Study On Risk Factors Related To T2DH And Analysis Of Medication Rules For Qi And Yin Deficiency Syndrom

Objective:1.The related risk factors for the occurrence of T2DH were investigated in order to construct a diagnostic prediction model,which could provide a basis for clinical early intervention,diagnosis,and prevention.2.Based on Traditional Chinese Medicine Inheritance Auxiliary System(V3.0),the medication rules for treating T2DH and syndrome of deficiency of both qi and yin were analyzed to provide theoretical guidance and effective basis for clinical medication.Methods:1.Two hundred T2DM patients who were admitted to the hospital between January 2020 and December 2022 were included in this retrospective study,after excluding 3 9 cases due to incomplete data.The patients were divided into two groups based on whether they had comorbid HTN:the DH group and the NDH group.Clinical data,including age,gender,BMI,blood test results,and echocardiography results,were collected and analyzed.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for T2DH,and a predictive model was constructed.The predictive model was evaluated comprehensively using the area under the ROC curve,the Ho smer-Lemeshow goodness-of-fit test,and the calibration test,and visualized using a line chart.2.One hundred complete T2DH and syndrome of deficiency of both qi and yin were included in this study.The data were analyzed using the"Traditional Chinese medicine inheritance auxiliary system(V3.0)"software provided by the Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences.The "data analysis" and"prescription analysis" modules were used to analyze and discover the drug rules,and a network visualization graph was obtained by setting an appropriate support number.The complex Kmeans algorithm and regression simulation clustering were used to explore the core combination and potential new prescriptions.Results:1.Comparison between DH and NDH groups:There were no significant differences(P>0.05)in gender,FBG,TC,TG,HDL-C,LDL-C,ALT,AST,ALB,BUN,CK-Mb,IMT,and EF between the two groups.Age,BMI,GHB,GLB,A/G,UA,eGFR,Scr,CK,LDH,MB,LVDD,IVSD,LVPWT,LVM,and LVMI showed statistically significant differences between the two groups(P<0.05).1.2.Construction of a prediction model for T2DH:Based on the results of multifactorial logistic regression analysis,GLB,Scr,LDH,and LVMI were used as predictors to construct the model as follows:3.Evaluation and testing of the prediction model:1)The area under the ROC curve was 0.860,indicating that the prediction model had good discriminative ability.2)The P-value of the Hosmer-Lemeshow goodness-of-fit test was 0.804,indicating that there was no significant difference between the predicted and observed values,and the prediction model has a good level of fit.The calibration curve was close to the ideal curve,indicating that the prediction model had good calibration ability.4.In the prescription of the top 100 commonly used traditional Chinese medicines,there were 208 types of drugs.The most frequently used drugs were dwarf lily turf tuber,milkvetch root and heterophy lly falsestarwort root.The drugs were mainly used for tonifying deficiency,clearing heat,and promoting blood circulation.Most of the drugs had a cold nature,followed by warm and neutral.The taste of the drugs was mostly sweet,and they were mostly related to the liver,lung,and kidney meridians.A total of 43 commonly used traditional Chinese medicine combinations were found.Based on association rules,14 pairs of drugs with high association were obtained.Cluster analysis identified 5 groups of 6 core drug combinations.Among them,group 5 was closest to the regression curve,as determined by the K-means clustering algorithm.Conclusion:1.There were significant differences in Age,BMI,GHB,GLB,A/G,UA,eGFR,Scr,CK,LDH,MB,IVSD,LVPWT,LVM,LVMI,LVM,and LVMI between patients with DH and NDH.2.Elevated levels of GLB,Scr,LDH,and LVMI in T2DM patients are independent risk factors for developing HTN complications.3.A T2DH prediction model was established,which was evaluated to have high discrimination,fit,and calibration abilities.It has certain value for early diagnosis and prevention of the disease and can provide clinical physicians with reference.4.The treatment principle focuses on benefiting qi and nourishing yin,regulating the five viscera,clearing heat and eliminating dampness,promoting blood circulation for removing blood stasis.The combination of dwarf lily turf tuber,heterophy lly fal sestarwort root,milkvetch root,kudzuvine root,figwort root,and danshen root is the core medication combination for treating T2DM combined with HTN of syndrome of deficiency of both qi and yin.