Study On The Distribution Of Non-ischemic Gangrene (muscle Gangrene) Syndrome Of Diabetic Foot And Its Biological Basis

Objective: To investigate the characteristics and distribution of traditional Chinese medicine(TCM)syndromes of non-ischemic gangrene in diabetic foot(Jin Ju).Through the modern testing technology,we can find the biological basis of different syndromes of patients with Jin Ju,and then establish a TCM syndrome differentiation and treatment system with syndromes as the target.It is an objectification,standardization and combination of disease and syndrome for the diagnosis and treatment of TCM syndromes of diabetic foot.And provide an objective reference for research.Methods: Using epidemiological investigation methods to develop epidemiological questionnaires,136 cases of diabetic foot non-ischemic gangrene(Jin Ju)patients were collected from the vascular diseases department of our hospital,using Epi Data data management software build database.Explore the distribution characteristics of TCM syndromes in patients with non-ischemic gangrene(Jin Ju)through factor analysis and clustering statistical methods.The serum of 136 patients with Jin Ju and 68 patients with diabetes mellitus from endocrinology department of our hospital were collected,and blood indexes such as AGEs,IL-8,s VCAM-1 and Hyp were detected,to analyze the correlation between different biological indicators in Jin Ju and different TCM syndromes of Jin Ju.Results: 1.Diabetic foot non-ischemic gangrene(Jin Ju)is mostly male and elderly patients,peripheral neuropathy is its main influencing factor.2.According to the results of factor analysis and cluster analysis,using the method of syndrome differentiation,it is considered that it is more reasonable to classify the TCM syndromes of non-ischemic gangrene(Jin Ju)of diabetic foot into four categories,namely,pattern of dampness-heat toxin,pattern of blood vessels stasis and obstruction,pattern of yin injured by heat toxici,pattern of deficiency of botn qi and blood.Among them,the pattern of dampness-heat toxin is the most,accounting for 33.1% of the total number.3.2h PBG,AGEs,CRP,IL-8,s VCAM-1,WBC,ALB,TC,HDL-C,RBC,HGB in the Jin ju group and the diabetes group,there was a statistically significant difference between the groups.4.2h PBG,CRP,IL-8,AGEs,Peripheral neuropathy,Diabetes course are independent risk factors for the development of non-ischemic gangrene(Jin Ju)in diabetic foot.RBC,ALB are independent protective factors for the occurrence of non-ischemic gangrene(Jin Ju)in diabetic foot.5.The CRP levels of patients withpattern of dampness-heat toxin were significantly higher than other patterns,P<0.05,the difference was statistically significant.The contents of ALB,TC and HDL-C were significantly lower than those of other TCM syndromes.The ALB had a comparison of P<0.05,and the TC and HDL-C had a comparison of P<0.007,the difference was statistically significant.The levels of s VCAM-1 and AGEs in patients with pattern of dampness-heat toxin were significantly higher than those in other pattern groups,but there was no statistically significant.Conclusion: 1.The clinical TCM syndrome of diabetic foot non-ischemic gangrene(Jin Ju)can be divided into 4 types,among which dampness-heat toxin is the mainly pattern.2.The cause of the formation of non-ischemic gangrene(Jin Ju)dampness-heat toxin in diabetic foot is related to Hyperglycemia and persistent inflammatory response caused by disorders of glucose and lipid metabolism in low-nutrition conditions.3.2h PBG,CRP,IL-8,AGEs,Peripheral neuropathy were independent risk factors for non-ischemic gangrene(Jin Ju)in diabetic foot.