| Objective: To explore the distribution law of TCM syndromes of diabetic foot(DF),and further analyze the correlation between TCM syndrome differentiation analysis of DF and various physical and chemical indexes.To provide objective and accurate evidence support for DF TCM syndrome differentiation and classification,and to modernize TCM syndrome differentiation,so as to supplement the deficiency of traditional TCM diagnosis of looking,hearing,asking and cutting.Methods: According to the inclusion criteria,68 DF patients hospitalized in the First Affiliated Hospital of XX University from January 2021 to January 2023 were selected as the observation group,and 20 other non-T2 DM patients without major internal diseases were selected as the control group.The data of four diagnostic methods in TCM were collected and classified according to TCM syndrome differentiation.During hospitalization,the physical and chemical indexes such as gender,age,personal history,past history,transcutaneous oxygen pressure(TCP O2),Fasting Blood-Glucose,FBG)and glycosylated hemoglobin A1 c were filled in the DF basic information questionnaire.Finally,the SPSS27.0 software package was used for statistical analysis of the above data to study the correlation between different TCM syndromes of DF and various physical and chemical indexes.Results: 1.There are more male patients with DF than female patients in this study,including 47 male patients and 21 female patients,accounting for 69.1% and 30.8%respectively.Among all DF cases,the youngest is 37 years old and the oldest is 93 years old.There are 51 patients over 60 years old,accounting for 75% of the total,and the number of patients increases obviously with age.2.Among the 68 DF patients included in this study,the proportion of patients who have a history of smoking or drinking is large,including 43 patients with a history of smoking,accounting for 63.2% of the total,and 36 patients with a history of drinking,accounting for 52.9% of the total.3.More than half of the patients in this study had hypertension in the past,reaching 42(61.7%);There were 14 patients with cardiac insufficiency(20.6%).There were 12 patients(17.6%)with previous cerebral infarction.There were 10 patients(14.7%)with previous renal insufficiency.4.The shortest history of diabetes mellitus,T2DM)is 1 year,and the longest history is 40 years.And with the gradual extension of the course of T2 DM,the number of patients is also increasing.Only 10 patients(14.7%)had a course of less than5 years.20 cases(29.4%)had a course of 5-15 years.38 cases(55.8%)were patients with 15 years or more.5.In the distribution of syndrome types,the patients with deficiency of both qi and yin are the most,reaching 21(31%);19 patients(28%)suffered from yin syndrome caused by heat toxin.There were 16 patients with blood stasis syndrome(24%);There are 12(18%)patients with damp-heat toxin syndrome.6.There was no statistical difference in the Tc PO2 value among deficiency of both qi and yin,blood stasis,heat-toxin type and heat-toxin syndrome(R>0.05).Comparing the mean values of each group,the Tc PO2 value of damp-heat toxin syndrome is higher than that of heat toxin damaging yin syndrome > deficiency of both qi and yin syndrome > blood stasis syndrome.The proportion of blood circulation disorder in deficiency of both qi and yin is the highest,which is 80.95%(Tc PO2 value ≤ 40 mm Hg).Followed by blood stasis syndrome,the proportion is 75%(Tc PO2 value ≤40mm Hg).Except the syndrome of yin injury caused by heat toxin,the patients with Tc PO2 values of the other three syndromes are all between 20 and 40.7.The relationship between TCM syndromes of 7.DF and FPG is as follows: excessive damp-heat toxin > blood stasis syndrome > deficiency of both qi and yin syndrome > heat toxin injuring yin syndrome,but there is no statistical difference between the two groups(P > 0.05).The relationship between DF TCM syndrome types and Hb A1 c is: damp-heat toxin excess >deficiency of both qi and yin > heat toxin damaging yin > blood stasis syndrome.There are significant differences between the two groups(P<0.01),but there is no significant difference between the remaining syndromes.8.In the comparison of coagulation function between the two groups,the fibrinogen,FIB),activated partial thromboplastin time(PT)and D-2 polymer in DF group were longer than those in control group,and the FIB was significantly higher than that in control group(P<0.05),suggesting that there was a statistical difference between the two groups.9.Compared with the percentage of white blood cells and neutrophils and hemoglobin,the syndrome of deficiency of both qi and yin is statistically significant(P < 0.01).There was a significant difference in white blood cells between the syndrome of blood stasis and the syndrome of yin injury caused by heat toxin and the syndrome of excessive damp-heat toxin(P < 0.01).There was a statistically significant difference between the deficiency of both qi and yin syndrome and the syndrome of heat toxin damaging yin(P<0.05).Conclusions: Sex(male),bad habits(smoking,drinking),age and duration of T2 DM may be risk factors for DF.2.The proportion of DF patients suffering from hypertension,cerebral infarction,cardiac insufficiency and renal insufficiency is high,which may be related to the disorder of glucose and lipid metabolism caused by age or T2 DM.3.In this study,the patients with deficiency of both qi and yin are the most,while the patients with excess of damp-heat toxin are the least,which may be related to the fact that patients often come to the hospital in the middle and late stage of DF.The proportion of Tc PO2 value lower than the normal level is the highest in the syndrome of deficiency of both qi and yin,suggesting that patients with deficiency of both qi and yin are more likely to have blood supply disorder in the dorsum of feet.Except the syndrome of yin injury caused by heat toxin,the patients with Tc PO2 values of the other three syndromes are all between 20 and 40.4.The patients with damp-heat toxin syndrome are characterized by the increase of FBG and Hb A1c;The average value of FBG in patients with yin injury caused by heat toxicity is the lowest;The mean value of Hb A1 c in blood stasis syndrome is the lowest.The relationship between TCM syndromes of DF is: the syndrome of damp-heat toxin is Hb A1 c > deficiency of both qi and yin > heat toxin hurting yin > blood stasis syndrome,and the statistical differences between blood stasis syndrome and deficiency of both qi and yin and damp-heat toxin syndrome are significant(P<0.01).5.FIB,PT and D-2 polymer in 5.DF group were longer than those in control group.6.Patients with deficiency of both qi and yin are characterized by decreased hemoglobin,while patients with yin injury due to heat toxicity and excessive damp-heat syndrome are characterized by increased percentage of white blood cells and neutrophils. |
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