Diabetic Retinopathy Study Of TCM Syndrome Characteristics

Objective:Clear The diabetic retinopathy syndrome characteristics of traditional Chinese medicine and TCM syndrome distribution regularity of different disease stages; the main pathological factors, contribute to further reveal the nature of the disease, clinical treatment, obtain better curative effect, provides certain theory basis for TCM, integrated traditional Chinese and Western Medicine effective prevention and treatment of DR.Methods:In2012February to2013February in Department of ophthalmology in Jiangsu Province Traditional Chinese Medicine Hospital were selected80cases of diabetic retinopathy, for the detection of symptoms were recorded and index, fill in the CRF, including systemic symptoms, ocular symptoms, tongue and pulse; vision, fundus,fundus fluorescein angiography and B-mode ultrasonography examination results. According to systemic syndrome, pulse, syndrome differentiation, divided into Yin scorching type, deficiency of qi and Yin, Yin-Yang deficiency, blood stasis blocking the collaterals according to the TCM syndrome type standard; According to the new DR international clinical classification, according to the ophthalmoscope examination,fundus fluorescein angiography and B-mode ultrasonography comprehensive determine the stages of DR, and then discuss patients with diabetic retinopathy syndrome characteristics of traditional Chinese medicine and TCM syndrome distribution regularity of different disease stages.Results：1. In this study, a total of80cases of patients with diabetic retinopathy, including33male patients accounted for41%,47cases of female patients accounted for59%. The age ranged from27to80years old, mean age57.5±10.348years old. The course was1months to40years, the average duration of11.939±7.9265years. Statistical analysis:there was no significant difference between the three kinds syndromes patients of sex and age and course of disease (P>0.05).2. Comparison of diabetic retinopathy proliferative and non-proliferative phase syndrome distribution, the statistical analysis:the overall syndrome NPDR group and PDR group distribution is different, with statistical significance (P<0.05). But the difference in constituent ratio of qi and Yin deficiency type between the two groups has no statistical significance (P>0.05), while to Yin scorching type or Yin-Yang deficiency,the difference in constituent ratio between the two groups were statistically significant (P<0.05), and Yin-Yang deficiency of more significant difference (P<0.01). We can see the NPDR mainly to Yin scorching type, while PDR mainly to the Yin-Yang deficiency type.3. Statistical analysis:a positive linear correlation between DR clinical stage and Syndrome differentiation of TCM (Spearman correlation coefficient=0.395, P=0.000<0.01). The regression equation:Y=0.748+0.330X, variance analysis of regression equation,F=15.606, P=0.000<0.01, suggesting that the regression equation is highly statistically significant.4. The distribution of blood stasis blocking collaterals type comparison:can’t think of mild-to-moderate NPDR group and severe NPDR group type blood stasis blocking collaterals constituent ratio have difference (P>0.05), while the PDR group compared with mild-to-moderate NPDR group, severe NPDR group, blood stasis blocking collaterals type constituent ratio have statistically significant difference (P<0.05), and blood stasis blocking collaterals constituent ratio between the PDR group and mild-to-moderate NPDR group is of more significant difference. Conclusion:1. In this study, three syndrome types in patients gender, age, course of disease have no statistical significance of differences. But because the survey subjects were patients with fundus fluorescein angiography in the Department of Ophthalmology, and the sample size is small, and the patients were found with DM as a starting point, with a strong subjective factors, so can’t jump to conclusions, needs further comprehensive study.2. Blood stasis as pathological products and pathogenic factors always exist in the whole process of diabetic retinopathy, and can cause and aggravate the development of diabetic retinopathy, is one of the important pathological factors of PDR. So promoting blood circulation to remove blood stasis method has important position in the whole diabetic retinopathy treatment process, Correctly grasp the timing and intensity of use of activating blood circulation to remove blood stasis has important significance for clinical.3. We can see the NPDR mainly to Yin scorching type, while PDR mainly to the Yin-Yang deficiency type. a positive linear correlation between DR clinical stage and Syndrome differentiation of TCM. With the diabetic retinopathy retinal change from light to heavy, the development process of the TCM syndrome type by Yin scorching to qi and Yin deficiency to deficiency of Yin and Yang. The DR lesions development is closely related to the evolution of the syndromes sinister and Yang; sinister and Yang, yin-Yang deficiency is the key pathological factors affecting the evolution of DR by nonproliferative to proliferative phase and the prognosis of DR. syndrome differentiation is the essence of TCM, so in the clinical treatment should be to observe the rule of yin and Yang.