| Objective:To explore the types of traditional Chinese medicine constitution that affect the occurrence of early type 2 diabetic nephropathy.To explore the distribution characteristics of TCM constitution of early type 2 diabetic nephropathy,analyze the relationship between various constitution types,clinical indicators and TCM syndrome types,guide further individualized diagnosis and treatment,and provide objective and scientific theoretical basis.Methods:Patients with type 2 diabetes(UACR<30mg/g,no diabetes complications were found)and 176 patients with early type 2 diabetic nephropathy(UACR:30-300mg/g)were included in T2 DM group and early T2 DN group,respectively.The TCM constitution types of patients in the two groups were determined,and the general conditions of T2 DM group and the general conditions,clinical indicators and TCM syndrome types of early T2 DN group were collected.Clinical data were summarized and analyzed using SPSS26.0statistical software.Results:1.Univariate analysis showed that there were statistically significant differences in age,diabetes course,hypertension history and drinking history between the T2 DM group and the early T2 DN group(P<0.05).2.The constitutions of T2 DM patients were mainly Yin deficiency(34.1%),phlegm-dampness(14.2%),qi deficiency(10.2%)and peace(9.7%),while the constitutions of early T2 DN patients were mainly Yin deficiency(26.1%),qi deficiency(21.6%),blood stasis(17%)and phlegm-dampness(11.4%).Univariate analysis showed that there were statistically significant differences between T2 DM group and early T2 DN group in body constitution distribution in peace and quality,qi deficiency and blood stasis(P<0.05).3.After correcting for age,diabetes course,hypertension history and drinking history by multivariate analysis,it was found that Qi-deficiency mass energy significantly affected the development of early T2DN(OR=2.256,P<0.05).Blood stasis energy significantly affected early T2 DN development(OR=2.385,P<0.05).However,the onset of early T2 DN was not significantly affected by peace and quality(P>0.05).4.Univariate analysis showed that there were statistically significant differences in gender,smoking history,age,SBP,DBP,TC,H-DLC,BUN,Scr,β2-MG,m ALB and UACR between patients with and without Qi-deficiency in early T2 DN patients(P<0.05).Multivariate analysis showed that age could significantly affect Qi-deficiency quality(OR=1.139,P<0.05).DBP significantly affected Qi-deficiency quality(OR=1.089,P<0.05).5.Univariate analysis showed that there were statistically significant differences in SBP,UA,β2-MG and UACR between patients with blood stasis and those without blood stasis in early T2DN(P<0.05).Multivariate analysis showed that SBP could significantly affect blood stasis(OR=0.948,P<0.05).β2-MG significantly affected blood stasis(OR=2.765,P<0.05);UACR significantly affected blood stasis(OR=1.005,P<0.05).6.Univariate analysis showed that in early T2 DN patients,there were statistically significant differences in BMI,TG,Scr and UA between phlegm-dampness patients and non-phlegm-dampness patients(P<0.05).Multivariate analysis showed that BMI could significantly affect phlegm and dampness(OR=1.428,P<0.05).TG significantly affected phlegm and dampness(OR=2.787,P<0.05).UA significantly affected phlegm-dampness(OR=1.013,P<0.05).Scr significantly affected phlegm-dampness(OR=0.947,P<0.05).7.Univariate analysis showed that there were statistically significant differences in age,BMI,TG,β2-MG and UACR between patients with Yin deficiency and those without Yin deficiency in early T2DN(P<0.05).Multivariate analysis showed that BMI could significantly affect Yin deficiency(OR=0.864,P<0.05).TG significantly affected Yin deficiency(OR=0.414,P<0.05).β2-MG significantly affected Yin deficiency quality(OR=0.44,P<0.05).8.In early T2 DN patients,the syndrome of spleen and kidney qi deficiency(33.5%),qi and Yin deficiency(30.1%)and Yin deficiency dry heat syndrome(29%)were more common,while the syndrome of Yin and Yang deficiency(7.4%)was rare.9.Single factor analysis showed that there were statistically significant differences in the distribution of Yin deficiency,Yang deficiency,Qi deficiency and blood stasis among different syndrome types(P<0.05).Patients with Yin deficiency are more likely to have Yin deficiency and heat syndrome,patients with Yang deficiency are more likely to have qi and Yin deficiency syndrome,and patients with qi deficiency and blood stasis are more likely to have spleen and kidney qi deficiency syndrome.Conclusions:1.The physique of T2 DM patients is mainly Yin deficiency,phlegm dampness,Qi deficiency and peace;The constitution of early T2 DN patients mainly consisted of Yin deficiency,qi deficiency,blood stasis and phlegm-dampness.T2 DM patients with Qi-deficiency and blood-stasis are more likely to develop early T2 DN.2.In early T2 DN patients,the proportion of males,smoking history,age,SBP and DBP in Qi-deficiency patients was higher than that in non-Qi-deficiency patients,and the H-DLC in Qi-deficiency patients was lower than that in non-Qi-deficiency patients.BMI,TG and UA were higher in patients with phlegm-dampness than in patients with non-phlegm-dampness,and Scr was lower in patients with phlegm-dampness than in patients with non-phlegm-dampness.The degree of urinary protein and glomerular injury were relatively serious in patients with blood stasis and qi deficiency.The damage of kidney function in patients with Yin deficiency is relatively mild.3.In early T2 DN patients,Qi-deficiency quality is positively correlated with age and DBP,and age and DBP can be used as reference indicators for the identification of Qi-deficiency quality in early T2 DN.Blood stasis was positively correlated with blood β2-MG and UACR,and negatively correlated with SBP.SBP,blood β2-MG and UACR could be used as reference indexes for early identification of blood stasis in T2 DN.Sputum and humidity were positively correlated with BMI,TG and UA,and negatively correlated with Scr.BMI,TG,UA and Scr could be used as reference indexes for early identification of sputum and humidity in T2 DN.Yin deficiency was negatively correlated with BMI,TG and blood β2-MG.BMI,TG and blood β2-MG could be used as reference indexes for early identification of Yin deficiency in T2 DN.4.The TCM syndrome types of early T2 DN patients are spleen and kidney qi deficiency syndrome,qi and Yin deficiency syndrome,Yin deficiency dryness and heat syndrome,while Yin and Yang deficiency syndrome are rare.5.Constitution type is related to syndrome type.Patients with Yin deficiency are more likely to have Yin deficiency dryness heat syndrome,patients with Yang deficiency are more likely to have Qi-Yin deficiency syndrome,and patients with qi deficiency and blood stasis are more likely to have spleen and kidney qi deficiency syndrome. |
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