Study On TCM Syndromes And Related Risk Factors Of Newly Diagnosed Diabetes Mellitus Complicated With Diabetic Kidney Disease

Objective:By collecting the second affiliated hospital of shandong university of TCM in endocrinology for nearly three years to begin the clinical data of diabetic kidney disease(CKD)patients with diabetes mellitus,studies new diabetes patients complicated with diabetes kidney disease related risk factors and law of TCM syndrome types of deep understanding of diabetes kidney disease(DKD)in patients with clinical characteristics,for the early prevention,diagnosis and treatment of the disease to provide new ideas.Methods:By means of case review,a total of 60 patients were selected from the outpatient department of endocrinology and ward of the second affiliated hospital of shandong university of traditional Chinese medicine from January 1,2017 to December 31,2019.According to the presence or absence of DKD in the newly diagnosed diabetes,the patients were divided into the newly diagnosed diabetes mellitus group with DKD(DKD group)and the newly diagnosed diabetes mellitus group without DKD(NDKD group),with 30 patients in each group.Detailed record patients’ gender,age,body mass index(BMI),waist circumference,systolic blood pressure(SBP),diastolic blood pressure(DBP),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),triglyceride(TG),total cholesterol(TC),fasting plasma glucose(FPG),2 h postprandial blood glucose(2 HPBG),glycosylated hemoglobin(HbA1c),creatinine(Scr),urea nitrogen(BUN),urinary inhibition(Cysc)and TCM syndrome type.The data of clinical observation were summarized and statistically analyzed using spss25.0 statistical software.Results:1.The average age of DKD group was 60.50 years old,and that of NDKD group was 55.77 years old.The average age of DKD group was significantly higher than that of NDKD group and the difference was statistically significant(P<0.05).Age was considered to be positively correlated with the onset of newly diagnosed diabetes mellitus with DKD.2.SBP of DKD group was higher than that of NDKD group and the difference was statistically significant(147.63>142.20,P=0.045),DBP of DKD group was higher than that of NDKD group and the difference was statistically significant(93.47>86.10,P=0.014).It was considered that hypertension was positively correlated with newly diagnosed diabetes mellitus with DKD.3.The BMI level of the DKD group was higher than that of the NDKD group and the difference was statistically significant(26.58>24.28,P<0.001).The waist circumference of the DKD group was higher than that of the NDKD group and the difference was statistically significant(89.32>85.58,P=0.003).BMI and waist circumference were considered to be positively correlated with the incidence of DKD.4.TC in the DKD group was higher than that in the NDKD group and the difference was statistically significant(5.00>4.62,P=0.014).TG in the DKD group was higher than that in the NDKD group and the difference was statistically significant(1.92>1.41,P=0.022).Hdl-c in DKD group was lower than that in non-ndkd group and the difference was statistically significant(1.10<1.21,P=0.009).TC and TG were considered to be positively correlated with the onset of newly diagnosed diabetes mellitus with DKD.5.FPG in the DKD group was higher than that in the NDKD group and the difference was statistically significant(10.58>9.46,P=0.049),2hPBG in the DKD group was higher than that in the NDKD group and the difference was statistically significant(14.86>12.60,P<0.001),and HbAlc in the DKD group was higher than that in the NDKD group and the difference was statistically significant(9.13>8.04,P=0.009).In the multivariate regression analysis,FPG,2hPBG and HbAlc were also related to the occurrence of DKD.Blood glucose was considered to be positively correlated with the onset of newly diagnosed diabetes mellitus with DKD.6.The BUN in the DKD group was higher than that in the NDKD group and the difference was statistically significant(6.91>5.84,P=0.013).The Cysc in the DKD group was higher than that in the NDKD group and the difference was statistically significant(2.31>1.58,P<0.001).BUN and Cysc were considered to be positively correlated with the onset of newly diagnosed diabetes mellitus with DKD.7.According to the TCM syndrome differentiation and analysis of newly diagnosed diabetes patients with DKD,the number of patients with qi and Yin deficiency syndrome was the largest,accounting for 50%,followed by the liver and kidney Yin deficiency syndrome(26.67%),qi and blood deficiency syndrome(13.3%),and spleen and kidney Yang deficiency syndrome(10%).Conclusion:1.through clinical observation found that both the related risk factors for diabetes kidney disease with diabetes mellitus change mainly for age,body mass index,waist circumference,systolic pressure,diastolic blood pressure,high density lipoprotein cholesterol,triglyceride,total cholesterol,fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,urea nitrogen,the elf inhibition C.2.The most common TCM syndromes of newly diagnosed diabetes mellitus with diabetic kidney disease were qi and Yin deficiency.The number of patients with qi and Yin deficiency syndrome was the largest,accounting for 50%,followed by liver and kidney Yin deficiency syndrome,qi and blood deficiency syndrome,spleen and kidney Yang deficiency syndrome.The main pathogenesis of DKD was primary deficiency.