| Objectives:By analyzing the constitution distribution of patients with type 2 diabetic peripheral neuropathy(T2DPN)and the correlation between different constitutions and homocysteine(Hcy),cystatin C(Cys-C),serum uric acid(SUA)and other indicators,new ideas and objective basis are provided for the individualized prevention and treatment of T2 DPN by Traditional Chinese Medicine(TCM)from the constitutional level.Methods:Selected 249 T2 DPN patients who were hospitalized in the Endocrinology Department of the Affiliated Hospital of Gansu University of TCM from January 2020 to December 2020 and met the criteria of this study.The patients’ constitutions were determined and grouped according to the standard of "Classification and Determination of TCM Constitutions".General data such as name,gender,age,duration of diabetes,BMI,and related indexes such as Hcy,Cys-C,SUA,Hb A1 c,FBG,FINS,TC,TG,HDL-C,LDL-Cwere collected.All observed data were collected and input into the database.SPSS 26.0 statistical analysis software was used to analyze the correlation between TCM constitution and research indicators.Results:1.The distribution of TCM constitution in 249 T2 DPN patients:Qi deficiency consititution in 47 cases(18.9%)> phlegm dampness consititution in 44 cases(17.7%)>Blood Stasis consititution in 38 cases(15.3%)> Yang deficiency consititution in 34 cases(13.7%)> damp heat consititution in 28 cases(11.2%)> Yin deficiency consititution in 27cases(10.8%)> qi stagnation consititution in 18 cases(7.2%)> Special constitution in 8cases(3.2%)> special nature in 5 cases(2.0%).Qi deficiency consititution,phlegm dampness consititution,blood stasis consititution and yang deficiency consititution were the main types.2.In this study,the level of Hcy in patients with blood stasis consititution was the highest,and the difference with other constitutions was statistically significant(P<0.05),Multinomial logistic regression showed that Hcy was positively correlated with blood stasis consititution.The level of Cys-C in patients with Qi deficiency consititutionwas the highest,and the difference was statistically significant compared with phlegm dampness consititution and damp heat consititution(P<0.05).The level of SUA in patients with damp heat consititution and phlegm dampness consititution was higher,and the difference with other constitutions was statistically significant(P<0.05),Multinomial logistic regression analysis showed that SUA was positively correlated with damp heat consititution and phlegm dampness consititution.3.In this study,the level of BMI of patients with phlegm dampness consititution was the largest,and that of patients with Yin deficiency consititution was the smallest,and The differences between the two constitutions and other constitutions were statistically significant(P<0.05),Multinomial logistic regression showed that BMI was positively correlated with phlegm dampness consititution,and negatively correlated with Yin deficiency consititution.The level of HOMA-IR in patients with phlegm dampness constitution was the highest,and the difference was statistically significant with other constitutions(P<0.05).The level of Hb A1 c in patients with Qi deficiency constitution was the highest,and the difference was statistically significant(P<0.05),Multinomial logistic regression analysis showed that Hb A1 c was positively correlated with Qi deficiency constitution.4.In this study,the level of TC in patients with phlegm dampness constitution was the highest,and the difference was statistically significant with other constitutions(P<0.05).The level of LDL-C in patients with damp heat constitution and phlegm dampness constitution was higher,and the difference with other constitutions was statistically significant(P<0.05),Multinomial logistic regression analysis showed that LDL-C was positively correlated with damp heat constitution.There was no significant difference in TG and HDL-C levels among different constitutions(P>0.05).5.In this study,the patients with blood stasis constitution and yang deficiency constitution were older,and there were statistically significant differences with qi stagnation constitution,damp heat constitution and phlegm dampness constitution(P<0.05).There was no statistically significant gender difference among constitutions(P>0.05).The duration of diabetes with Yin deficiency constitution was shorter,and there were statistically significant differences with Qi deficiency constitution and yang deficiency constitution(P<0.05).Multinomial logistic regression analysis showed hat the course of diabetes was negatively correlated with Yin deficiency constitution.Conclusion:1.The TCM Constitution of T2 DPN patients is mainly composed of qi deficiency constitution,phlegm dampness constitution,blood stasis constitution and yang deficiency constitution,In clinical practice,we should pay attention to the application of Tonifying Qi and warming Yang,resolving phlegm and removing dampness,promoting blood circulation and dredging collaterals.2.The level of Hcy lwas positively correlated with blood stasis consititution;The levels of SUA and LDL-C were positively correlated with damp heat consititution and phlegm dampness consititution;The levels of BMI,HOMA-IR and TC were positively correlated with phlegm dampness consititution;The level of Hb A1 c was positively correlated with Qi deficiency consititution.3.Hcy,Cys-C,SUA,age,course of diabetes,BMI,HOMA-IR,Hb A1 c,TC,LDL-C levels can be used as reference indexes for TCM constitution identification of T2 DPN,and guide the guide the clinical application of individualized TCM in the prevention and treatment of T2DPN. |
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