| Based on fully study of previous researches to discuss the relationship between liver and diabetic peripheral neuropathy, this research observed566type2diabetes mellitus patients from Xiamen area in order to find out the prevalence and clinical characteristics of diabetic peripheral neuropathy. In addition, we used the method of syndrome factor to observe the clinical symptoms of144cases of patients with diabetic peripheral neuropathy to discover the chief pathogenesis characteristics of diabetic peripheral neuropathy.Part1The Study on the Clinical incidence and Symptoms of Diabetic Peripheral NeuropathyObjective:To study the prevalence and clinical characteristics of diabetic peripheral neuropathy, providing the basis for further theoretical and clinical research.Methods:The cases with type2diabetes mellitus hospitalized in the First Affiliated Hospital of Xiamen University, from December2011to November2012were for the study, and their western diagnostic of diabetes according to the1999WHO diagnostic criteria for diabetes, peripheral neuropathy lesions with reference to the diagnostic criteria for diabetes Guide2010Edition. We collected the patient’s clinical status, divided patients into diabetic peripheral neuropathy group and non-diabetic peripheral neuropathy group and described datas by the statistical analysis.Results:1There were566cases with diabetes mellitus hospitalized together, including312cases of patients with DPN patients, whose prevalence was55.12%. The average age of the the DPN group was significantly higher than the NDPN group, the former were (60.62±11.02) years old, and the latter were (58.15±14.23) years old, the difference was statistically significant (P<0.05).2Among the566patients, the minimum duration of diabetes mellitus was10 days, and the maximum duration was40years, the average duration of7.5years, the average duration in DPN group was (8±6.87) years, higer than that in NDPN group, the average duration (6.82±7.39) years, there was a significant difference between the two groups (P<0.05).3The male282cases, in whom the DPN group were141cases, and the average age of the DPN group of men was (58.92±11.7) years, higher than that of NDPN group (55.16±14.17) years old, a significant difference between the two groups(P <0.05). The female284cases, female patients in the DPN group of171cases, NDPN group of113cases, and there was no significant difference between the two groups (P>0.05). The age of men DPN population concentrated in50-65years old and women in DPN group from the age of50years old showed growth trend evident and reached the peak by65-year-old.4Among171cases of DPN female patients, the average age was (62.02±11.7) years old, menopause figure represented85.39%, age at menarche was (14.53±2.35) years, and age at menopause was (49.23±4.60) years old, while in NDPN group, among the113cases of female patients, the average age was (61.87±13.47) years old, and age at menarche was(14.22±1.88) years old, age at menopause was (49.53±3.36) years, the comparison between the two groups, the difference was not statistically significant(P>0.05).5Among312cases of DPN patients,171cases treated numbness as the first symptom, associating with tingling sense of ants crawling, burning sensation, itching, fatigue, cold feeling, intermittent claudication, swelling pain and so on.Conclusions:The diabetic peripheral neuropathy patients have high prevalence, most of them are aging, middle-aged women, in patients with diabetic peripheral neuropathy incidence of occult, but clinical studies have found that symptoms of diabetic peripheral neuropathy patients more than those who are asymptomatic, and numb limbs are the chief clinical characteristics.Part2The Study of TCM Syndromes on Diabetic Peripheral NeuropathyObjective:To study the syndromes characteristics of diabetic peripheral neuropathy, and explore the chief pathogenesis characteristics, in order to provide clinical evidence for liver treatment of diabetic peripheral neuropathy.Methods:Diabetic peripheral neuropathy patients from the First Affiliated Hospital of Xiamen University and Xiamen Eye Center were for the study, and their DPN diagnostic criteria and exclusion criteria the same as first part. Collected the patient’s symptoms and signs. And the Four Diagnostics and TCM syndrome element differentiation were used, the former employed Inspection, Auscultation and Olfaction, Interrogation, Feeling Pulse and Palpation, in order to obtain objective evidences and indications of the clinical status. The latter is the procedure to analyse and synthesize such evidences and indications, which supplied by Fujian Traditional Chinese Medicine University. Then we used the statistical methods to study the relationships between liver and the syndromes of DPN.Results:1Among144case DPN patients, the youngest was35years old, and the oldest was80years old, the average age of the DPN patients were (60.28±10.30) years old. Female accounted for52.78%, while men accounted for47.22%. In the age stratification, there were4persons in30-39years old goup,21persons in40-49years old group,54persons in60-69years old group,27persons in70-79years old group, and only1person in80-85years old group. The minimum duration of diabetes mellitus was1.5months, and the maximum duration was30years, the average duration of8.05years, in which the durations less than5years were49cases, between5-9years were38cases,10-19years were44cases, and20-30years were13cases.2The characteristics of the syndromes were numbness, urinate very much at night, blurred vision, pale red tongue, thin coating, white tongue, thready pulse and taut pulse.3There first15syndrome elements of the disease location in DPN patients were respectively the liver, kidney, meridians, spleen, lung, skin, bones, uterus, stomach, heart, tables, gallbladder, mind(brain), bladder and colon. In the Five Parenchymatous Viscera syndrome elements of the disease location, the liver proportion was58.33%, kidney56.94%, spleen21.53%, lung6.94%, heart4.17%. The syndrome elements scores of the liver, kidney were relatively high.4Deficiency syndrome element scores over100were Blood Deficiency, Yang Deficiency, Yin Deficiency and Qi Deficiency. Empirical syndrome element scores over100were Wet, Phlegm and Blood Stasis.5According to the syndrome element of the disease location in liver or not,144DPN patients were divided into two groups, namely, liver group (84cases) and non-liver group (60cases), there were no significant difference of age and gender between the two groups(P>0.05). Blood Deficiency, Yin Deficiency, Yang Deficiency and Qi Deficiency syndrome elemen scores in liver group were higher than that in the non-liver group, the differences were statistically significant (P <0.01, P<0.05, P<0.01, P<0.01). Blood Deficiency, Yin Deficiency and Blood Stasis syndrome elemens positive rate in liver group were significantly higher than that in non-liver group (P<0.01).6The liver showed best positive correlation with Blood Deficiency (Spearman=0.732, P value<0.01). And there was also positive correlation between the liver and Yin Deficiency (Spearman=0.572, P value<0.01).7Compared with non-liver group, patients in liver group had significantly impatient irritability, blurred vision, taut pulse syndromes.(P<0.05, P<0.01, P<0.01).8Compared with non-liver group, patients in liver group had significantly blurred vision, numbness, cold sensation, and tingling pain symptoms (P<0.01, P<0.01, P<0.01).Conclusions:1DPN symptoms are complicate. Liver and kidney are the major syndrome elements of disease locations, but other disease locations may involved in.2Liver Blood Deficiency is one of the main pathogenesis of DPN. |
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