Analysis Of TCM Syndrome Types And Clinical Characteristics In Newly Diagnosed Type 2 Diabetes Patients With Non-alcoholic Fatty Liver Disease

Objective:By exploring the clinical data of newly diagnosed type 2 diabetes with non-alcoholic fatty liver disease,this study is to analyze the correlation between TCM syndromes and clinical data,and to provide a theoretical basis for Traditional Chinese Medicine(TCM)to prevent and treat newly diagnosed T2DM combined with NAFLD.Methods:301 newly diagnosed T2DM combined with NAFLD patients who had been received treatment in the endocrinology department of Affiliated Hospital of Hunan University of Traditional Chinese Medicine,from January 2019 to December2020 were included in the study.General information such as age,gender,body mass index(BMI),biochemical indicators and four-diagnosis data methods of patients were collected.According to the diagnostic characteristics,they were divided into five groups:liver depression and spleen deficiency syndrome,phlegm-damp internal syndrome,damp-heat syndrome,qi-yin deficiency in liver and kidney syndrome,yang deficiency in spleen and kidney syndrome.All the patients included in the study were tested for BMI,UA,Hb A1c,FBG,25(OH)D,HOMA-IR(CP)and blood lipid(total cholesterol,triglycerides,high density lipoprotein and low-density lipoprotein)of all subjects.All data were collected and entered into the data-base.Multinomial logistic regression was used to analyze the relevance between TCM syndrome types and clinical data.Results:1.The distribution of TCM syndromes of 301 newly diagnosed type 2 diabetes patients with non-alcoholic fatty liver,in descending order of frequency:liver depression and spleen deficiency syndrome(29.9%),phlegm-damp internal resistance syndrome(22.59%),damp-heat internal accumulation Syndrome(18.27%),liver and kidney yin deficiency syndrome(15.95%),spleen and kidney yang deficiency syndrome(13.29%),and liver depression and spleen deficiency syndrome are the most common.2.Among the five groups of TCM syndromes of 301 newly diagnosed type 2diabetes patients with non-alcoholic fatty liver,the age of patients with liver depression and spleen deficiency syndrome is the youngest,and there is a statistical difference between liver and kidney yin deficiency syndrome and spleen and kidney yang deficiency syndrome Meaning(P=0.048,P=0.005).3.The levels of BMI and HOMA-IR(CP)in the syndrome of phlegm-dampness internal resistance are the highest among the five groups of TCM syndromes,and their BMI levels are related to the syndrome of liver stagnation and spleen deficiency,liver and kidney yin deficiency,and spleen and kidney yang deficiency.The difference is statistically significant(P=0.010,P=0.000,P=0.021);there are statistical differences between its HOMA-IR(CP)level and the syndrome of liver depression and spleen deficiency,liver and kidney yin deficiency,and spleen and kidney yang deficiency.Academic significance(P=0.000,P=0.000,P=0.011).4.The results of multi-class logistic regression analysis showed that BMI,HOMA-IR(CP),UA,TG and phlegm-damp internal resistance syndrome were positively correlated(P<0.05,?_BMI=0.126,?_HOMA-IR(CP)=0.275,?_UA=0.007,?_TG=0.223),25(OH)D has a negative correlation with phlegm-damp internal resistance syndrome(P<0.05,?_25(OH)D=-0.041);UA,TG,Hb A1c and damp-heat internal accumulation The syndrome has a positive correlation(P<0.05,?_UA=0.005,?_TG=0.213,?_{Hb A1C}=0.241).Conclusion:1.Newly diagnosed T2DM patients with NAFLD are more common with liver-stagnation and spleen-deficiency syndrome,and the age of onset is younger.2.BMI,UA,TG,HOMA-IR are the risk factors of phlegm-damp internal resistance syndrome,25(OH)D is the protective factor;UA,Hb A1c,TG are the risk factors of damp-heat internal syndrome.3.The TCM syndrome differentiation of newly diagnosed T2DM patients with NAFLD is phlegm-damp internal resistance syndrome and the subtype3-SIRD in the new type of diabetes has similar clinical characteristics,namely severe insulin resistance and high BMI.