Clinical Features Of Diabetic Foot And The Correlation Between Physical And Chemical Indexes And TCM Syndromes

Objective:This study first determined the most commonly used diabetic foot(DF)syndrome differentiation type through literature research,and then discussed the correlation between the clinical features of DF and TCM syndrome differentiation types and the four indicators of blood glucose,blood lipids,uric acid and coagulation.On the one hand,it provides more reliable evidence for the unity of DF TCM syndrome differentiation.On the other hand,it objectively and accurately diagnoses the medical syndrome,and supplements the deficiency of the four diseases.Method:This topic first searches and screens the literature on DF TCM syndromes published in the three major Chinese databases in the past ten years,and statistics the commonly used TCM syndrome differentiation types and common syndrome types to determine the syndrome differentiation used in the clinical research of this topic..Then 117 patients with DF who met the inclusion criteria were selected(30 non-diabetic patients were selected as the control group).According to the clinical symptoms and physical signs of patients with DF,they were identified according to the syndrome differentiation of the literature study.At the same time,basic information of patients was collected,and the first blood tests,blood lipids,liver and kidney function,and four coagulation parameters were taken after admission.Finally,SPSS 21.0 software package was used for statistical analysis of data to study the clinical features of DF and the correlation between different syndromes and physical and chemical indicators.Result:1.Through the literature review,the most frequently occurring DF syndromes were:cold dampness,dampness,heat,blood stasis,venom,and yin deficiency;the six types with the highest frequency of occurrence were as follows:Sheng type(15.1%),blood stasis type(11.8%),heat-toxic flaming type(7.7%),Qi-yin deficiency type(7.1%),cold-resistance type(5.9%),and thermal poisoning(yin)(5.3%);The higher frequency of the evidence is:blood stasis(20.2%),qi deficiency(15.7%),yin deficiency(12.1%),damp heat(11.2%),toxic heat(7.8%),blood deficiency(6.1%)and Yang deficiency(3.5%).2.Among the cases included,the number of male patients was significantly higher than that of females,with a ratio of 2:1 for males and females;71.8%of those aged over 60 years old;and those with previous smoking history and drinking history accounted for 65.5%and 59.8%of the total;Those who had had a history of hypertension,cerebral infarction,and coronary heart disease accounted for 84.6%,65.5%,and 64.1%of the overall population;those with a diabetes duration of 10 years or more accounted for 75.2%of the total.3.Among the included cases,the patients with blood stasis type were the most common,accounting for 31.6%of the total;the rest were:damp heat and toxic type(29.1%)>Qiyin deficiency type(17.9%)>cold dampness type(11.1%)>Thermal poisoning Yin type(10.3%).4.Patients with early DF accounted for only 12%of the total,with the most cases being damp heat and poisonous;medium-term patients accounted for 45.3%of the total,with the most common types of damp heat and blood stasis,and blood stasis type;the number of patients with advanced disease accounted for 42.7%of the total,of which Qiyin Two virtual types are more common.5.The highest FPG was found in patients with overheat poisoning and negative,compared with the other four syndromes(P<0.01).The highest HbAlc was found in patients with overheat poisoning,and it was associated with blood stasis type,damp heat and poisonous type.There were statistically significant differences in the patients with deficiency of both qi and yin(P<0.01).The HbAlc in patients with cold and dampness were higher,and there was a statistically significant difference between the two groups(P<0.05).6.The TG in the DF group was significantly higher than that in the non-DM group,with significant statistical differences(P<0.01).The TC elevation in cold and dampness-resistance type patients was significantly different from that of blood stasis type and heat poison type(P<0.01),and it was statistically significant compared with patients with deficiency of both qi and yin(P<0.05);LDL-C was the highest in cold and dampness-resistance type patients,and there was a statistically significant difference compared with other four groups(P<0.01);DH was higher in damp-heat-toxic type group,and was associated with blood stasis type and thermal toxicity.There was a statistically significant difference between the patients with yin deficiency and deficiency of qi and yin(P<0.05).7.The APTT of the DF group was longer than that of the control group,and the FIB was significantly higher than that of the control group,and the statistical difference was significant(P<0.01).The APTT prolonged in patients with deficiency of both qi and yin was significantly different from that of damp-heat-toxic and cold-to-cold-resistance type(P<0.05).The FIB in blood stasis-resistance patients was higher than that in the other four groups.Significance(P<0.05).8.Uric acid in the DF group was significantly higher than that in the non-diabetic group,with statistically significant differences(P<0.01).The UA in patients with damp-heat-toxic syndrome was higher,and there was a statistically significant difference between patients with yin deficiency syndrome and qi-yin deficiency syndrome(P<0.05),and there was a statistically significant difference compared with blood stasis syndrome(P<0.01).Conclusion:1.With regard to DF TCM syndrome differentiation,each medical family basically reached an agreement on five types of syndromes:dampness,heat,poisonousness,blood stasis,heat poisoning,yin deficiency,qi-yin deficiency,and damp-cold resistance.The DF solid pathogenic factors mainly consisted of blood stasis,heat toxicity,and dampness and heat.Among them,blood stasis was the most common;and the virulence factors were Qi deficiency,yin deficiency,blood deficiency and yang deficiency.2.From the distribution of syndromes,DF patients with blood stasis type are the most common,and the rest are followed by dampness,heat,poisonousness,qi and yin deficiency,cold dampness,and heat poisoning.Diabetic foot patients in the early treatment rate is relatively low,the condition did not cause enough attention.Patients with early DF were mainly characterized by damp heat and poisonous type.In the middle stage,the type of damp heat and poisonous type and blood stasis type were more common.In late stage,the type of deficiency of both qi and yin was dominant.3.Patients with hot poisoning and dia-betic diabetic foot are characterized by elevated FPG and HbAlc,and patients with cold and dampness depressive DF are characterized by elevated HbA1c.4.Lipid metabolism is closely related to the occurrence of DF.Chinese medicine"wetness evil" is an important pathogenic factor of dyslipidemia in DF patients.The TG elevation was significant in patients with damp heat and poisonous type,and the LDL-C and TC levels in patients with cold dampness were significantly increased.5.Patients with diabetic foot have abnormal clotting mechanisms.Deficiency of qi and yin deficiency type DF patients is characterized by the prolongation of APTT;blood coagulation abnormalities in blood stasis type DF patients are often characterized by elevated FIB.6.Elevated blood uric acid is associated with the development of DF.In particular,patients with hot and humid toxin type DF are characterized by elevated uric acid.