Zhongguo linchuang yanjiu (Dec 2023)
Regression analysis of insulin resistance and Chinese medicine syndromes in patients with diabetic kidney disease
Abstract
Objective To analyze the interdependent relationships between insulin resistance (IR) related indicators and Chinese medicine syndromes in patients with diabetic kidney disease (DKD) of stages G2 and A2/3,and to explore rules of Chinese medicine syndromes differentiation in patients with DKD (stages G2 and A2/3). Methods A total of 98 patients with DKD (stages G2 and A2/3) admitted to Nanjing Drum Tower Hospital from January 2015 to December 2016 were retrospective analyzed. The general clinical indexes, the frequency of Chinese medicine syndromes and the distribution of Chinese medicine syndromes type were investigated. Furthermore, IR related indicators including fast blood glucose (FBG), fast insulin (FIN), fast C-Peptide (FCP) and homeostatic model assessment of insulin resistance (HOMA-IR) were examined, respectively. And then, the multivariate regression analysis of IR related indicators and Chinese medicine syndromes was performed. Results Among 98 patients with DKD (stage G2, A2/3), root cause syndrome included 64 cases of spleen-kidney Qi deficiency syndrome, 20 cases of deficiency of both Qi and Yin syndrome, 8 cases of Yin deficiency dryness-heat syndrome, and 6 cases of deficiency of both Yin and Yang syndrome. The clinical manifestation syndrome included 42 cases of blood stasis syndrome, 10 cases of phlegm stasis syndrome, 5 cases of damp-heat syndrome, and 1 case of cold-dampness syndrome. There were 58 cases of complex syndrome types, including 28 cases of spleen-kidney Qi deficiency and blood-stasis syndrome. Compared with non spleen-kidney Qi deficiency syndrome patients, the TG, FIN, FCP and HOMA-IR in patients with spleen-kidney Qi deficiency syndrome were significantly increased (P＜0.05). Logistic regression analysis showed that there was no correlation between Chinese medicine symptoms (frequent or clear urination, fatigue, numbness, and soreness in the waist and knees) and elevated FBG and FIN(P＞0.05). For those with fatigue symptom, the probability of FCP elevation was 7.661 times higher than those without this symptom (P＜0.05). For those with fatigue symptom and frequent or clear urination symptom, the probability of HOMA-IR elevation was 10.787 and 5.911 times higher than those without the symptom, respectively (P<0.05). Conclusion The main Chinese medicine syndrome feature of DKD(G2，A2/3)patients is spleen and kidney Qi deiciency, and its clinical feature is the different degrees of increase in IR related indicators. The increases in IR related indicators have the interdependent relationships with the main Chinese medicine syndromes, and can be considered as the objective syndrome factors of Chinese medicine syndrome differentiation.
Keywords
