Research On The Distribution Of Symptoms Of Diabetic Peripheral Neuropathy And Its Correlation With Anxiety And Depression

ObejectiveBy observing and collecting clinical case data,this study analyzes the distribution of traditional Chinese medicine(TCM)syndromes and the psychological state of anxiety and depression in patients with diabetic peripheral neuropathy(DPN).The study aims to preliminarily explore TCM Syndromes of DPN and its correlation with depression and anxiety,to make clinicians pay attention to the influence of emotional factors in the diagnosis and treatment of DPN,and provide guidance for the prevention and clinical treatment of DPN.MethodsPatients who met the diagnostic criteria and exclusion criteria of DPN in the Department of Nephrology and endocrinology of Dongzhimen Hospital Affiliated to Beijing University of traditional Chinese medicine from April 2019 to January 2020,were selected as the research objects and collected patient observation forms.The general condition,TCM syndrome score scale,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used as the observation indicators.To investigate the general situation and TCM syndrome distribution of enrolled DPN patients.According to the results of SAS and SDS,the patients were divided into normal emotion group and abnormal emotion group,and the abnormal emotion group was further divided into simple anxiety group,simple depression group and anxiety combined depression group.The general situation and TCM syndrome distribution among the groups were statistically analyzed.SPSS22.0 statistical software was used for statistical processing of the obtained data.Research resultsAmong the 93 DPN patients included in this study,the prevalence of male was higher than that of female,mainly middle-aged and elderly patients,and overweight and obese patients were in the majority.According to the statistics of the frequency of syndromes in DPN patients,it was found that qi deficiency syndrome and yin deficiency syndrome were the most common,while phlegm dampness syndrome and blood stasis syndrome were the highest.The frequency of heat knot syndrome in male was significantly higher than that in female,and the frequency of blood stasis in female was sign ificantly higher than that in male.The proportion of liver-yang hyperactivity syndrome and phlegm-dampness syndrome in the elderly group was significantly higher than that in the middle-aged group.Analysis of SAS and SDS results of 93 DPN patients showed that there were 50 patients with mood abnormalities(53.8%).Among them,simple depression accounted for 34.4%,anxiety combined with depression accounted for 14%,simple anxiety accounted for the least,accounting for 5.4%.The comparison between normal emotion group and abnormal emotion group:In terms of age distribution,the patients in both groups were aged 50-70 years old.In terms of gender composition,the ratio of men and women in the group with normal emotions was 1.69:1,the ratio of men and women in the group with abnormal emotions was 1.63:1.There was no significant difference in gender,age,BMI distribution,diabetescomplications and complications.In terms of TCM syndrome distribution,the proportions of Yin deficiency syndrome,qi deficiency syndrome,blood deficiency syndrome,blood stasis syndrome,hyperactivity of liver-yang syndrome and phlegm dampness syndrome in the emotional abnormal group were higher than those in the emotional normal group,while the heat syndrome of the emotional normal group was higher than that of the emotional abnormal group,but there is no statistical significance.The proportion of depression heat syndrome,damp heat syndrome and yang deficiency syndrome in abnormal mood group was significantly higher than that in normal mood group with statistical difference.The comparison among the abnormal mood groups:In the terms of age distribution,the simple depression group and anxiety combined depression group was concentrated in 50-80 years old,and the simple anxiety group was concentrated 40-70 years old.In terms of gender composition,the ratio of male to female in the anxiety group was 1.5:1,the ratio of male to female in the depression group was 3.6:1,and the ratio of male to female in the anxiety and depression group was 0.3:1.The results indicated that there were statistical differences in gender composition between the anxiety and depression group and the depression group alone.There was no significant difference in the distribution of gender,BMI,diabetes complications and complications between the three groups.In the distribution of TCM syndromes,yang-deficiency syndrome was significantly higher in the group with anxiety and depression than in the group with depression alone.The analysis of TCSS scores and SAS and SDS scores of 93 patients with DPN found that SAS and SDS scores showed an increasing trend with the increase of Toronto score grading,but there was no statistical significance.By analyzing the correlation between TCM syndrome distribution and SAS and SDS scores of 93 DPN patients,it was found that the scores of SAS and SDS were positively correlated with qi depression,depression heat and damp heat.There was a positive correlation between SAS score and yin deficiency and yang deficiency.By analyzing the correlation between TCM Syndrome Distribution and SAS and SDS scores of 93 DPN patients,it was found that SAS score was positively correlated with qi depression syndrome,stagnant heat syndrome,damp heat syndrome,yin deficiency syndrome and yang deficiency syndrome.SDS score was positively correlated with qi stagnation syndrome,heat stagnation syndrome and damp heat syndrome.Conclusions1.In this study,the major syndrome characteristic of DPN patients are deficiency in origin and excess in superficiality.The deficiency mainly consists of qi deficiency syndrome and yin deficiency syndrome,while the excess mainly consists of phlegm-dampness syndrome and blood stasis syndrome.There are significant differences in TCM syndrome distribution among different gender and age groups of DPN patients.2.DPN patients had significant anxiety and depression.The syndrome of depression heat,damp heat and yang deficiency was the obvious syndrome elements of DPN patients with anxiety and/or depression.3.In the syndrome classification of DPN patients,qi stagnation syndrome,heat stagnation syndrome,damp heat syndrome,Yin deficiency syndrome and Yang deficiency syndrome were positively correlated with SAS score.Qi stagnation syndrome,heat stagnation syndrome and damp heat syndrome are positively correlated with SDS integral.It can be known that DPN patients with qi stagnation syndrome,heat stagnation syndrome,dampness heat syndrome,Yin deficiency syndrome and Yang deficiency syndrome are prone to emotional abnormalities.4.In patients with YANG-deficiency syndrome(YANG-deficiency syndrome)with DPN,the number of patients with anxiety combined with depression was significantly higher than those with depression alone.