| Purpose:In this study,we collected the clinical case data of T2 DM complicated with skin pruritus,and analyzed the related risk factors and TCM syndrome types of T2 DM complicated with skin pruritus by retrospective research method,so as to provide some reference for clinical diagnosis and treatment.Material and method:Patients with Type 2 diabetes mellitus(T2DM)who were hospitalized in the Department of Endocrinology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2019 to April 2021 were selected.According to the course record,the patients were divided into T2 DM group and T2 DM group with pruritus.The statistics include the gender,age,course of disease,BMI,smoking history,drinking history,random blood glucose,Hb A1 c,electrocardiogram,history of cardiovascular and cerebrovascular diseases,genetic history of hypertension,genetic history of coronary heart disease,calcium,phosphorus,Eosinophile granulocyte Count,Basophil Count,hemoglobin,lymphocyte Count,TG,TC,LDL-C,HDL-C,UA,e GFR,MALB/UCR,diabetes complications,and TCM syndrome types.Results:1 Data comparison between the two groups showed statistically significant differences in age,course of disease,HBA1 c,random blood glucose,calcium,combined carotid artery sclerosis(plaque formation)and combined lower extremity artery sclerosis(plaque formation)between the two groups(P<0.05).2 Logistic regression analysis of random blood glucose showed P=0.048<0.05;and the result of logistic regression analysis with carotid atherosclerosis(plaque formation)showed P=0.028<0.05.3 The frequency of complications or comorbidities in patients with 36 cases T2 DM combined itchy skin is Carotid sclerosis(plaque formation)(29 cases)> double lower extremity atherosclerosis(plaque formation)(25 cases)> hypertension(18 cases)> Diabetic peripheral neuropathy(13 cases)> coronary heart disease(12 cases)> Diabetic nephropathy(10 cases)> Diabetic retinopathy(4 cases).4 36 cases patients of T2 DM combined itchy skin had high-to-low syndromes: qi and yin deficiency combined with blood stasis(16 cases)> damp heat entrapped spleen and blood stasis syndrome(10 cases)> yin deficiency fire flourishing syndrome(5 cases)> syndrome of liver stagnation and qi stagnation(2 cases)> syndrome of deficiency of spleen and kidney =syndrome of qi stagnation due to spleen deficiency = symptoms of heat into blood(1 case).5 The pathogenesis factors of 36 patients with T2 DM combined with skin itching included spleen-qi deficiency(18 cases,50%),yin deficiency(21 cases,58.3%),and kidney deficiency(1 case,2.7%);evidence of blood stasis(26 cases,accounting for 72.2%),damp heat(10 cases,accounting for 27.8%),blood heat(6 cases,accounting for 16.7%),qi stagnation(3 cases,8.3%).6 36 cases of T2 DM patients with skin pruritus and 57 traditional Chinese medicines with a frequency of >1 cluster analysis results were divided into four categories: Qi and Yin deficiency and blood stasis syndrome(465 times,52.9%),damp-heat internal accumulation syndrome(153 times,32.9%),Yin deficiency syndrome(37,8.0%),spleen deficiency and blood heat(29 times,6.2%).7 The medication results of 36 T2 DM patients with pruritus included tonic drugs(136,26.8%),blood activating drugs(97,19.1%),heat-clearing drugs(91,18%),and dampness drugs(31,6.1%).Phlegm-resolving and cough-relieving drugs(38,7.5%),antiseptic drugs(29,5.7%),diuretic and dampening drugs(28,5.4%),qi regulating drugs(16,3.2%),anti-epidemic drugs(16,3.2%)),astringent drugs(15,3.0%),hemostatic drugs(3,0.6%),tranquilizers(3,0.6%),rheumatism drugs(2,0.4%),offensive drugs(1,0.2%),flat Hepatic wind medicine(1,0.2%).8 The results of TCM syndrome data analysis showed that the multiple comparison(LSD) in the single-factor ANOVA test showed that there was a difference in BMI between only Qi and Yin deficiency with blood stasis syndrome and damp-heat trapping spleen with blood stasis syndrome(P=0.048<0.05).Conclusion:1 T2 DM with itchy skin associated with age,duration,random blood glucose,Hb A1 c,calcium,merger carotid sclerosis(plaque formation),double lower extremity atherosclerosis(plaque formation),and random blood glucose and carotid atherosclerosis(plaque formation)are related risk factors for T2 DM with skin pruritus.2 Patients with T2 DM complicated with carotid atherosclerosis(plaque formation)are more prone to skin pruritus..3 Qi and Yin deficiency combined with blood stasis syndrome is the main syndromic type of T2 DM complicated with skin pruritus.4 The main pathogenesis factors of T2 DM patients with skin itching are spleen-qi deficiency,yin deficiency,and blood stasis.5 Patients with T2 DM complicated with pruritus are mainly treated with tonics and drugs for promoting blood circulation and removing blood stasis.In terms of treatment,it is in line with Shi Yan's thoughts of strengthening spleen and invigorating qi,nourishing yin and promoting blood circulation in treating T2 DM..6 In T2 DM patients with skin itching,the BMI of patients with damp-heat trapped spleen and blood stasis syndrome is higher than that of patients with Qi and Yin deficiency and blood stasis syndrome. |
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