A Study On The Distribution Characteristics Of The Syndromes Of Diabetic Kidney Disease And The Correlation Between The Three Yin And Three Yang Constitutions

Background:Diabetic Kidney Disease is one of the diabetic microvascular complications that mainly manifests itself as the metabolism disorder of nutrients in the body such as sugar,lipid,protein and glomerular damage.It belongs to the category of "diabetes nephropathy" in the diagnosis of Chinese medicine.The rapid development of my country's economy and the changes in people's dietary structure and living habits have caused the incidence,disability,mortality,and medical expenses of diabetes and its complications to increase year by year,which has increased the burden on people and seriously affected people.The quality of life,thus controlling the development of diabetes and its complications,has a profound impact on human health.Instructor Professor Zhao Jinxi has dedicated to the study of Chinese medicine in the prevention and treatment of diabetes and its complications for many years.He adheres to the spirit of "familiar with the classics" and puts forward that the Six Classics are six physiological systems,which is based on the "Six Classics Theory" of Shang Han Treatise.Thus "Three Yin and Three Yang System Theory" and "Three Yin and Three Yang Constitution Theory" is derived from Shang Han Treatise which have extremely high theoretical significance and clinical value.Objective:Diabetic Kidney Disease is chronic kidney disease caused by diabetes.It is one of the most important and serious microvascular complications of diabetes.It is currently the main cause of end-stage renal disease.Modern medical treatment of this disease is still limited.This study is based on Professor Zhao Jinxi's three-yin and three-yang constitution theory,and aims to explore the characteristics of the distribution of TCM syndrome elements in patients with DKD in various stages,analyze the characteristics of the distribution of three-yin and three-yang constitution in patients with DKD in each stage,as well as find the correlation between TCM syndrome elements and three-yin and three-yang physiques,summarizes Professor Zhao Jinxi's diagnosis and treatment thinking of the trinity of physique differentiation,disease differentiation,and syndrome differentiation in the treatment of DKD.The study will provide scientific evidence and prevention and treatment measures for the clinic.Methods:This study is a cross-sectional survey.DKD patients who were hospitalized and treated in the Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine from June 2019 to December 2020 were collected,and eligible research subjects were included.The basic data of the patients were recorded according to the "Medical Record Data Collection Form",including patient's basic information,general conditions,laboratory examinations and four-diagnosis information,etc,and collect data on clinical syndrome elements of TCM according to the "DKD TCM Syndrome Elements Collection Form".Enter the patient's basic information and physical fitness,TCM syndrome elements and other relevant information into the EXCEL table,and use software:SPSS 22.0 for statistical analysis:use frequency and composition ratio for classification indicators,use(?)for measurement data,and use chi-square for rate and composition ratio Test,use Binary Logistic regression model to screen the impact of that TCM syndrome distribution on DKD stages,laboratory indicators,and three-yin and three-yang physical fitness.Use multivariate Logistic regression model to screen the impact of that DKD staging on three-yin and three-yang physical fitness.Results:?Analysis of the basic situation:A total of 300 patients with DKD stage ?-?were included in this study.Among them,199 cases(66.3%)were in stage ?,37 cases were in stage ?(12.3%),and 64 cases were in stage ?(21.3%).The age group of the included patients was between 24 and 80 years old,with an average age of about 58 years old.The average body mass index of DKD ?-? stage is 25kg/m2.In terms of the course of diabetes,the average course of stage ? is 11 years,the course of stage ? is 16 years,and the course of stage ? is 17 years.In terms of the course of proteinuria,the average course of stage ? is ?year,the course of stage ? is 4 years,and the course of stage V is 4 years.In terms of the course of diabetic retinopathy,the average course of stage ? is 0.2 years,the course of stage? is 0.8 years,and the course of stage ? is 1.4 years.In terms of the course of creatinine elevation,the average course of stage ? is 0.2 years,the course of stage ? is 1.6 years,and the course of stage V is 2.9 years.The course of diabetic years,proteinuria years,DR years,creatinine elevated years and 24hUTP,Cr,BUN,ALB,HbAc,eGFR of DKD ? patients are different from those of stage ??? patients,and the difference is statistically significant(P<0.05).There was no significant difference between BMI and FBG in DKD ???patients.The combined use of ARB drugs in DKD V patients was higher than that of patients in other stages(P<0.05).?Distribution of TCM syndrome elements:Among the four main deficiency syndromes,the top rank of TCM syndrome of DKD ? are Yin deficiency 136 cases(11.2%),Qi deficiency 102 cases(8.4%),and Yang Deficiency 77 cases(6.3%).Factors of ? are Yin Deficiency 20 cases(10.2%),Qi Deficiency 11 cases(9.3%),and Yang Deficiency 12 cases(5.6%).Factors of V are Yin Deficiency 37 cases(8.4%),Blood Deficiency 31 cases(7%),Yang Deficiency 28 cases(6.4%),and Qi Deficiency 27 cases(6.1%).Among the twelve stagnant syndromes,the top three syndrome elements of DKD ? are:blood stasis syndrome 152 cases(12.5%),stagnation-heat syndrome 121 cases(10%),and heat-condensation syndrome 105 cases(8.7%).Factors of DKD ? are blood stasis syndrome 27 cases(12.5%),dampness-heat syndrome 20 cases(9.3%),phlegm-dampness syndrome 18 cases(8.4%).Factors of ? are blood stasis syndrome 55 cases(12.5%),stagnation-heat syndrome 41 cases(9.3%),and phlegm-dampness syndrome 40 cases(9.1%).The four main deficiency syndrome elements are Qi-deficiency,Yin-deficiency syndrome,and Yang-deficiency syndrome in DKD ???,while in DKD ?,QI?blood?Yin and Yang-deficiency are the main syndrome elements.Among the twelve stagnant syndromes,Blood stasis syndrome is accompanied by the progression of DKD stags.In addition,DKD ? is often accompanied by stagnation-heat syndrome and heat-condensation syndrome;DKD ? is often accompanied by dampness-heat syndrome and phlegm-dampness syndrome;DKD V is often accompanied by stagnation-heat syndrome and phlegm-dampness syndrome.?Correlation between TCM syndromes and laboratory indicators:Increasing BUN increased the risk of Qi deficiency syndrome,and the difference was statistically significant(P<0.05).The reduction of ALB increased the risk of blood deficiency syndrome,and the difference was statistically significant(P<0.05).The decrease of eGFR increased the risk of water wetness syndrome,and the difference was statistically significant(P<0.05).?Correlation between the various stages of DKD and TCM syndromes:Among the four primary deficiency syndromes,DKD ? is correlated with yin deficiency,and the difference was statistically significant(P<0.05).DKD V is correlated with blood deficiency,and the difference was statistically significant(P<0.05).Among the twelve stagnant syndromes,DKD? is correlated with the syndromes of stagnation-heat,heat-toxic,lier-yang,qi-stagnation,blood-stasis,and phlegm-heat,and the difference was statistically significant(P<0.05).DKD? is correlated with stagnation-heat,and the difference was statistically significant(P<0.05).DKD ? is correlated with phlegm-dampness,water-dampness,fluid-retention,dampness-turbidity syndrome,and the difference was statistically significant(P<0.05).?The distribution of three yin and three yang constitutions:Among 300 cases of DKD?-?,Jue-yin physique:113 cases(37.67%),Shao-yang physique:106 cases(35.33%),Yang-ming physique:57 cases(19%),Shao-yin physique:9 cases(3%),Tai-yin physique:9 cases(3%),and Tai-yang physique:6 cases(2%).Among them,Jue-yin physique,Shao-yang physique and Yang-ming physique are more common in DKD,while Tai-yang physique,Tai-yin physique and Shao-yin physique are rare.?The correlation between DKD stages and three-yin three-yang physiques:DKD ? is correlated with Yang-ming physique and Shao-yang physique,and the difference is statistically significant(P<0.05).DKD ? is correlated with Yang-ming physique and Shao-yang physique,and the difference is statistically significant(P<0.05).There was no obvious correlation between DKD V and the three yin and three yang physiques,and the difference isn't significant(P>0.05).?Correlation between three-yin three-yang physiques and TCM syndromes:Among patients with DKD ?,those with Yang-ming physique are correlated with heat-toxin syndrome,and the difference is statistically significant(P<0.05).People with Shao-yang physique are correlated with liver-yang syndrome,and the difference is statistically significant(P<0.05).People with Tai-yin physique are correlated with water-dampness syndrome,and the difference is statistically significant(P<0.05).People with Jue-yin physique are correlated with blood-stasis,yin-deficiency,qi-stagnation,liver-yang,blood-deficiency syndrome,and the difference is statistically significant(P<0.05).Among patients with DKD ?,those with Shao-yang physique are correlated with liver-yang syndrome,and the difference is statistically significant(p<0.05).Among patients with DKD?,those with Jue-yin physique are correlated with blood stasis syndrome,liver-yang syndrome,and the difference is statistically significant(P<0.05).Conclusion:?The distribution of syndrome elements changes with DKD staging.There is a certain correlation between the syndrome and laboratory indicators,which provides a basis for the standardization of syndrome.?Physique affects the generation and development of DKD.The research data of this group shows that people with Yang-ming and Shao-yang physique have a higher risk of getting DKD than those with other physique types.?Physical fitness affects the distribution of syndrome elements.Yang-ming physique is related to heat-toxic syndrome;Shaoyang physique is related to liver-yang syndrome;Taiyin physique is related to water-dampness syndrome;Jue-yin physique is related to blood stasis syndrome and liver-yang syndrome.The identification of three yin and three yang physique provides new ideas for disease prevention and treatment based on syndrome differentiation.