Correlation Analysis Between The Characteristics Of TCM Syndrome Elements And Subfoveal Choroidal Thickness In DR

Objective:To summarize the distribution characteristics of TCM syndrome factors(referred to as“syndrome elements”)of diabetic retinopathy(DR),explore the development rule of the disease,further refine TCM syndrome differentiation,and provide some theoretical reference for TCM diagnosis and treatment of DR;by measuring the subfoveal choroidal thickness(SFCT)of DR patients,analyze the correlation between different stages of DR and SFCT and the influencing factors;at the same time,combined with the syndrome differentiation results of TCM syndrome elements,explore the correlation between syndrome elements and SFCT,and provide theoretical ideas for delaying the disease in clinical practice and further syndrome differentiation and treatment.Methods:From October 2020 to December 2022,302 patients(604 eyes)with type 2 diabetes were diagnosed in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine and consulted by ophthalmology or in ophthalmology clinic and ward,including161 patients(322 eyes)with diabetic retinopathy and 141 patients(282 eyes)with type 2diabetic non-retinopathy.The syndrome factors were investigated,and the basic information of the patients was collected.Clear SFCT was obtained by enhanced depth imaging spectral domain optical coherence tomography(EDI-OCT).Excel database and SPSS 26.0 statistical software were used to statistically describe and analyze the data.Results:1.Distribution of single syndrome factors: The frequency of syndrome factors of disease location in NDR group ranked from high to low,followed by liver,spleen,kidney and lung;the frequency of syndrome factors of disease location in DR group ranked from high to low,followed by liver,kidney,spleen and lung.In the NDR group,the frequency of disease syndrome factors ranked from high to low,followed by qi deficiency,yin deficiency,phlegm syndrome,blood stasis,yang deficiency,and blood deficiency;in the DR group,the frequency of disease syndrome factors ranked from high to low,followed by qi deficiency,yin deficiency,yang deficiency,blood stasis,and phlegm syndrome;2.Distribution of compound syndrome factors: In NDR group,the highest frequency of single syndrome element in disease location syndrome factors was liver,and the highest frequency of combined two syndrome elements was liver + kidney;in DR group,the highest frequency of single syndrome element in disease location syndrome factors was spleen and kidney juxtaposition;the highest frequency of combined two syndrome elements was liver+ kidney;3.SFCT was 274.47 ± 79.48 μm in NDR group and 236.26 ± 60.25 μm in DR group.There was significant difference in SFCT between the two groups(P < 0.05);4.The thickness of SFCT was significantly different between no obvious retinopathy and mild NPDR(P < 0.05),between no obvious retinopathy and moderate NPDR(P <0.05),between no obvious retinopathy and severe NPDR(P < 0.001),and between no obvious retinopathy and PDR(P < 0.001);5.Satisfactory fasting blood glucose control 259.0(216.00-306.25)μm,poor fasting blood glucose control 245.0(201.25-282.00)μm,the difference in SFCT between the two groups was statistically significant(P < 0.05);6.There was no significant difference in SFCT between DR and each disease location syndrome factor(P > 0.05),and there was no significant difference in SFCT between DR and each disease location syndrome factor(P > 0.05),indicating that the disease location and disease location syndrome factor of DR patients had no significant effect on SFCT.Conclusion:1.The syndrome factors of single disease location in NDR group and DR group were mainly liver,spleen and kidney,and the syndrome factors of single disease location were mainly qi deficiency and yin deficiency.2.In the distribution of compound syndrome factors between NDR group and DR group,the syndrome elements of disease location were mainly disyndrome element complex(liver+ kidney)and single syndrome element(liver,spleen,kidney).The syndrome factors of disease in NDR group were mainly single syndrome elements(phlegm syndrome and qi deficiency),and the syndrome factors of disease in DR group were mainly two syndrome elements(qi deficiency + yin deficiency and qi deficiency + blood stasis),indicating that the syndrome factors of disease in DR group were more complex;3.SFCT in DR group was thinner than that in NDR group;4.SFCT is thinner in patients with poor fasting glucose control than in those with satisfactory fasting glucose control,suggesting that blood glucose may be a factor affecting choroidal thickness;5.TCM syndrome factors of the two groups had no significant effect on SFCT;however,different stages of DR had a significant effect on SFCT,and SFCT may be an important parameter for the development of DR.