| Objective: To observe the clinical characteristics of patients with diabetes complicated with pulmonary tuberculosis,to explore the risk factors of patients with diabetes complicated with pulmonary tuberculosis,and to lay a foundation for early clinical recognition and prevention of patients with diabetes complicated with pulmonary tuberculosis.Logistic regression analysis was used to explore the correlation between TCM syndrome types and objective indicators in patients with diabetes complicated with pulmonary tuberculosis,so as to provide traditional Chinese and western medicine basis for syndrome differentiation and classification in patients with diabetes complicated with pulmonary tuberculosis.Methods: Data of 105 patients with pulmonary tuberculosis and diabetes complicated with pulmonary tuberculosis admitted to the Department of Pulmonary Medicine of Gansu Provincial Hospital of Traditional Chinese Medicine and the Outpatient Department of Traditional Chinese Medicine of Lanzhou Pulmonary Hospital from January 1,2021 to December 31,2021 and meeting the inclusion criteria were retrospectively analyzed.General data,clinical symptoms,laboratory tests and imaging data of patients were collected.SPSS25.0 statistical software was used for data analysis,and P<0.05 was considered statistically significant.The differences in clinical data between the two groups were compared,and the above indicators were successively included in the univariate Logistic regression analysis.The indicators with statistically significant differences were included in the multivariate Logistic regression equation to analyze the risk factors of DM-PTB.The TCM syndrome types of DM-PTB patients were classified and sorted out,and the correlation between the above indexes and TCM syndrome types of DM-PTB patients was further analyzed by Logistic regression.Result:(1)Risk factors: High erythrocyte sedimentation rate(ESR),high activated partial prothrombin time(APTT),high C-reactive protein(CRP),low albumin(ALB),low globulin(GLB),low hemoglobin(HB)and low absolute lymphocyte value(LY)were independent risk factors for DM-PTB(P<0.05).(2)TCM syndrome types of DM-PTB patients: The distribution of TCM syndrome types of DM-PTB was summarized into seven categories,and the frequency of occurrence in descending order was lung Yin deficiency > Qi and Yin deficiency > Phlegm-heat interformation > liver-kidney Yin deficiency > Heat excessive injury to fluid > Yin and Yang deficiency > Yin and Yang deficiency.(3)Comparison of general data among syndrome types: there was no statistical difference in the overall distribution of gender and age among the syndrome types(P>0.05).(4)Comparison of blood routine between syndrome types: the hemoglobin(HB)of phlegm-heat interjunction type was lower than that of liver-kidney Yin deficiency type,and the HB of phlegm-heat interjunction type was lower than that of lung Yin deficiency type;HB of phlegm-heat interjunction type was lower than that of Qi-yin deficiency type.HB of phlegm-heat interjunction type was lower than that of Yin deficiency type;The level of HB in phlegm-heat interjunction type was lower than that in heat-excessive injury-fluid type(P<0.05),but there was no statistical significance in HB distribution among other syndrome types(P>0.05).There were no significant differences in the total distribution of WBC,neutrophil absolute value(NE),LY and platelets(PLT)among all syndrome types(P>0.05).(5)Comparison of coagulation indexes among syndrome types: the D-dimer of lung Yin deficiency type was lower than that of phlegm-heat interjunction type(P<0.05),but there was no statistical difference among other syndrome types(P>0.05).There were no significant differences in APTT and prothrombin time(PT)among the syndrome types(P>0.05).(6)Comparison of ESR,CRP,GLB and ALB among syndrome types: There was no statistical difference in ESR distribution among syndrome types(P>0.05);The CRP of phlegm-heat interjunction type was higher than that of lung Yin deficiency type,liver and kidney Yin deficiency type and Qi Yin deficiency type(P<0.05).GLB of liver-kidney Yin deficiency type was higher than that of heat-excessive injury-fluid type and lung Yin deficiency type(P<0.05).The ALB of phlegm-heat interjunction was lower than that of Yin deficiency and fire deficiency,and the ALB of liver and kidney Yin deficiency was lower than that of lung Yin deficiency,Qi and Yin deficiency,heat excessive injury to fluid,Yin deficiency and fire exuberance,and Yin and Yang deficiency(P<0.05).(7)Comparison of lesion sites among syndrome types: There was no statistical difference in the overall distribution of lesion sites among syndrome types(P>0.05).(8)Comparison of lesion morphology among syndrome types: There was no statistical difference in the overall distribution of lesion morphology among syndrome types(P>0.05).Conclusion:1.High APTT and high CRP are independent risk factors for DM-PTB,and these risk factors are of great significance in preventing PTB patients from transforming into DM-PTB patients.2.TCM syndrome types of DM-PTB patients are mainly lung Yin deficiency and Qi Yin deficiency,which should be distinguished clinically.3.There are differences in objective indicators among TCM syndrome types in DM-PTB patients,indicating that there is an internal relationship between TCM syndrome types and objective indicators.When D-dimer>1.26 or CRP>75.53 or HB<125,the syndrome differentiation is more likely to be phlegm-heat interjoint DM-PTB.There is a high possibility that the syndrome differentiation is liver-kidney Yin deficiency type DM-PTB.In addition to the combination of the four diagnoses,the objective indicators also have a certain reference value,and the relevant clinical examinations can be guided by the syndrome differentiation. |
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