| By observing the ocular function of diabetic patients with different TCM constitutions,the influencing factors of ocular surface function changes in diabetes patients and their correlation with TCM constitution were explored,which provided a theoretical basis for clinical intervention.Methods1.Object400 patients with diabetes in the inpatient department of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine f-rom March 2018 to February 2019 were collected.The questionnaire was used to record the gender,age,time of use of electronic products,type of diabetes,duration of disease,treatment plan and treatment time.Whether there are diabetic complications,systemic underlying diseases,and the Ocular surface disorder index(OSDI)is used to record the scores of the patients' eye discomfort symptoms,and the TCM physical fitness analyzer is used to identify the TCM constitution.2.Ocular surface condition detectionThe Keratograph 5M ocular surface comprehensive analyzer was used to detect the tear film rupture time,non-invasive tear river height,tear film lipid layer thickness,meibomian gland integrity,ocular surface fluorescence staining,etc.Corneal endothelium was used to detect the number of corneal endothelium.The patient' s visual acuity and intraocular pressure were recorded,and the patient was diagnosed with diabetic retinopathy using a slit lamp and an ophthalmoscope.3.Detection of biochemical indicatorsThe patient's glycated hemoglobin is detected and the patient's blood glucose during hospitalization is recorded.4.Statistical methodsStatistical method data were analyzed using SPSS 19.0 software.The frequency distribution table of the count data of each group was compiled.The x 2 test was used to compare the count data groups.The continuous variables were represented by(x±s).The comparison among multiple groups was analyzed by one-way analysis of variance.The influencing factors of diabetes were analyzed by unconditional logistic regression..Statistical tests were performed on both sides,and P<0.05 indicated that the difference was statistically significant.result:1.Among the 400 patients with diabetes mellitus,220 patients with dry eye syndrome,including 118 female patients and 102 male patients,the incidence rate was 55%,the male to female ratio was 1:1.157,and the elderly group was 34.6%.The youth group accounted for 33.6%and the middle-aged group accounted for 31.8%.The middle-aged group was mostly female patients,and the elderly group was mostly male patients,and the differences were statistically significant.2.Among the 220 patients with diabetic dry eye,the TCM physique identification self-help system learned that there were 184 cases of single constitution and 36 cases of physique.Among the single constitutions,Yin deficiency,phlegm and qi deficiency were more than 22.8%,19%and 16.8%,respectively,with special enamel and blood sputum being less,accounting for 2.7%and 3.3%respectively.In this study,the frequency of single TCM constitutional classification of 184 cases of diabetic dry eye was yin deficiency>phlegm-dampness>qi deficiency>yang deficiency>qi stagnation>damp heat>peace and quality>blood sputum>special quality.In the physique of the collateral body,there are five kinds of physiques,which are yin deficiency+qi stagnation+qi deficiency,Phlegm and dampness+qi stagnation,qi deficiency+qi stagnation,accounting for 33.4%,22.2%and 22.2%,respectively.Virtual+Qi Yu+Qi deficiency,dampness+yin deficiency are less,accounting for 11.1%.3.Gender,course of disease,time of use of electronic products,glycemic control,diabetic retinopathy,and chronic complications of diabetes were all factors influencing dry eye syndrome in diabetic patients(P<0.01).4.There was a correlation between gender,disease duration,age and TCM constitution type(P<0.01),electronic product use time,blood glucose control,chronic complications of diabetes,diabetic retinopathy,retinal laser photocoagulation,vitrectomy and There was no correlation between TCM constitution types(P>0.05).Yang deficiency and phlegm dampness are more coumon in male patients.Qi stagnation and physique are more common in female patients;yin deficiency is more common in patients with a disease duration of less than 5 years,and yang deficiency and qi deficiency are more common in patients with a disease duration greater than 5 years.The phlegm-dampness,bloody sputum and special sputum are more common in young people.The qi stagnation is more common in middle-aged people.The yin deficiency and physique are more common in the elderly.5.Compare the tear height,tear film rupture time,ocular surface fluorescence staining,lipid layer thickness grading,meibomian gland integrity score and dry eye symptom score of each TCM constitution type.The results show that patients with different TCM constitution types The difference in fluorescein staining of the ocular surface was statistically significant(P<0.05).There was a significant difference in the fluorescein staining between the plain and the other 8 single physiques(two pairs,P<0.05);qi deficiency and yin There is a difference in the fluorescein staining of imaginary and sputum blood(two-two contrast,P<0.05);tear height,tear film rupture time,meibomian gland integrity score,lipid in different TCM patients There was no significant difference in layer thickness grading and dry eye symptom scores(P>0.05).6.The correlations between the influencing factors and tear height,tear film rupture time,ocular surface fluorescence staining,lipid layer thickness grading,meibomian gland integrity score,and dry eye symptom score were compared.The results showed that male patients had corneal epithelium than female patients.It is more susceptible to injury(P<0.05);the longer the electronic product is used,the higher the fluoroscopy of the ocular surface,the shorter the tear film rupture time,the more likely the corneal epithel ium i5 damaged(P<0.05);the longer the course of the disease,the tear river The lower the height(P<0.05);the worse the glycemic control,the shorter the tear film rupture time(P<0.05);the diabetic dry eye syndromo without diabetic retinopathy is more prone to corneal epithelial damage.(P<0.05);patients with chronic complications of diabetes had shorter tear film rupture time,which was more likely to lead to decreased tear film stability(P<0.05).conclusion:1.The incidence of dry eye in diabetic patients is about 55%,with the elderly being the second,the younger being the second,the middle-aged being the least,the elderly with more males,and the middle-aged people with more females.There is a certain correlation between diabetes and dry eye and traditional Chinese medicine.The common single constitution is yin deficiency,phlegm and stagnation,and qi deficiency.It is more common in yin deficiency+qi stagnation+qi deficiency,phlegm and dampness+qi stagnation.,qi deficiency+qi stagnation.2.Gender,course of disease,time of use of electronic products,blood glucose control,diabetic retinopathy,and chronic complications of diabetes are all influential factors of diabetes dry eye syndrome,and there is a correlation between gender,type of diabetes,duration of disease and TCM constitutiof..3.There is a correlation between ocular surface fluorescence staining and TCM constitution type.Patients with peace and qi deficiency are more likely to have corneal epithelial damage.4.The longer the female and electronic products are used,the more likely the corneal epithelium is damaged in diabetic dry eye patients;the longer the course of the disease,the lower the tear river height;the poor glycemic control,diabetic nephropathy,and diabetes Chronic complications such as peripheral neuropathy can lead to shorter tear film breaks in patients. |
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