The Relationship Between Obese Patients With Different TCM Syndromes And Serum Thyroid-stimulating Hormone Levels And Related Factors

Purpose:This article analyzes the distribution of different TCM syndrome types of obese patients and compares the correlation between different TCM syndrome types and serum Thyroid Stimulating Hormone(TSH)and other metabolic indicators in obese patients,so as to provide different clinical treatment and prevention or delay.Provide a reference for the occurrence and development of syndrome obesity.Method : We selected obese patients who attended the Endocrinology Clinic of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine between December 2019 and December 2020.Based on the inclusion and exclusion criteria,a total of145 obese patients who met the criteria were included in this study.According to the "Chinese Medicine Clinical Diagnosis and Treatment Terminology and Syndrome Part" and "Chinese Medicine Internal Medicine" and the clinical diagnosis and treatment experience of Professor Wang Mei from the Department of Endocrinology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,obese patients are divided into spleen deficiency and dampness syndrome,spleen and kidney yang deficiency syndrome,Four types of syndromes,gastric heat and dampness syndrome,phlegm and blood stasis syndrome,were used as the basis for grouping.Collect the general condition and clinical information of the four groups of patients,including: age,gender,height,weight,body mass index(BMI),waist circumference(WC),TCM symptoms,tongue and pulse,serum TSH,blood lipids,Liver function,and input case data into Excel table for sorting and classification,using SPSS23.0 software for statistical analysis,counting data using chi-square test for comparison between groups,expressed as number of cases or composition ratio.Measurement data satisfying normal distribution and homogeneity of variance were compared between groups using single-factor analysis of variance,expressed as mean ± standard deviation,and those not satisfied were compared with nonparametric test,which could be expressed as median±interquartile range.Logistic regression analysis was used to compare the correlation between metabolic indexes and TCM syndrome types.P<0.05 was considered statistically significant.Results:1.Statistical results of the distribution characteristics of obesity TCM syndrome types Among obese patients,patients with spleen deficiency and dampness syndrome are the most common clinically,with 51 cases,accounting for 35.17%,30 cases with gastric heat and dampness syndrome,accounting for 20.69%,29 cases with phlegm and stasis syndrome,accounting for 20.00%,and spleen and kidney Yang deficiency syndromes 35 Cases,accounting for 24.14%.2.The statistical results of serum TSH,BMI and WC Serum TSH was positively correlated with BMI(r = 0.180,P<0.05),and there was no correlation between serum TSH and WC(P>0.05).3.Statistical results of serum TSH and gender The average serum TSH level of obese female patients was 3.10 ± 2.04 u IU/ml,the average serum TSH level of male patients was 2.89±2.14 u IU/ml,and the average serum TSH level of women was higher than that of men(P<0.05).4.Statistical results of serum TSH and blood lipids Serum TSH was positively correlated with TG(r = 0.174,P<0.05),and serum TSH was not correlated with TG,HDL-C,LDL-C(P>0.05).5.The statistical results of serum TSH and obesity TCM syndrome types The average serum TSH level of 145 obese patients was 2.99±2.89 u IU/ml.The serum TSH levels of the four groups of patients were as follows: spleen and kidney yang deficiency syndrome(3.72±4.94)>spleen deficiency and dampness syndrome(3.21±1.66)>phlegm and blood stasis Syndrome(2.50±2.35)>Stomach-heat and dampness syndrome(2.25 ±1.20).Among the four groups,the serum TSH level of spleen deficiency and dampness syndrome was higher than that of stomach heat and dampness syndrome(P<0.05),and the serum TSH level of spleen deficiency and dampness syndrome was higher than that of phlegm and blood stasis syndrome,which was significant(P<0.01);spleen and kidney yang The serum TSH level of deficiency syndrome was higher than that of gastric-heat-dampness syndrome,phlegm and blood stasis syndrome(P<0.05),and serum TSH was a risk factor of spleen and kidney yang deficiency syndrome(OR=1.093,P<0.05).6.The statistical results of obesity TCM syndrome types and blood lipids There were statistical differences in TG and HDL-C among the four groups of patients.The TG levels of the four groups of patients were as follows: spleen deficiency and dampness syndrome> spleen and kidney yang deficiency syndrome> phlegm and blood stasis syndrome> stomach heat and dampness syndrome,TG in the stomach heat and dampness syndrome,spleen deficiency dampness syndrome,spleen and kidney yang deficiency syndrome There was a statistical difference between the two groups(P<0.05).The spleen deficiency and dampness syndrome was higher than that of the spleen and kidney yang deficiency and stomach heat and dampness syndrome,and higher than the normal value;the four groups of patients had HDL-C level was higher than that of spleen deficiency and dampness syndrome,stomach heat and dampness syndrome,spleen and kidney yang deficiency syndrome,and there was a statistical difference in pairwise comparison(P<0.05),but the HDL-C levels of the four groups were within the normal range.Conclusion:1.In the clinical TCM classification of obesity,the syndrome of spleen deficiency and dampness is the most common.2.Obese patients with spleen and kidney yang deficiency have the highest serum TSH levels,and serum TSH is a risk factor for spleen and kidney yang deficiency.Clinically obese patients with spleen and kidney yang deficiency should pay more attention to monitoring serum TSH.3.The serum TSH level of women in obese patients is higher than that of men.Female obese patients should pay more attention to the screening of serum TSH.