Study On The Correlation Between Diabetic Peripheral Neuropathy And Traditional Chinese Medicine Constitution And Other Factors

Objective: Diabetic peripheral neuropathy(DPN)is the most disabling and serious complication of diabetes mellitus(DM).At present,DPN is considered as a result of combined action of various factors,and its specific pathogenesis is unclear.Thus,preventive administration of therapeutics deserves more attention.Focusing on the traditional Chinese medicine(TCM)constitutional type of patients,and combining with correlated clinical indexes,this article attempts to explore the possible risk factors for DPN complication in patients with type 2 diabetes mellitus through clinical retrospective study.The morbidity of DPN may be reduced by controlling risk factors before DPN coming on.Materials and methods: Retrospective study method was used.Two hundred and eight patients with type 2 diabetes mellitus were randomly selected from wards and clinics of TCM Department and Endocrinology Department in Second Affiliated Hospital of Dalian Medical University,to be used for a case-control study.One hundred and eight patients with DPN were divided into DPN group,while one hundred patients without DPN were divided into non DPN group.The "Chinese constitution classification decision table" formulated by China Association of Traditional Chinese Medicine was used as a template to develop a questionnaire.All patients received a questionnaire survey about the type of TCM constitution.The proportions of TCM constitution types were compared between DPN group and non DPN group.To further clarify the differences,the ratios of each TCM constitution were compared too.The sexes,ages,diabetic duration,BMI,systolic blood pressure,and diastolic bloodpressure of all patients were collected and compared between the two groups.The following biochemical indicators were also collected and compared between the two groups,including fasting blood glucose,2h-postprandial plasma glucose,glycosylated hemoglobin,fasting C peptide,2h-postprandial C peptide,fasting insulin,insulin resistance index,blood lipids(total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A1,apolipoprotein B),urine albumin and urine albumin/creatinine ratio.The TCM constitution types and related indicators showing statistically significant differences(P<0.05)were absorbed into the logistic regression analysis to obtain the risk factors for DPN complication in patients with type 2 diabetes mellitus.Results: TCM constitution distributions were different between DPN group and non DPN group.More Yuxue constitution,Yangxu constitution and Tanshi constitution were found in DPN group than in non DPN group(P<0.05).The durations of patients in DPN group were longer than that in non DPN group(P<0.05).Compared with non DPN group,the DPN group showed higher levels of 2h-postprandial blood glucose,glycosylated hemoglobin,fasting insulin and insulin resistance index(P<0.05).The levels of 2h-postprandial C peptide in DPN group were lower than that in non DPN group(P<0.05).The levels of BMI,systolic blood pressure,diastolic blood pressure,fasting blood glucose,fasting C peptide,blood lipids(total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A1,apolipoprotein B),urine albumin and urine albumin/creatinine ratio showed no significant differences between two groups(P>0.05).The results of logistic regression analysis showed that Yuxue constitution(P=0.031,OR=2.270),Yangxu constitution(P=0.028,OR=3.056),duration(P=0.037,OR=1.050)and fasting insulin(P=0.013,OR=1.026)were risk factors for DPN complication in patients with type 2 diabetes mellitus.Conclusion: 1.The TCM constitution types Yuxue constitution,Yangxu constitution and Tanshi constitution are relevant to the occurrence of DPN.Yuxue constitution and Yangxu constitution are risk factors for DPN complication in patients with type 2diabetes mellitus.2.Diabetic duration,fasting insulin,glycosylated hemoglobin,2h-postprandial blood glucose and 2h-postprandial C peptide are closely related to the occurrence of DPN.Diabetic duration and fasting insulin are risk factors for DPN complication in patients with type 2 diabetes mellitus.With diabetic duration and fasting insulin increasing,the morbidity of DPN rises.