| Objective:Based on the analysis of 148 cases of patients with type 2diabetic peripheral neuropathy,this paper summarizes the overall law of the distribution of common syndromes and syndromes of traditional Chinese medicine,and discusses the correlation between different syndromes and physical and chemical indexes.Combined with the experience of tutor in the treatment of diabetic peripheral neuropathy,the clinical characteristics of this disease and the direction of traditional Chinese medicine diagnosis and treatment are analyzed,in order to provide more ideas and scientific basis for clinical diagnosis and treatment.Methods:A retrospective study was conducted to collect the data of 148 patients with type 2 diabetic peripheral neuropathy(T2DPN)who were treated in the inpatient department of endocrinology in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from March 2019 to December 2021.According to the diagnostic criteria of ’Guideline for Clinical Diagnosis and Treatment of Diabetic Peripheral Neuropathy in Traditional Chinese Medicine ’(2016 edition),the data of syndrome types were sorted out,and the relevant basic information and clinical index examination results were analyzed.The information collection table was formulated,including the general data of patients,complications,four diagnostic information,biochemical indicators,nerve conduction velocity and other indicators.The data into the computer,establish a database and use SPSS26.0software for statistical analysis.Results:1.In terms of syndrome type distribution,the qi deficiency and blood stasis syndrome type of 148 patients was the most,53 cases,accounting for36 %,and the liver and kidney deficiency syndrome type was the least,22 cases,accounting for 15 % of the total number.In terms of gender,the male to female ratio was 1.3 : 1,no statistical significance(P > 0.05).2.In terms of age and course of disease,among the four groups of different syndromes,the liver and kidney deficiency group and the phlegm and blood stasis blocking collaterals group were older,and the liver and kidney deficiency group was significantly different from the other three groups(P < 0.05).In terms of course of disease,the liver and kidney deficiency group and the phlegm and blood stasis blocking collaterals group had longer course of disease,and the qi deficiency and blood stasis group and yin deficiency and blood stasis group had shorter course of disease.There was statistically significant difference in qi deficiency and blood stasis syndrome group compared with phlegm and blood stasis blocking collaterals syndrome group and liver and kidney deficiency syndrome group(P < 0.05),and there was statistically significant difference in yin deficiency and blood stasis syndrome group compared with liver and kidney deficiency syndrome group(P < 0.05).3.In terms of BMI,the phlegm and blood stasis syndrome group had the largest BMI,and the liver and kidney deficiency syndrome group had the smallest BMI.The difference between the phlegm and blood stasis syndrome group and the other three groups was statistically significant(P < 0.05).4.In terms of blood pressure,the systolic blood pressure(SBP),diastolic blood pressure(DBP)and pulse pressure difference(DP)among the four groups of different syndromes were statistically significant(P < 0.05).The SBP,DBP and DP values in the liver and kidney deficiency group were the highest in the four groups,and were statistically significant compared with those in the other three groups(P < 0.05).5.In terms of blood glucose-related indicators,the blood glucose levels in the yin deficiency and blood stasis syndrome group and the liver and kidney deficiency syndrome group were higher,while the blood glucose levels in the qi deficiency and blood stasis syndrome group and the phlegm and blood stasis blocking collaterals syndrome group were lower.The differences between each two groups were statistically significant(P < 0.05).Among the four syndromes of T2 DPN,the levels of glycosylated hemoglobin in the yin deficiency and blood stasis syndrome group and the liver and kidney deficiency syndrome group were higher,while the levels of glycosylated hemoglobin in the qi deficiency and blood stasis syndrome group and the phlegm and blood stasis blocking collaterals syndrome group were lower.The differences between each two groups were statistically significant(P < 0.05).In terms of serum C peptide,the highest level of serum C peptide was found in the phlegm and blood stasis obstructing collaterals syndrome group,and the lowest level was found in the liver and kidney deficiency syndrome group.The difference between the two groups was statistically significant(P < 0.05).6.In terms of blood lipids,there was no significant difference in high density lipoprotein and low density lipoprotein among the four groups(P >0.05).The total cholesterol of the phlegm and blood stasis syndrome group was the highest,and the difference was statistically significant compared with the other three groups(P < 0.05).The triglyceride of the phlegm and blood stasis syndrome group was the highest,and the difference was statistically significant compared with the other three groups(P < 0.05).7.In terms of uric acid,there was no significant difference between the four groups(P > 0.05).From the level of cystatin C,liver and kidney deficiency group were compared with the other three groups,the difference was statistically significant(P < 0.05).8.In terms of motor nerve conduction velocity,the median nerve and common peroneal nerve of patients with liver and kidney deficiency syndrome were significantly lower than those of the other three groups,and the differences were statistically significant(P < 0.05).In terms of sensory nerve conduction velocity,there were statistically significant differences in the median nerve,sural nerve,qi deficiency and blood stasis syndrome group and yin deficiency and blood stasis syndrome group of patients with liver and kidney deficiency syndrome(P < 0.05).There were statistically significant differences in the median nerve,sural nerve,qi deficiency and blood stasis syndrome group and yin deficiency and blood stasis syndrome group of patients with phlegm and blood stasis blocking collaterals syndrome(P <0.05).9.The incidence of complications of type 2 diabetic peripheral neuropathy from high to low is as follows : lower limb atherosclerosis,hypertension,coronary heart disease,diabetic retinopathy,dyslipidemia,fatty liver,osteoporosis,and diabetic nephropathy.Conclusion:1.In this study,148 cases of type 2 diabetic peripheral neuropathy in patients with TCM syndrome frequency from high to low in order for qi deficiency and blood stasis syndrome,yin deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,liver and kidney deficiency syndrome.2.T2 DPN is not associated with gender,but with age and course of disease.The average age of patients in the liver and kidney deficiency group was the largest,and that in the qi deficiency and blood stasis group was the smallest.Short course of disease is mostly distributed in Qi deficiency and blood stasis syndrome group and Yin deficiency and blood stasis syndrome group,belongs to T2 DPN early and middle;long course of disease is mostly distributed in phlegm and blood stasis syndrome and liver and kidney deficiency syndrome group,belongs to late disease.3.FBG and Hb A1 c in patients with qi deficiency and blood stasis syndrome were low;b MI,TC,TG and C-peptide indexes of patients in the phlegm-blood stasis syndrome group were higher;the highest values of blood pressure,course of disease and age in patients with liver and kidney deficiency syndrome were obvious,and the nerve conduction velocity index showed obvious damage.4.In this study,the top three complications of type 2 diabetic peripheral neuropathy were macrovascular complications such as lower limb atherosclerosis,hypertension and coronary heart disease. |
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