| PurposeThrough the analysis of TCM syndrome types of early onset type 2 diabetes patients and the collection of case data,this paper studies the distribution of syndrome types of early onset type 2 diabetes patients,and discusses the correlation between different TCM syndrome types of early onset type 2 diabetes,risk factors and biochemical indicators,with a view to providing theoretical guidance for the clinical syndrome differentiation,prevention and treatment of early onset type 2 diabetes with integrated traditional Chinese and western medicine.MethodThe four diagnostic data of early onset type 2 diabetes patients hospitalized in the Endocrinology Department of the Affiliated Hospital of Traditional Chinese Medicine of Guangzhou Medical University from November 1,2020 to January 31,2023 were collected to determine the TCM syndrome type,collect the general information of patients(name,gender,age,course of disease,body mass index),risk factors(family history of diabetes,smoking history,drinking history,diet,labor situation)and biochemical indicators during hospitalization,SPSS25.0 statistical software was used to analyze the distribution characteristics of TCM syndrome types of the disease and their relationship with the general situation,risk factors and biochemical indicators.P<0.05 was the statistical difference,P<0.01 was the significant difference.Result1.A total of 130 patients with early-onset type 2 diabetes were included in this study,including 99 males(76.15%),31 females(23.85%),and 3.19:1 males(3.19:1 males).The maximum age of 130 patients is 45 years old and the minimum age is 19 years old.The age quartiles are 32,37 and 40.Taking 10 years as a range,there are 2 cases under 20 years old,22 cases between 20 and 30 years old,89 cases between 31 and 40 years old,and 17 cases over 40 years old,concentrated between 31 and 40 years old.74 cases(56.92%)had a disease course of ≤ 1 year,27 cases(20.77%)had a disease course of 2-4 years,and 29 cases(22.31%)had a disease course of ≥ 5 years.2.The distribution of TCM syndrome types of early onset type 2 diabetes patients included in this study from high to low in frequency are: dampness and heat trapping spleen syndrome(40 people,30.77%),yin deficiency and heat excess syndrome(37 people,28.46%),qi yin deficiency syndrome(24 people,18.46%),blood collateral stasis syndrome(15 people,11.54%),yin yang deficiency syndrome(14 people,10.77%).3.There was no statistical difference in the gender distribution of TCM syndrome types(P>0.05).The syndrome of yin and yang deficiency is the largest in age,and there is a statistical difference between the syndrome of damp-heat trapping spleen and the syndrome of yin deficiency and heat exuberance(P<0.05).Early onset T2 DM patients with a course of≤ 1 year accounted for 36.49% and 33.78% of damp-heat syndrome and yin deficiency and heat excess syndrome,respectively,while those with a course of ≥ 5 years accounted for31.03% and 27.59% of both qi and yin deficiency syndrome and yin and yang deficiency syndrome,respectively.4.The average body mass index(BMI)of the patients included this time was 25.66 ±4.30 Kg/m2,of which 85 were overweight and obese,accounting for 65.39%.The median BMI of damp-heat syndrome with spleen entrapment was 28.76 Kg/m2,which was statistically different from other syndrome types(P <0.05).5.Among the risk factors of early onset type 2 diabetes,83 people had a family history of diabetes,accounting for 63.85%;67 people had a high-fat diet,accounting for 51.54%,and 91 people lacked exercise,accounting for 70%,both exceeding 50%.There was no statistical difference among family history,smoking history,drinking history and staying up late syndrome types of diabetes(P>0.05),but there was statistical difference among high fat diet,high sugar diet and lack of exercise syndrome types(P<0.05).Among them,high fat diet and lack of exercise accounted for 43.3% and 39.6% of damp-heat syndrome,which was statistically different from other syndrome types(P<0.05),and high sugar diet accounted for46.3% of yin deficiency and heat excess syndrome,which was statistically different from other syndrome types(P<0.05),6.Taking the syndrome type of traditional Chinese medicine as the dependent variable,BMI and risk factors as the covariates,the logistic regression analysis showed that high fat diet,lack of exercise and BMI were positively correlated with damp-heat syndrome(OR>1,P<0.05),and were the risk factors of damp-heat syndrome;High-sugar diet was positively correlated with yin deficiency and heat excess syndrome(OR>1,P<0.05),and was the risk factor of yin deficiency and heat excess syndrome.7.There was no statistical difference in fasting blood glucose,postprandial 1h blood glucose,postprandial 2h blood glucose,postprandial 2h C-peptide,and glycosylated hemoglobin among TCM syndrome types(P>0.05),but the median of glycosylated hemoglobin of each syndrome type was greater than 10%,with the highest median of 11.8%in yin deficiency and heat excess syndrome.There was a statistical difference between fasting C-peptide and postprandial 1-hour C-peptide in different TCM syndrome types(P<0.05),with the lowest median of yin deficiency and heat excess syndrome.8.There was a statistical difference in triglycerides among different TCM syndromes(P<0.05),with the highest syndrome of damp-heat trapping spleen.There was no statistical difference in total cholesterol,high-density lipoprotein and low-density lipoprotein among different syndrome types(P>0.05),but the syndrome of damp-heat trapping spleen was the highest in total cholesterol and low-density lipoprotein,and the syndrome of damp-heat trapping spleen was the lowest in high-density lipoprotein.9.There was no statistical difference in blood uric acid,blood urea nitrogen,blood creatinine,and estimated glomerular filtration rate(e GFR)among different syndrome types(P>0.05),but blood uric acid was the highest in damp-heat syndrome,blood urea nitrogen and blood creatinine were the highest in yin and yang deficiency syndrome,followed by qi and yin deficiency syndrome,and e GFR was the lowest in yin and yang deficiency syndrome.10.Taking the syndrome type of traditional Chinese medicine as the dependent variable and biochemical indicators as the covariate,the disordered multi-classification logistic regression analysis showed that fasting C-peptide,postprandial 1-hour C-peptide,triglyceride were positively correlated with damp-heat syndrome(OR>1,P<0.05).Conclusion1.The distribution of syndrome types of early onset type 2 diabetes patients from high to low in frequency are: dampness and heat trapping spleen syndrome,yin deficiency and heat excess syndrome,qi and yin deficiency syndrome,blood collateral stasis syndrome,yin and yang deficiency syndrome.It can be seen that early onset type 2 diabetes is mainly manifested as evidence because it is mainly young people.Among them,the early course of the disease is mainly characterized by damp-heat syndrome,yin deficiency and heat excess syndrome,and the later stage is characterized by deficiency of both qi and yin,yin and yang.It shows that with the progress of the disease,the evolution law of the disease changes from positive syndrome to deficiency syndrome.2.Early onset type 2 diabetes is more common in men,and most patients’ BMI is higher than normal.The risk factors of diabetes are family history of diabetes,high-fat diet and lack of exercise.It can be seen that poor diet lifestyle and family inheritance are high-risk factors of early onset type 2 diabetes.In clinical practice,we should increase the publicity and education of diabetes knowledge among young and middle-aged people,encourage a positive and healthy diet lifestyle,and do a good job in screening early diabetes among these highrisk groups.3.The early onset type 2 diabetes patients with damp heat trapping spleen syndrome have a shorter course of disease,a lower age,and are in the early stage of the course.There are many risk factors such as high-fat diet,lack of exercise,and clinical problems such as high BMI,triglycerides,cholesterol,uric acid levels,and insulin resistance.Therefore,in the clinical diagnosis and treatment of early onset type 2 diabetes with damp heat trapping spleen syndrome,attention should be paid to reducing the intake of high-fat food and strengthening exercise,Control body weight,blood lipid and uric acid levels,and improve insulin resistance of patients.4.There are more risk factors of high sugar diet in patients with yin deficiency and heat exuberance syndrome,accompanied by clinical features of poor blood sugar control and lower islet function.Therefore,in the clinical diagnosis and treatment of yin deficiency and heat exuberance syndrome,attention should be paid to reducing the intake of high sugar food,actively controlling blood sugar level,and paying attention to the protection of islet function at the same time.5.The early onset type 2 diabetes with deficiency of both qi and yin and deficiency of both yin and yang has a longer course of disease,a higher age,and is in the middle and late stages of the course.It has the clinical characteristics of high levels of blood urea nitrogen,creatinine,and low levels of e GFR.Therefore,attention should be paid to the protection of renal function in the clinical diagnosis and treatment of deficiency of both qi and yin and deficiency of both yin and yang. |
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