Distribution Of TCM Syndromes And Its Related Factors In Diabetic Lower Extremity Vascular Lesions

Purpose:To explore the influencing factors of diabetic lower extremity arterial disease(DLEAD) by analyzing the clinical data of patients with DLEAD and diabetic non-lower extremity arterial disease, so that we can prevent it earlier. To provide reference for the standardization of TCM Syndrome Types and clinical syndrome differentiation and treatment,we studied the distribution characteristics of TCM syndrome types of DLEAD, and analyzed the relationship between the common TCM syndromes and the outcome measures.Material and method:In this article, a prospective study was used to collect the patients with diabetes mellitus(DM) in Department of Endocrinology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from November 2015 to February 2016.Patients were divided into Qi and Yin deficiency with blood stasis、Damp heat trapping spleen and blood stasis, Yin and Yang deficiency with blood stasis type, Yin deficiency and excessive heat with blood stasis referring to the diagnostic criteria of the guidelines for clinical research of new drugs of traditional Chinese medicine in 2002, combined with the clinical diagnosis and treatment in the Department of endocrinology of our hospital.The sex, age, duration of diabetes, BMI, WC, TG, TC, LDL, HDL, Hb A1 c, and complications of the patients were recorded.Using SPSS17.0 statistics software to establish database for statistical analysis.Results:1.The total number of cases was 246, Among them,there were 185 cases with DLEAD and 61 cases without DLEAD.male 140 cases, female 106 cases, aged between 31-81 years old, the course of disease between 1-35 years. The average age of the DLEAD group was(63.43±8.73)years old,significantly greater than control group, and the average duration were longer(17.16±8.18 years), WC values were larger(91.11±10.70cm),the difference was statistically significant(P <0.05).The values of TG, TC, LDL, Hb A1 c in group DLEAD were higher than control group,but HDL, C-peptide 0min, C-peptide 120 min were lower than patients in control group,the difference was statistically significant(P <0.05),There was no significant difference between the two groups in BMI and gender(P>0.05).2.Among the 185 patients in DLEAD group, the highest proportion of TCM Syndrome is damp heat trapping spleen and blood stasis type 76 cases(accounting for 41.08%), followed by Qi and Yin deficiency with blood stasis、Yin and Yang deficiency with blood stasis, 55 cases and 50 cases(accounting for 29.73% and 27.03%), the least proportion is Yin deficiency and excessive Heat with blood stasis type, only four cases(accounting for 2.16%).3.Compared with damp heat trapping spleen and blood stasis,the patients of Yin and Yang deficiency with blood stasis type with the longest course of the disease(14.90±5.72 years). damp heat trapping spleen and blood stasis were higher than the patients of Yin and Yang deficiency with blood stasis 、Qi and Yin deficiency with blood stasis in terms of BMI and WC(26.66±2.67kg/m2﹑95.27±13.91cm),(P < 0.05),there was no significant difference in the mean age of each syndromes(P > 0.05).4. The value of TG was higher in damp heat trapping spleen and blood stasis than in patients with both Yin and Yang deficiency with blood stasis type, but the value of HDL was lower.The value of TC was higher in damp heat trapping spleen and blood stasis than in patients with both Qi and Yin deficiency with blood stasis type, the difference was statistically significant(P<0.05),in LDL,There was no statistical significance in the value of C-peptide 0min,C-peptide 120 min and Hb A1 c amomg each syndromes(P>0.05).5.With regard to the incidence of concomitant disease and complications.in DLEAD group, the highest proportion was diabetic peripheral neuropathy with 156 cases(accounting for 84.32%), followed by hypertension with 126 cases(accounting for 68.11%), coronary heart disease with 67 cases(accounting for 36.22%).Conclusion: 1.The occurrence of DLEAD may be related to patients with old age 、long duration of diabetes and the abdominal obesity.2.Lipid abnormalities, poor islet function and poor glycemic control may promote the occurrence of DLEAD in a certain extent.3. The distribution features of TCM syndrome type in DLEAD were as follows:Damp heat trapping spleen and blood stasis >Qi and Yin deficiency with blood stasis > Yin and Yang deficiency with blood stasis type>,Yin deficiency and excessive heat with blood stasis;Damp heat trapping spleen and blood stasis is the most common TCM type in DLEAD and more closely related to BMI, WC, dyslipidemia;Yin and Yang deficiency with blood stasis type was more affected by diabetes course of disease and dyslipidemia.4.The prevalence of diabetic peripheral neuropathy and hypertension were higher in DLEAD patients.