Objective: To explore the traditional Chinese medicine (TCM) diagnosis and treatment of type 2 diabetes in Tianjin urban population. Methods: A cross-sectional study was conducted on hospital patients with type 2 diabetes in TCM hospitals of different levels in Tianjin from 2003 to 2007. The multiphasic stratified cluster sampling method was adopted in selecting the target hospital. Finally 3 496 patients were selected as the survey sample. Then the constituent ratios of diabetes in different syndrome types were calculated. Results: In this study, the descending sort proportion of TCM syndrome types of type 2 diabetes in Tianjin urban population was deficiency of both qi and yin, stagnation of phlegm-dampness, exuberant heat due to yin deficiency, deficiency of both yin and yang, and blood stasis and qi stagnation. Most of the diabetes patients with deficiency of both qi and yin, deficiency of both yin and yang, and stagnation of phlegm-dampness were older than 60 years. Most of the diabetes patients with exuberant heat due to yin deficiency were 50 to 59 years old, while the diabetes patients with blood stasis and qi stagnation were 40 to 49 years old. The frequency of Danggui (Angelica sinensis) use was high in the diabetes patients with deficiency of both qi and yin; the frequency of Chenpi (Citrus reticulate Blanco) use was high in the diabetes patients with exuberant heat due to yin deficiency; the frequency of Baishao (Radix Paeoniae Alba) use was high in the diabetes patients with deficiency of both qi and yin; the frequency of Gancao (Radix Glycyrrhizae) use was high in the diabetes patients with stagnation of phlegm-dampness; and the frequency of Xingren (Semen Armeniacae) use was high in the diabetes patients with blood stasis and qi stagnation. Conclusion: The main syndrome types of diabetes patients in Tianjin urban area are deficiency of both qi and yin, stagnation of phlegm-dampness and exuberant heat due to yin deficiency. And the patients are mainly older than 50 years. The most frequently used herbs are Danggui (Angelica sinensis), Chenpi (Citrus reticulate Blanco), Baishao (Radix Paeoniae Alba), Gancao (Radix Glycyrrhizae) and Xingren (Semen Armeniacae).

BACKGROUND: The incidence of diabetic peripheral neuropathy (DPN) is affected by various related factors, which can manifeste in patients with simple diabetes mellitus. However, which of these factors are involved in the occurrence of DPN in diabetic patients?OBJECTIVE: To analyze the risk factors for DPN in patients with type 2 diabetes mellitus.DESIGN: A hospital-based one-to-one pair-matched case-controlled investigation.SETTING: School of Public Health, Tianjin Medical University.PARTICIPANTS: Totally 111 outpatients or inpatients with DPN (DPN group) were recruited from the Metabolic Disease Hospital of Tianjin Medical University from December 2002 to November 2003, including 53 males and 58 females. Inclusive criteria: Diagnosed according to the diagnostic standards for diabetes mellitus recommended by American Diabetes Association (ADA) in 1997; Typing for type 2 diabetes mellitus according to the program by ADA in 1997; Decline or disappearance of achilles tendon reflex, knee tendon reflex, etc.; Decline or disappearance of pain sensation and thalposis; Decline or disappearance of diapason vibration sense. Meanwhile, 111 outpatients or inpatients with simple diabetes mellitus were selected as the control group. Informed consents were obtained from all the subjects.METHODS: The patients were investigated at admission or in the outpatient department with self-designed questionnaires, including more than 80 items of general information, past history, family history, etc. The results of laboratory examinations were recorded. The data were catalogized and input into computer. Multivariate conditional logistic regression was used to establish main effect equation for analyzing the risk factors for DNP.MAIN OUTCOME MEASURES: Risk factors for DNP.RESULTS: All the 111 patients with DNP and 111 patients with simple diabetes mellitus were involved in the analysis of results. The protective factors for DNP included higher educational level, intensive treatment, coronary heart disease and tea drinking. The risk factors for DNP included longer duration of diabetes mellitus, poor situation of blood sugar control, treating with insulin, diabetic nephropathy, diabetic retinopathy, history of diabetic ketonemia, more meat intake before diabetes mellitus, vertigo, dryness of skin, hypertension, history of injury, history of smoking, higher waist-to-hip ratio, higher level of blood cholesterol. The results of multivariate Logistic regression analysis showed that the following factors were significantly associated with DPN: longer duration of diabetes mellitus, treating with insulin, vertigo, more meat intake before diabetes mellitus, alcohol drinking and history of injury (operation, frostbite, etc.).CONCLUSION: DPN is related to various risk factors, such as longer duration of diabetes mellitus, treating with insulin, vertigo, alcohol drinking, more meat intake before diabetes mellitus, history of injury, etc., which all can increase the risk of diabetic neuropathy in patients with type 2 diabetes mellitus. Patients and physicians should pay more attention to these risk factors during the course of prevention and treatment.

Objective To explore risk factors of type 2 diabetes mellitus in suburban of Tianjin.Methods A frequently matched community-based case-control study was conducted in Tianjin suburb.The multi-phasic stratified cluster sampling method was adopted.Finally 9 961 people were selected as study subjects.All of 585 patients with type 2 diabetes mellitus were recruited as cases,and 620 persons without type 2 diabetes mellitus were chosen as controls.The two groups were frequently matched by age and sex.Results Family history of diabetes mellitus(OR=2.671),depression(OR=3.759),higher level of BMI(OR=1.502) and WHR(OR=1.740),history of hypertension(OR=2.016),history of hyperlipoidemia(OR=1.867),were risk factors for type 2 diabetes mellitus while increased the risk of type 2 diabetes.And increasing intake of fruits(OR=0.736) was shown to be reversely associated with diabetes mellitus.Conclusions Family history of diabetes mellitus,depression,overweight,central obesity,history of hypertension,history of hyperlipoidemia were risk factors of type 2 diabetes mellitus in suburban of Tianjin,while increasing intake of fruits was shown to be a protective factor of diabetes mellitus.

Objective To evaluate the effects of a comprehensive intervention including regular aerobic exercise and health education on knowledge,attitude,belief,practice (KAP) scores,body mass index (BMI),waist circumferences,blood pressure,serum glucose and lipid levels in middle-aged and elderly people with overweight and obesity.Methods Three resident communities were chosen randomly from Wangdingdi community in Nankai district in Tianjin.Totally 125 overweight people were involved in this study,62 and 63 people were randomly assigned to intervention group and control group respectively.The members of intervention group were asked to participate in aerobic exercise and health education program 3 times per week within 6 months.And control group members received no intervention.Then to evaluate the effects of intervention of regular aerobic exercise and health education by physical examination and questionnaire.Comparison between intervention group and control group was performed using a repeatedmeasures analysis of variance.Results The comprehensive intervention resulted in significant improvement of the KAP scores [13.82 (95％CI:12.42-15.23)] and high-density lipoprotein cholesterol [0.22(95％ CI:0.17-0.28) mmol/L] and reductions in intervention group in body mass index [-0.47 (95％ CI:-0.58-0.36) kg/m2],waist circumference [-4.00 (95％ CI:-5.01--2.99) cm],systolic blood pressure [-11.69 (95％ CI:-13.84--9.55) mmHg] (1 mmHg=0.133 kPa),fasting plasma glucose [-1.21 (95％ CI:-1.55--0.88) mmol/L],triglyceride [-0.06 (95％ CI:-0.25-0.13) mmol/L],low-density lipoprotein cholesterol [-0.48 (95％ CI:-0.62--0.34) mmol/L].Conclusion Regular aerobic exercise and health education program in community can successfully reduce body mass index,waist circumference and some other risk factors related to overweight and obesity.It is effective to improve awareness,physical fitness,change lifestyle for middle-aged and elderly people in the community.

Objective: To study the distribution of sub-health and occupational stress as well as their correlation among middle school teachers in Tianjin, then provide evidences for prevention and control of the status of sub-health. Methods: A total of 3 522 middle school teachers from six districts of Tianjin were recruited with stratified cluster sampling strategy for the investigation of Sub-Health Measurement Scale version 1.0 (SHMS V1.0) and Occupational Stress Inventory-Revised Edition (OSI-R) . Results: Detection rate of sub-health status among Tianjin middle school teachers was 58.55%. Men had significantly lower sub-health detection rate (55.19%) than women (59.71%) . Sub-health detection rate increased with age (P<0.05) , the sub-health detection rate among middle school teachers more than 50 years old was the highest (66.84%) . The mean score of OSI-R was 403.18±41.80 with the scores of 176.00±21.05, 103.17±17.53, and 124.02±20.28 for ORQ, PSQ, PRQ, respectively, which showed significantly difference compared with the occupational stress norm of China (P<0.001) . The mean scores of OSI-R, ORQ, PSQ, PRQ in different health status were significantly different (P<0.001) . The partial correlation analysis between the scores of sub-health and occupational stress of middle school teachers showed that the scores of occupational role and personal strain were negatively correlated with the scores of sub-health state (P< 0.001) , while, there was significantly positive correlation between the scores of personal resource and the scores of sub-health state (P<0.001) . Conclusion Sub-health detection rate of middle school teachers in Tianjin is higher. Effective measures should be taken to appropriately mitigate the occupational stress level of middle school teachers, increase personal resources, and scientific and effective health guidance and education should be strengthened.