Objective Study On TCM Syndrome Types Of Diabetic Foot Ulcer

OBJECTIVE: To explore clinical manifestations,traditional Chinese medicine syndrome characteristics,distribution regularities of TCM about diabetic foot ulcer and the correlation of TCM syndrome differentiation of diabetic foot ulcer and objective indicators,provide some reference for syndrome differentiation of diabetic foot ulcer.METHODS: 140 DFU patients were divided into syndrome of damp-heat with exuberance of virulence and tendon rotten,yin injured by heat-toxicity and collateral stasis,deficient Qi and Yin combined blood stasis,Yin deficiency of both liver and kidney combined blood stasis,Spleen and kidney yang-deficiency combined of phlegm-blood stasis.The general conditions of patients and objective indicators of Chinese medicine were collected to analyze the clinical features and distribution of each syndrome and discuss the relationship between TCM syndromes and objective indexes,using 30 pure type 2 diabetes patients taken as control.RESULTS: 1)We were studied 140 patients with diabetic foot ulcer,there were 90 male cases,50 female cases,man to women was 1.8 to 1.About 73.6% of these patients,have the duration of diabetes more than 5 years.In these patients,foot ulcers local infection rate was 81.4%;Wagner 2 accounted for most,by 37.9%;The number of ulcer?2 accounted for 69.3%.2)The morbidity of the type of qi and blood deficiency was 28.6% which was much higher than other syndrome types in all patients.TCM Syndrome of diabetic foot ulcer was complex as well as various,It typically presents with systemic signs in such aspects as qi deficiency or Yin deficient and local symptoms of qi deficiency with blood stasis also was most common.3)Total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),hemoglobin,and blood albumin levels significantly lower in patients with DFU than simple type 2 diabetes group.The level of Cys-C and hibrinogen in DFU were markedly lower than those in patients of type 2 diabetes.However,the result showed that the level of CRP and PCT of DFU patients with damp-heat with exuberance of virulence and tendon rotten was higher than that of patients with simple type 2 diabetes.4)Compared with other patients,the proportion of male of patients with syndrome of damp-heat with exuberance of virulence and tendon rotten and deficient Qi and Yin combined blood stasis,syndrome of Yin deficiency of both liver and kidney combined blood stasis was older.The level of CRP and severity of the infection of patients with syndromes of damp-heat with exuberance of virulence and tendon rotten with yin injured by heat-toxicity and collateral stasis were higher than other syndromes.Meanwhile the level of PCT of damp-heat with exuberance of virulence and tendon rotten syndrome was higher than other patients,but there was no differences in Wagner classification.The morbidity of ischemic heart disease with syndromes of Yin deficiency of both liver and kidney combined blood stasis,Spleen and kidney yang-deficiency combined of phlegm-blood stasis were the highest.The level of TC with syndrome of deficient Qi and Yin combined blood stasis were lower than other syndromes.The level of TC with Spleen and kidney yang-deficiency combined of phlegm-blood stasis was higher than other syndromes,but the albumin levels lower than other types.5)Multivariate Logistic regression analysis revealed that CRP,blood albumin and infection of classification were major risk factors of TCM syndrome of damp-heat with exuberance of virulence and tendon rotten.The syndrome of deficient Qi and Yin combined blood stasis which major risk factor was low level of TC,and the high level of total cholesterol,reduced blood albumin were an important risk factors for Spleen and kidney yang-deficiency combined of phlegm-blood stasis.CONCLUSION:1)The patients with diabetic foot ulcer were characterized as older age,highly-incidence rates of ulcers with local infection,long duration of diabetes mellitus.2)The clinical symptoms of diabetic foot ulcer was complicated and varied.Another TCM syndrome type with deficient Qi and Yin combined blood stasis was the most common.3)The proportion of men with syndrome of damp-heat with exuberance of virulence and tendon rotten was higher,infection is more serious,and the CRP and PCT level were higher.Age of patients with syndrome of yin injured by heat-toxicity and collateral stasis was much younger,infection is more serious,and the CRP level was higher.Hypolipaemia,hypoalbuminemia,were tended to occur in patients with syndrome of deficient Qi and Yin combined blood stasis,and hypoalbuminemia,hypercholesterolemia were tended to occur in patients with syndrome of Spleen and kidney yang-deficiency combined of phlegm-blood stasis.Age of patients with syndrome of Yin deficiency of both liver and kidney combined blood stasis was older,and cardiovascular disease was tended to occur in patients.4)There is a strong correlation between the TCM syndrome types of diabetic foot ulcers and conventional objective indicators,and it provide some reference for syndrome differentiation of diabetic foot ulcers.