Development And Application Of A Diagnostic Scale For Kidney Yin Deficiency In Diabetic Nephropath

Objective:1.Development of scale:As one of the important types of diabetic kidney disease,kidney Yin deficiency is a universal diagnostic scale of kidney Yin deficiency from the existing diagnostic scale of kidney Yin deficiency,which lacks specificity and cannot be fully applied to the quantitative diagnosis of kidney Yin deficiency in diabetic kidney disease.In addition,the existing diagnostic criteria are mostly differentiated from the qualitative level,but have not yet risen to the quantitative level.At present,the unified and recognized diagnostic scale of kidney and Yin deficiency in diabetic kidney disease has not been formed.Therefore,this study developed a quantitative diagnosis scale of diabetic kidney disease and kidney Yin deficiency syndrome to make its diagnosis more objective and standardized.2.Application study of the scale:this study is the preliminary application of kidney Yin deficiency of diabetic kidney disease,discusses the distribution of kidney Yin deficiency in different stages of diabetic kidney disease,and the relationship between the degree of diabetic kidney Yin deficiency grade and different stages,and the four diagnostic information integral statistical analysis,provide objective basis for clinical understanding of the distribution of kidney Yin deficiency in diabetic kidney disease.Methods:1.Development of scale:According to the development procedures and methods of this scale,the quantitative diagnosis standard of kidney Yin deficiency in diabetic kidney disease is formulated.The specific methods and steps are as follows:(1)Clarify the research purpose and set up a working group;(2)include the items through the literature search and book review results,conduct preliminary screening of the items,and do standardized treatment,and establish the entry pool of kidney Yin deficiency syndrome;(3)we screened the items subjectively based on two rounds of Delphi expert consultation method;(4)133 diabetic kidney patients were included,the four diagnosis information was collected,and the frequency analysis method,correlation coefficient method,differentiation analysis method and a coefficient method were objectively screened to form the final scale items;(5)empower the scale items through the combination of expert experience and factor analysis;(6)determine the diagnostic threshold of the scale by using ROC curve;(7)quantified the diagnostic scale of kidney and Yin deficiency of diabetic kidney disease;(8)evaluated the validity of the scale;(9)reincluded 51 patients with diabetic kidney disease,and 3+1 validation mode was used to verify the sensitivity,specificity and judgment accuracy of the scale.2.Application study of the scale:(1)133 patients included in the study scale and 51 patients reincluded in small sample clinical validation were included as the study subjects;(2)the kidney Yin deficiency scale of diabetic kidney disease developed by the study scale was used as the diagnostic criteria,and the patients were divided into kidney Yin deficiency group(109 cases)and non-kidney Yin deficiency group(75 cases)according to the diagnosis threshold of 27.5;(3)In the kidney Yin deficiency group,the total score of<38 is mild,the total score of 38 is<73 was moderate,and the total score of 73 is severe;(4)Collect relevant clinical data of the subjects in the deficiency syndrome of diabetic kidney disease and analyze the distribution of kidney Yin deficiency syndrome in different stages of diabetic kidney disease;(5)Statistical analysis of the information points of four diagnosis of the kidney Yin deficiency syndrome of diabetic kidney disease.Results:1.Development of scale:The final scale items of this study were as follows:wasting,forgetfulness,loose teeth,hot flashes,night sweats,five upset,dry mouth,dry throat,tinnitus,deafness,dry eyes,blurred vision,thin tongue,red tongue,less moss,and fine pulse.To assign the items,the diagnostic threshold of the calculated scale was 27.5,the sensitivity of the scale was 79%,the specificity was 100%,the degree determined by the quartile method was:total score<38 is mild,38 total score<73 is moderate,total score 73 is severe.After the reliability and validity of the scale and the clinical verification of small samples,the sensitivity was 92.59%,specificity 100%and accuracy 96.08%.2.Application study of the scale:(1)Comparison of basic data between kidney Yin deficiency syndrome group and non-kidney Yin deficiency syndrome group:The subjects in the kidney Yin deficiency syndrome group were slightly older compared with the non-kidney Yin deficiency syndrome group(P<0.05).However,there was no statistical difference between the two groups in gender,body mass index,systolic blood pressure,diastolic blood pressure,duration,stage of diabetic kidney disease and the stage of diabetic kidney disease(P>0.05);(2)Statistics on the four diagnosis information points of 184 patients with kidney Yin deficiency,and the points from high to low were:dry throat,dry mouth,hot flashes,night sweats,thin tongue,tinnitus,less moss,less moss,loose teeth,thin body loss,deafness,red tongue,fine pulse,hot heart,dry eyes,blurred vision,and forgetfulness.Conclusions:1.Development of scale:The reliability,validity,sensitivity,specificity and diagnostic accuracy of diabetic kidney disease developed in this study are all high,which makes the diagnostic criteria of kidney Yin deficiency in diabetic kidney disease more objective and unified.2.Application study of the scale:Patients with diabetic kidney disease are more likely to age compared with non-kidney Yin deficiency syndrome.In the four diagnosis information,dry throat,dry mouth,hot flashes,night sweats,thin tongue,tinnitus and deafness have greater diagnostic significance of kidney Yin deficiency in diabetic kidney disease compared with other items.