Analysis Of Related Risk Factors And TCM Syndrome Elements Of Diabetic Retinopathy Complicated With Vitreous Hemorrhage

Objective: To extract the medical record information of inpatients diagnosed with diabetic retinopathy(DR)in the clinical medical record system of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,establish a basic database,and collect the main information of patients with diabetic retinopathy complicated with vitreous hemorrhage(VH)Symptoms,signs and four-diagnosis information,analyze and study the independent risk factors and syndrome elements of DR complicated with vitreous hemorrhage,in order to provide a reference for the Chinese medicine prevention and treatment of diabetic retinopathy complicated with vitreous hemorrhage.Methods: Collect the information of DR patients hospitalized in the ophthalmology and endocrinology department of our hospital from December 2018 to December 2020.According to the inclusion and exclusion criteria,a total of 166 patients with DR were collected and their basic information was entered and an Excel database was established(Mainly include: basic information,history of smoking,history of drinking,history of hypertension,family history,laboratory indicators,routine ophthalmological examination,eye B-ultrasound,fundus color Doppler ultrasound,etc.).The SPSS26.0 software was used to compare the differences between the general conditions of the NPDR group and the PDR group,VH group and non-VH group,such as age,course of disease,past history,and laboratory indicators,and analyze the related risk factors and independent risks of DR complicated with VH factor.At the same time,the main clinical symptoms and pulse conditions of patients with DR complicated with VH were collected,and the syndrome elements were extracted according to the patient’s symptoms and pulse conditions,and the distribution characteristics of the syndromes of DR complicated with VH were summarized.result:1.Among DR patients,the NPDR group is compared with the PDR group,age,diabetes course,fasting blood glucose,glycosylated hemoglobin,triglycerides,total serum cholesterol,high-density lipoprotein,low-density lipoprotein,creatinine,uric acid,urea nitrogen,The differences in drinking history and systolic blood pressure were statistically significant(P<0.05).There were no significant differences in gender,smoking history,hypertension,family history of diabetes,apolipoprotein A,apolipoprotein B,diastolic blood pressure,red blood cell count,and hemoglobin(P>0.05).2.Among patients in the PDR stage,compared with the non-VH group,the course of diabetes,fasting blood glucose,glycosylated hemoglobin,total serum cholesterol,high-density lipoprotein,creatinine,uric acid,and urea nitrogen have statistically significant differences(P<0.05).and gender,history of smoking,history of hypertension,family history of diabetes,history of drinking,age,systolic blood pressure,diastolic blood pressure,low-density lipoprotein,triglycerides,apolipoprotein A,apolipoprotein B,red blood cell count,hemoglobin The difference was not statistically significant(P>0.05).In the multivariate logistic regression analysis,high-density lipoprotein(OR=0.041,95%CI:0.003-0.538),glycosylated hemoglobin(OR=2.283 95%CI:1.338-3.898)Is an independent risk factor that affects the occurrence of VH in type 2 DR.3.Analysis of the distribution frequency of TCM symptoms and syndrome elements:(1)In the early stage of DR complicated with VH,more symptoms include hot flashes and night sweats(12.0%),fatigue(9.2%),irritability(9.2%),anorexia(9.2%),and lack of breath(8.3%).%),numbness of hands and feet(8.3%),insomnia(6.4%),five upset fever(5.5%),and more symptoms in the mid-term are: fatigue(12.1%),sublingual collaterals tortuous(11.1%),Hot flashes and night sweats(8%),cold limbs(7.0%),dry mouth(6.0%),numbness of hands and feet(6%),dry stool(5%),irritability(5%),insomnia and dreaminess(5%),heavy head and body sleepiness(5%);and in the late stage,the sublingual veins are tortuous(23.2%),the head and body are heavy(11.6%),cold limbs are cold(10.4%),and lips are dark(10.4%).9.3%)and frequent nocturia(6.9%).(2)The frequency of pulse conditions in the early stage are as follows: thin pulse(47%),number(26%),astringent(10.5%),string(10.5),rush(2%),slippery(2%),Shen(2%)%),the mid-term distribution is as follows: astringent(30%),fine(20%),number(17%),rush(13%),string(9%),slip(5.5%),Shen(5.5%),And in the later stage: Shen(26%),astringent(26%),slippery(20%),fine heat(15%),rush(8%),number(2.5%),string(2.5%).(3)The frequency distribution of TCM syndrome elements of DR complicated with VH is as follows: Yin deficiency(29.0%)> fire(19.4%)> Qi deficiency(16.1%)> blood stasis(12.9%)> Qi depression(8.1%)> Blood deficiency(6.4%)> phlegm dampness(4.8%)>Yang deficiency(3.2%);blood stasis(28.1%)> Qi deficiency(22.5%)> Yin deficiency(21.1%)> Phlegm dampness(7.0%)> Fiery heat(5.6%)> Qi stagnation(5.6%)> Yang deficiency(5.6%)> Blood deficiency(4.2%),and blood stasis(30.9%)> Phlegm dampness(16.3%)> Yang deficiency(16.3%)in the late stage)> Yin deficiency(14.5%)> Qi deficiency(12.7%)> Qi stagnation(3.6%)> Blood deficiency(1.8%)> Fiery heat(1.8%).in conclusion :1.The course of diabetes,age,systolic blood pressure,glycosylated hemoglobin,fasting blood glucose,triglycerides,total serum cholesterol,high-density lipoprotein,low-density lipoprotein,creatinine,urea nitrogen,uric acid,and history of drinking are NPDR progressing to the process of PDR Related risk factors.2.Comparing the VH group with the non-VH group,diabetes course,fasting blood glucose,glycosylated hemoglobin,serum total cholesterol,high-density lipoprotein,creatinine,uric acid,and urea nitrogen are related risk factors for DR complicated by VH,and glycosylated hemoglobin is DR complicated by VH The independent risk factor for AIDS,high-density lipoprotein is a protective factor.3.As the course of DR complicated with VH progresses,the characteristics of its syndrome elements are gradually changing from yin deficiency and heat to qi deficiency,yin deficiency and then to yin deficiency and yang deficiency.The development characteristics of its syndrome elements are dynamic,while blood stasis This syndrome element runs through the entire course of the disease.