Abstract
Objective The purpose of this study is to analyze and summarize the syndrome distribution, syndrome evolution, and Chinese herb medicine characteristics of T2D in heat stage. Method In this study, 228 heat-stage T2D patients were divided into three groups based on the course of disease. Group 1 (the course of disease ≤5 years) included 118 patients. Group 2 (5< the course of disease ≤10 years) had 73 patients. Group 3 (the course of disease >10 years) consisted of 37 patients. The main methods used in our study were complex network community partitioning algorithms and Sankey diagram visualization, based on the clinical electronic medical record data we collected. Result In the three groups, the nodes with the highest node degree are all “heat syndrome.” Edge weight between “heat” and “dampness,” “qi stagnation,” “phlegm,” “liver,” and “stomach” is the largest. During the whole course of treatment, 60.17%, 63.01%, and 62.16% of the patients' syndromes in groups 1, 2, and 3, respectively, were ascribed to the heat stage all the time. The patients' syndromes in groups 1 and 2 easily transformed to the syndrome of deficiency of both qi and yin of the spleen and stomach. In group 3, 27% of the patients' syndromes were easily transformed into kidney yin deficiency and qi deficiency and blood stasis syndrome. The largest Chinese herb communities of the patients whose syndromes did not change after treatment in the three groups were all heat-clearing drugs. The proportion of blood-activating drugs in patients with syndrome changes increased significantly after treatment. Conclusion (1) The basic syndrome of T2D patients in the heat stage is liver-stomach heat syndrome. (2) T2D patients in the heat stage tend to deteriorate towards the direction of qi and yin deficiency syndrome. However, the longer the course of the disease is, the more likely it is to deteriorate to the direction of kidney yin deficiency syndrome and blood stasis syndrome. (3) Drugs that can help T2D patients in the heat stage to maintain their condition stably are heat-clearing drugs represented by Coptis chinensis, which usually need to be combined with warming interior drugs such as Zingiberis Rhizoma and Pinelliae Rhizoma.
Highlights
Type 2 diabetes (T2D), namely, “xiaoke” of TCM, is a chronic and complex disease with diverse etiologies, long course, and different stages
(3) Drugs that can help T2D patients in the heat stage to maintain their condition stably are heat-clearing drugs represented by Coptis chinensis, which usually need to be combined with warming interior drugs such as Zingiberis Rhizoma and Pinelliae Rhizoma
In TCM, we concluded that diabetes had four different pathological stages based on clinical symptoms and manifestations, namely, stagnation stage, heat stage, deficiency stage, and injuring stage [1]. e heat stage is equivalent to the heat stage-to-mid period of diabetes and indicates the attack of disease [2]. erefore, the heat stage is an extremely critical stage in the development of T2D. e study in [3] had shown that T2D patients in the heat stage are mostly obese, and the main syndrome is excess heat syndrome, but the specific type and the evolution direction of heat syndrome had not been explained clearly at present
Summary
Type 2 diabetes (T2D), namely, “xiaoke” of TCM, is a chronic and complex disease with diverse etiologies, long course, and different stages. Considering the irreversibility of the increase in the course of the disease, at the key treatment point of the heat stage, if we can make clear the evolution direction of the syndrome of patients with different courses of disease and use effective Chinese herb medicine to treat them pertinently, it will be of great help to prevent the aggravation of the disease or even to reverse the current poor state of the disease. Based on the above situation, this study mainly uses complex network community discovery algorithm and Sankey diagram to find out the syndrome evolution and Chinese herb medicine characteristics of T2D patients with different courses of disease in TCM heat stage, so as to provide reference for clinic
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