Research On The Related Factors Of Common Microvascular Disease In Diabetes And The Distribution Of TCM Syndrome Types

Objective:To explore the related factors affecting type 2 diabetes mellitus microvascular disease,distribution of TCM syndromes and the relationship between DR and DN lesion degree,so as to provide clinical help for prevention,early detection,treatment and delay of type 2 diabetes mellitus microvascular disease.Methods:Retrospective study was conducted on all the patients who had been consulted by the ophthalmology department of Dongzhimen hospital affiliated to Beijing university of traditional Chinese medicine from January 2015 to December 2015,and the patients admitted with the first clinical diagnosis of diabetes were selected.Collect the patients' general basic information(name,case number,gender,age,course of the disease,BMI),physical and chemical indicators(HbA1c,24 h urine protein,urine trace albumin,serum creatinine),ophthalmology consultation information,TCM four diagnostic data,etc.According to the diagnostic staging and grading criteria of diabetic retinopathy(DR)and diabetic nephropathy(DN),322 patients were divided into two groups:non-diabetic microangiopathy group(NDMAP group)and diabetic microangiopathy group(DMAP group).The DR group was divided into 3 groups and5 levels:3 groups(NDR group,NPDR group,PDR group);Grade 5:grade 1:no obvious diabetic retinopathy observed in NDR;Grade 2:mild NPDR;Level 3:moderate NPDR;Level 4:severe NPDR;Level 5:PDR.DN can be divided into no DN,stage I,stage II,stage?,stage IV and stage V.The SPSS20.0 statistical software was used for statistical analysis,descriptive statistical analysis was performed on general data,and four-grid chi-square test was used for gender and diabetic microangiopathy.Chi-square test was used for the course of disease,BMI,age of onset,HbAlc,urinary microalbumin and the occurrence of diabetic microvascular diseases,and non-parametric rank sum test was used for the occurrence of 24-hour urinary protein,serum creatinine and diabetic microvascular diseases.The relationship between DR classification and DN staging was analyzed by bivariate correlation analysis.Descriptive statistical analysis was conducted on the syndromes of diabetic microvascular diseases,and chi-square test was usedto analyze whether there were differences between qi and Yin deficiency,spleen and kidney Yang deficiency,phlegm and blood stasis,damp-heat and NDMAP group and DMAP group.Results:1 General data results:among the 322 patients in this study,183 were male and 139 were female,the ratio of male to female was about 1.32:1.The chi-square test of four-grid table was conducted between gender and DMAP incidence respectively,and the difference between the two groups was not statistically significant(P>0.05),suggesting that gender may have nothing to do with the incidence of DR.;2 Chi-square test was used for the course of disease,BMI,age of onset,HbAlc,24-hour urinary microalbumin and the occurrence of diabetic microvascular diseases.The P values of course of disease,HbAlc and uva were all less than 0.05,which was considered as a possible risk factor for DMAP.The P values of age and BMI were both greater than 0.05,suggesting that age and BMI might not be risk factors for DMAP;3 Nonparametric rank sum test was used for the occurrence of 24-hour urinary protein,serum creatinine and diabetic microvascular diseases,and the P values were all less than 0.05,suggesting that 24-hour urinary protein and serum creatinine were risk factors for DMAP;4 The bivariate correlation analysis was used to analyze the relationship between DR classification and DN staging,and it was concluded that Kendall correlation coefficient=0.575,P=0.000<0.01,Spearman correlation coefficient=0.653,P=0.000<0.01.It could be considered that there was a linear relationship between DR classification and DN staging,and the correlation was significant;5 Among the 322 patients with T2 DM,256 were DMAP patients.According to the statistics,there were 10 syndromes in total,which were listed as:Qi and Yin deficiency,phlegm and blood stasis transresistance card 76 cases(29.69%),qi and Yin deficiency sy ndrome 43 cases(16.80%),spleen and kidney Yang deficiency,phlegm stasis transresistan ce 36 cases(14.06%),qi and Yin deficiency,hot and humid embodiment the 35 cases(13.67%),spleen and kidney Yang deficiency,water in the wet stop issuing 21 cases(8.20%),liver and kidney Yin deficiency,hot and humid intrinsic 15 cases(5.86%),liver depressio n,phlegm stasis transresistance spleen deficient 9 cases(3.52%),qi deficiency and blood stasis,hot and humid intrinsic 9 cases(3.52%),spleen and kidney Yang deficiency,hot and humid intrinsic 6 cases(2.34%).There were 6 cases(2.34%)of Yin deficiency with internal heat and blood stasis.Qi and Yin deficiency and spleen and kidney Yang defic iency are the main syndromes of deficiency,while phlegm and blood stasis and dampn ess and heat are the main syndromes of deficiency.There were differences between qi and Yin deficiency,spleen and kidney Yang deficiency,phlegm and blood stasis,damp-he at and NDMAP group and DMAP group.Conclusions:DMAP is a disease in which multiple factors influence each other.Among them,course of disease,HbAlc,uric microalbumin,24-hour urine protein and serum creatinine are risk factors for the occurrence of DMAP,while age of onset and BMI have nothing to do with the occurrence of DMAP.There is a linear relationship between DR classification and DN staging,and the correlation is significant.The top four TCM syndromes of DMAP are deficiency of qi and Yin,mutual obstruction of phlegm and blood stasis,deficiency of qi and Yin,mutual obstruction of spleen and kidney Yang,deficiency of qi and Yin,damp-heat accumulation.