Correlation Analysis Between TCM Syndrome Distribution And Blood Inflammatory Indexes In Type 2 Diabetic Retinopath

Objective:By explore the correlation between TCM syndrome types of type 2diabetic retinopathy(DR)and blood inflammatory indexes such as NLR,PLR,MLR,CRP,etc.to provide new research ideas for the objectification and standardization of DR syndrome differentiation,and to provide a certain reference value for the prevention and treatment of DR with the combination of traditional Chinese and western medicine,so as to guide the clinical work.Methods:This study collected 133 DR patients who met the inclusion and exclusion criteria in the Department of Endocrinology,affiliated Hospital of Liaoning University of traditional Chinese Medicine from December 2021 to December 2022.Collecting the basic information of patients,TCM four diagnostic information,physical and chemical indicators and other data,refer to the diagnostic criteria of TCM syndrome type,carry out syndrome differentiation and classification of DR patients.All the collected data were inputted into the database,and the statistical software SPSS26.0was used to analyze the distribution of TCM syndrome types and DR stages to explore the differences between TCM syndrome types and general data and inflammation indicators.Results:1.DR TCM syndrome type and DR staging distribution: this study included 81 patients(59.1%)with deficiency of both qi and yin and collateral stasis,33 patients(24.1%)suffered from liver and kidney deficiency and eye collateral malnutrition,and There were 17 cases(12.4%)with yin-yang deficiency,Blood Stagnation and phlegm coagulation syndrome.There were 85 cases of NPDR(63.9%)and 48 cases of PDR(36.1%).The most in NPDR was deficiency of both qi and yin and stagnation of collaterals and collaterals syndrome(55 cases),the syndrome of deficiency of both yin and yang and blood stasis and phlegm was the least(3 cases),the syndrome of deficiency of both yin and yang and blood Stagnation and phlegm was the most in PDR(20 cases),lack of liver and kidney,eye and collaterals syndrome was the least(12cases).2.The results of correlation analysis between DR TCM syndrome types and general data: in terms of gender distribution,there were 72 males(54.1%)and 61 females(45.9%).There was no significant gender difference among TCM syndrome types(P >0.05).In terms of age distribution,there were 69 elderly patients(51.9%),56middle-aged patients(42.1%)and 8 young patients(6%).The patients with deficiency of both qi and yin and blood stasis blocking collaterals were younger(P < 0.05).There was significant difference in the course of diabetes among different TCM syndrome types of DR.There was no significant difference in the distribution of BMI among different TCM syndrome types of DR.3.The results of correlation analysis between different TCM syndrome types of DR and physical and chemical indexes: there were significant differences in Hb A1 c and LDL-C among different TCM syndrome types of DR,and the expression levels of Hb A1 c and LDL-C were the highest in deficiency of both yin and yang and blood stasis and phlegm syndrome,while there was no significant difference in TG、 TC and HDL-C among different TCM syndrome types of DR.4.The results of correlation analysis between DR staging and blood inflammation indexes: the distribution of NLR,PLR,MLR,PDW,MPV and CRP on NPDR and PDR was statistically significant,while the distribution of WBC and MPV on NPDR and PDR was not statistically significant.The results of ROC curve analysis showed that the best critical values of NLR,MLR,PLR,PDW,MPV and CRP were 2.785、0.265、178.255、3.73、16.25、9.25 respectively.The areas under the ROC curve were 0.707、0.618、0.638、0.635、0.626 and 0.628,respectively.The sensitivity and specificity of NLR for predicting the optimal critical value of PDR were 64.6% and 72.9%,respectively.The sensitivity and specificity for predicting the optimal critical value of PDR were 39.6% and 78.8%,respectively.The sensitivity and specificity for predicting the best critical value of DR proliferation were 33.3% and 90.6%,respectively.The sensitivity of PDW to predict the optimal critical value of DR proliferation was 60.4%,and the specificity was 65.9%.The sensitivity and specificity of DR were 47.9% and74.1%,respectively.5.The results of correlation analysis between different TCM syndrome types of DR and inflammatory indexes: there were significant differences in NLR、PLR、MLR、CRP、PDW and MPV in different TCM syndrome types of DR.The expression levels of NLR、PLR、MLR、CRP、PDW and MPV were the highest in the syndrome of deficiency of both yin and yang,blood stasis and phlegm obstruction.Conclusion:1.The common TCM syndrome types of type 2 diabetic retinopathy are deficiency of both qi and yin and blood stasis of collaterals.The distribution of each syndrome type accords with the pathogenesis evolution law of deficiency of both yin and yang from deficiency of both qi and yin and deficiency of liver and kidney,and the age,course of disease and Hb A1 c may be positively correlated with the distribution of TCM syndrome types.2.The level of blood inflammation in patients with PDR is relatively higher than that in patients with NPDR,in which NLR can be used as an auxiliary index for the diagnosis of PDR;NLR,PLR,MLR,CRP,PDW,MPV are correlated with TCM syndrome types of type 2 diabetic retinopathy,and the expression levels of NLR,PLR,MLR,CRP,PDW and MPV in Yin-Yang deficiency and blood stasis phlegm coagulation syndrome are higher than those in the other two syndrome types.