Diabetic Foot Of TCM Differentiation Types Related Influencing Factors And The Correlation Study Of Wagner Grading

Objective:To explore the influence factors of TCM differentiation types in diabetic foot and the correlation study of wagner grading,severe diabetic foot,toe/limb risk factors.Methods:Selected from 2012 to 2016 in shandong provincial hospital endocrinology in hospital,included in the standard,270 patients with diabetic foot,the data were retrospectively analyzed.Classified in two Logistic regression analysis to determine the occurrence of heavy diabetic foot and cut toe/limb risk factors.Results:(1)270 cases of diabetic foot patients,male to female ratio is:1.4:1,91.5% of the patients were greater than or equal to 51 years old,87.4% of the patients with diabetes duration>5years,91.1% of the patients with glycosylated hemoglobin(HbA1c)>6.5%.(2)Many complicated with diabetes peripheral neuropathy in patients with diabetic foot,burn/burns(54.7%) is the most common cause of foot ulcer,good hair at digit place(63.7%).(3)Diabetic foot ulcer secretion bacteria culture positive rate was 71.2%.Cut the toe/limbs had occurred in Wagner class 3-5(heavy) patients, qi and Yin deficiency syndrome group was the highest(20.0%).(4)Syndrome of cold-dampness blocking collaterals group the total protein(TP) higher than the other group,serum albumin(ALB) higher than the hot and humid poison severe syndrome group,syndrome of yin injured by heat-toxicity group,qi-yin deficiency syndrome group,qi-yin deficiency syndrome group platelet count(Pt) higher than syndrome of cold-dampness blocking collaterals group,syndrome of static blood blocking blood vessels group,hot and humid poison severe syndrome group,p<0.05.(5)More arterial occlusion of lower limb in syndrome of static blood blocking blood vessels group.(6)Syndrome of cold-dampness blocking collaterals group and syndrome of static blood blocking blood vessels group mainly in Wagner class 0-2(light) of patients,p<0.05;hot and humid poison severe syndrome group and qi-yin deficiency syndrome group mainly in heavy patients,p<0.01.(7)The WBC count is high(OR=1.128,95%CI:1.032~1.233),lower limb artery occlusion rate is high(OR=2.233,95%CI:1.253~3.980) for heavy risk factors of diabetic foot,high hemoglobin levels(OR=0.979,95%CI:0.965~0.993) are the protective factors.(8)High foot osteonecrosis rate(OR=15.491,95%CI:5.016~47.847),lower limb artery occlusion rate is high(OR=2.837,95%CI:1.106~7.275)are risk factors for cutting toe/limb.Conclusion:(1)A long duration of diabetes, blood sugar control deviation, older patients prone to diabetic foot.There are often triggers and pathogen infection.(2)Syndrome of cold-dampness blocking collaterals group,see more at early stage of diabetic foot disease is lighter,its total protein(TP) is higher than other groups;Qi-yin deficiency syndrome group sees more at late diabetic foot,illness,cut the toe/limb rate is higher.(3)High rate of infection, lower limb artery occlusion are heavy risk factors of diabetic foot, foot osteonecrosis and lower limb artery occlusion increases the risk of cutting toe/limb.