Correlation Between TCM Syndromes Of Diabetic Retinopathy And Ankle-Brachial Index,Visceral Fat And Serum Glucolipid Metabolism

Objective:The purpose of this study was to explore the correlation between TCM syndrome types of diabetic retinopathy(DR)and objective indicators such as the ankle brachial index,visceral fat and serum glucose and lipid metabolism,and to differentiate the syndromes of DR.The objectification and standardization research of DR provides a certain reference basis,and provides new ideas for the prevention and control of traditional Chinese medicine in DR.Methods:The data of 110 DR patients who visited the ophthalmology department,endocrinology department and standardized metabolic disease management center of the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2021 to January 2022 were collected,according to TCM syndromes and fundus pictures,the patients were divided into 4 groups: Qi-yin deficiency syndrome group,Spleen and kidney deficiency syndrome group,Yin deficiency with stasis syndrome group,Phlegm stasis block syndrome group,The ankle brachial index(ABI),visceral fat area(VFA),visceral adiposity index(VAI),subcutaneous fat area(SFA),Fasting plasma glucose(FPG),glycosylated hemoglobin type A1c(Hb A1c),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),and grouped Comparison and multi-class logistic regression analysis.Results:1.There was no significant difference in gender,BMI classification,waist circumference,VAI,SFA,TG and HDL-C among the groups(P>0.05).There was a statistically significant difference in age among the groups.The oldest was the Phlegm and blood stasis syndrome group,followed by the Yin deficiency and blood stasis syndrome group,and the Qi-yin deficiency syndrome group(P<0.05).There were differences in the course of T2 DM among the groups.There was statistical significance(P<0.001),the longest course of T2 DM was in the Phlegm and blood stasis syndrome group,followed by the Yin deficiency and blood stasis syndrome group,the Spleen and kidney deficiency syndrome group,and the Qi-yin deficiency syndrome group(P<0.01)There was a statistically significant difference in ABI among the groups(P<0.001).The lowest ABI value was in the Phlegm and blood stasis syndrome group,followed by the Yin deficiency and blood stasis syndrome group,the Spleen and kidney deficiency syndrome group,and the Qi-yin deficiency syndrome group.There were significant differences in VFA among the groups,the highest VFA was in the Spleen and kidney deficiency syndrome group,followed by the Qi-yin deficiency syndrome group and the Phlegm and blood stasis syndrome group(P<0.05);There were significant differences in FPG among the groups(P<0.001).The highest FPG value was in the Phlegm and blood stasis syndrome group,followed by the Yin deficiency and blood stasis syndrome group and the Qi-yin deficiency syndrome group(P<0.01).There was a statistically significant difference in Hb A1 c between the groups(P<0.05),and the Hb A1 c value in the Phlegm and blood stasis syndrome group was higher than that in the Qi-yin deficiency syndrome group(P<0.01).The TC value of the Phlegm and blood stasis syndrome group was higher than that of the Qi-yin deficiency syndrome group(P<0.05).The LDL-C value of the Spleen and kidney deficiency syndrome group was higher than that of the Qi-yin deficiency syndrome group(P<0.01).2.Results of multi-category Logistic regression analysis: this study has not found any risk factors for DR in Qi-yin deficiency syndrome.The risk factors of Spleen and kidney deficiency syndrome are long course of T2 DM,high VFA value and high LDL-C value;The risk factors of Yin deficiency and blood stasis syndrome are long course of T2 DM and low ABI value;the risk factors of Phlegm and blood stasis syndrome are long course of T2 DM,low ABI value and high TC value.Conclusions:1.DR TCM syndrome types are correlated with ankle-brachial index and visceral fat.ABI value and VFA value can be used as objective reference for DR TCM syndrome differentiation.Among them,low ABI value is a risk factor for Yin deficiency and blood stasis syndrome and phlegm-blood stasis syndrome,and high VFA value is a risk factor for Spleen and kidney deficiency syndrome.2.The TCM syndrome types of DR are correlated with the course of T2 DM,TC and LDL-C,and can be used as objective reference of TCM syndrome differentiation of DR.Among them,long course of T2 DM and high LDL-C value are risk factors for Spleen and kidney deficiency syndrome,Long course of T2 DM is a risk factor for Yin deficiency and blood stasis syndrome.Long course of T2 DM and high TC value are both risk factors for Phlegm and blood stasis syndrome.