glycosylated hemoglobin level;phlegm-dampness is positively correlated with BMI and hyperlipidemia history;Qi-deficiency is positively correlated with age and smoking history,and negatively correlated with drinking history.5.There was a significant difference in glycosylated hemoglobin levels between patients with yin-deficiency and yang-deficiency(Z=-2.576,P=0.023);there was a significant difference in BMI between patients with phlegm-dampness and yang-deficiency,qi-deficiency,and peaceful-physique(Z =-4.402,-4.55,3.363,P=0.001,0.001,0.008);there was a significant difference in urinary albumin/creatinine between patients with yang-deficiency and phlegm-dampness and peaceful-physique(Z=2.962,3,340,P=0.031,0.008).Conclusion: 1.Among the 201 patients with stage III and IV diabetic nephropathy,the proportion of males was higher than that of females,among them,middle-aged and elderly patients are mostly.2.Among the 201 patients with stage III and IV diabetic nephropathy,the distribution of constitution type was mainly qi-deficiency,yang-deficiency and phlegm-dampness.Among them,stage III diabetic nephropathy was characterized by qi-deficiency,phlegm-dampness and yin-deficiency.Stage IV diabetic nephropathy was characterized by yang-deficiency.3.The early stage of diabetes is mostly phlegm-dampness,and in the middle and late stages,qi-deficiency and yang-deficiency are common.4.The higher the serum creatinine level,the greater the possibility of yang-deficiency;the higher the glycated hemoglobin level,the greater the possibility of yin-deficiency;the higher the BMI level,the easier it is to form phlegm-dampness;the older the age,the more smoking The history of patients with qi-deficiency is more likely,and patients with a history of drinking are less likely to develop qi-deficiency.There are significant differences between glycosylated hemoglobin,urinary microalbumin/creatinine and BMI in different constitutions.