Retrospective Study On Risk Factors And TCM Syndromes Characteristics Of Diabetic Macular Edema

Objective : Extraction of Chengdu university of traditional Chinese medicine hospital clinical scientific research information sharing system in diabetic retinopathy,diabetic retinopathy,DR)in hospitalized patients(disease information,establish the underlying database,and the macular OCT image data set up independent database,logistic regression analysis method is applied to research on the origin and development of diabetic macular edema independent risk factors,the characteristics of TCM syndrome distribution and its influence on the severity of DME,for DME provide certain evidence-based basis for clinical prevention and treatment of traditional Chinese medicine.Method:Collected in January 2014-December 2016,Chengdu university of traditional Chinese medicine hospital clinical information of DR patients,in accord with a standard case 265 cases,with 183 cases patients with DME,82 cases of patients with DME.All of the patients information and macular disease and OCT measurement data set up by the professional export and Excel database(mainly include: basic information,personal history,family history,complained of quartering,past medical history,disease,physical and chemical index,signs,routine examination of ophthalmology of traditional Chinese medicine(TCM),OCT,four diagnostic information,etc.),at the same time to inspect the database,orderly and standardized treatment.By SPSS 19.0 software to compare the different thickness of macular DME age,course of the disease,blood pressure,blood lipid,body mass index,fasting glucose,glycosylated hemoglobin,blood routine,urea nitrogen,24 h urine protein and micro albumin etc,Chi-square method is used to compare different visual grading and DR installment of macular thickness difference,and application of logistic analysis method to study the independent risk factors of the macular thickness.Results:1.The study of macular thickness of the risk factors showed that diabetes duration,glycosylated hemoglobin,smoking history,drinking history,past medical history,blood calcium,phosphorus,urea nitrogen,hemoglobin,blood uric acid,total protein,albumin,24 h urine protein and urine trace albumin is macular thickness of the common risk factors.The difference had statistical significance(P<0.005).And age,systolic pressure,diastolic blood pressure,body mass index,erythrocyte,potassium,creatinine,fasting blood sugar,cholesterol,triglycerides,high-density lipoprotein cholesterol(hdl-c),low-density lipoprotein cholesterol(ldl-c)had no effect on macular thickness,there was no statistically significant difference(P > 0.05).2.Classified orderly logistic regression analysis results:Macular thickness four levels(normal group,the mild,moderate and severe group)as the dependent variable,the single factor(P < 0.05 indicators as independent variables,logistic regression analysis,the regression results show that drinking(r = 2.915,P = 2.915),high uric acid(r = 0.004,P = 0.004),high glycosylated hemoglobin(r = 0.169,P = 0.169)were independent risk factors for the development of DME.3.TCM symptoms and syndrome factor analysis:(1)The different TCM symptoms in patients with macular thickness distribution from high to low top 3 is: Normal group:languid(56%),less gas lazy words(51%),and extremities numbness(45%);Mild group: less gas lazy words(58%),and extremities numbness(50%),tooth is loose hair loss(44%);Moderate group: less gas lazywords(53%),five upset hot insomnia(45%),and extremities numbness(45%);Severe group: sublingual collaterals circuity(67%),extremities numbness(59%)and skin fault(59%).The DME distribution results of TCM symptoms show that have nausea and vomiting,tinnitus,deafness,rou GUI cold pain,oral,dim complexion,chest pain,dark purple face amount of foot edema,frequent urination,night to urinate,yellow greasy coating on the tongue,pain has its place,languid,night sweats,insomnia,much dream,the skin of a fault,dim vision than patients with no symptoms of the patients with more serious degree of macular edema(P < 0.05),the difference was statistically significant.(1)The different TCM syndrome factor of macular thickness distribution is from high to low respectively is: Normal group: Yin deficiency(82%),deficiency(62%),heat and humidity(49%),blood stasis(35%);Mild group: Yin deficiency(74%),deficiency(45%),blood stasis(39%)and phlegm turbidit(27%);Moderate group(n=53): blood stasis(53%),phlegm turbidity(53%),Yin deficiency(49%),deficiency(49%);Severe group(n=46): blood stasis(80%),phlegm turbidity(67%),Yin deficiency(63%)and Yang deficiency(54%).Conclusion:1.The DME risk factors include: DR course,drinking,smoking,hemoglobin,uric acid,glycosylated hemoglobin,blood calcium,phosphorus,urea nitrogen,total protein,albumin,24 h urine protein and urine trace albumin and hypertension,hyperlipidemia,diabetes,kidney disease,coronary heart disease,diabetes peripheral neuropathy.Independent risk factors for the development of DME incude: Drinking,high uric acid and high glycosylated hemoglobin.2.DME is closely related to the severity of DR,and DME can occur at any stage of DR,but with DR severity is not parallel.3.Blood stasis and phlegm dampness were closely related to the degree of DME.Patients with DME showed blood stasis syndrome and phlegm dampness syndrome,and the degree of DME was more severe.With thickeniess incrieasing,TCM symptom of Patients with D ME from qi and Yin deficiency syndrome evolution of blood stasis phlegm dampness syndromes.