Traditional Chinese Medical Syndrome Distribution And Serum Prolidase In Patients With Diabetes Peripheral Neuropathy

Objective:The first study provided a basis for DPN’s treatment according to syndrome differentiation, through a retrospective analysis of TCM syndrome and syndrome type change of peripheral neuropathy of471type2diabetes mellitus inpatients in Jiangsu Province Traditional Chinese Medicine Hospital and investigating the regularities of distribution and the pathogenesis of DPN’s TCM syndrome type. The second study explored the clinical significance through detecting the changes of PLD level of early type2diabetes mellitus and type2diabetes peripheral neuropathy and analyzing the influencing factors.Methods:Case-control study was employed. Cases in the first study obtained from471type2DPN hospitalized patients of Jiangsu Province Traditional Chinese Medicine Hospital, from Feb2011to May2012. Of them253are males and218are females who were16-88years, mean60.01±12.03years, the mean duration was99.92±84.93months. Sum up the corresponding TCM syndrome type and analyzed the regularities distribution through the acquisition of age, sex, DM course, TCM symptoms and tongue and pluse, etc. Cases in the second study obtained from type2diabetes mellitus patients of Jiangsu Province Traditional Chinese Medicine Hospital, from Sep2012to Jan2013. The cases were divided into DPN Group (38Cases) and early DM Group (33Cases) according to whether there is DPN. Collect general information, serum PLD and other blood and urine biochemical indexes of patients and completed the electrophysiological examination and Toronto score. Analyzed the PLD level different and influence factors between the two groups.Results:The first study:(1) The frequency of various TCM Syndrome of DPN are in the following descending order: stagnation of blood> syndrome with yin asthenia>yang deficiency syndrome> syndrome of deficiency of QI> Phlegm dampness (heatness) syndrome.Sum up in4main types of syndrome, deficiency of yin with phlegm stagnation (59cases,12.5%), deficiency of qi with phlegm stagnation, deficiency of both qi and yin with phlegm stagnation (89cases,18.9%), yin-yang deficiency with phlegm stagnation (189cases,40.1%), respectively.(2) The relationship among TCM syndrome type and different age and diabetes course:Compared with group of≤60years, the deficiency of qi and yin symptom or with phlegm stagnation was significantly reduced(P<0.01), and the deficiency of yin and yang symptom or with phlegm stagnation was significantly increased(P<0.01) in group>60years. Compared with Group DM course<5years, deficiency of yin or both with phlegm stagnation, deficiency of qi and yin or with phlegm stagnation was significantly reduced(P<0.01, or P<0.05), and yin-yang deficiency or with phlegm stagnation was significantly increased (P<0.01) in Group DM course≥10years. Compared with Group DM course5-10years, the scale of deficiency of qi and yin or with phlegm stagnation was significantly reduced (P<0.05).The second study:(3) Compared with Group early DM, the PLD level of Group DPN Significantly reduced, TCSS increased significantly (P<0.01). The PLD level of males in Group DPN was lower than that in control group (P<0.05). TCSS grade of males and females in Group DPN both accordingly higher than that in control group and there was a significant difference (P<0.01).(4) Kendall correlation analysis showed:The correlation about Serum PLD and purine trione was negative(P<0.05). The correlation about Serum PLD and metabolic parameters TC, TG,60’PG and120’PG was positive(P<0.05-0.01). The correlation about Serum PLD and neurotrophic agent and/or aldose reductase inhibitors and/or applying of drugs improving microcirculation (Mecobalamine and/or Pancreatic kininogenase enteric-coated tablets and/or Epalrestat) was positive(P<0.05). The correlation about Serum PLD and sensory conduction velocity of the left ulnar nerve was negative(.P<0.05).(5) Multiple stepwise regression showed:the drugs of improved DPN,uric acid,the right side of sural nerve distal latency,the right side of ulnar nerve motor conduction velocity was independent risk factors of serum PLD.Conclusion:(1) Distribution of TCM syndrome type of471Cases of Type2diabetes mellitus DPN was: yin-yang deficiency or with phlegm stagnation syndrome>deficiency of qi and yin or with phlegm stagnation syndrome> deficiency of qi or with phlegm stagnation syndrome=deficiency of yin or with phlegm stagnation syndrome.(2)Compared with early DM Group, the serum PLD level of DPN Group significantly reduced.(3)PLD and collagen metabolism have close relationship with the development and progression of DPN.Related mechanism needs further study.