Study On The Related Factors And Diagnostic Model Of The Syndrome Of Qi And Yin Deficiency Combined With Blood Stasis In Diabetic Peripheral Neuropath

Purposes:By analyzing the collected clinical data of patients with both qi-yin deficiency and blood stasis syndrome and non-qi-yin deficiency and blood stasis syndrome of diabetic peripheral neuropathy(DPN),the related factors of DPN with qi-yin deficiency and blood stasis syndrome were analyzed,the syndrome characteristics were discussed,and the predictive indicators were screened.The multi-parameter combined syndrome diagnosis model is constructed to provide reference for clinical syndrome differentiation and treatment,and provide theoretical basis for the objectification of TCM diagnosis and treatment of DPN.Method:Data of 303 DPN patients hospitalized in The Department of Endocrinology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from December2020 to December 2021 are collected.There are 150 cases of qi-yin deficiency and blood stasis syndrome,and 153 cases of non-qi-yin deficiency deficiency and blood stasis syndrome.Two groups of patients with general information,clinical symptoms,tongue picture and pulse condition,objective indicators are collected for univariate analysis,and then a preliminary screening of related factors into binary logistic regression model for variable selection,multi-parameter clinical prediction model is established according to the data,and the distinction and calibration degree of the corresponding model are tested.The optimal truncation value is calculated by The Jorden index,and the sensitivity and specificity of the clinical prediction model are determined.Result:1.In terms of general information,age,smoking history,body mass index(BMI)and waist circumference are correlated with qi-yin deficiency and blood stasis syndrome DPN(P<0.05),while gender,other accompanying disease,course of disease,family history and drinking history are not correlated with qi-yin deficiency and blood stasis syndrome DPN(P>0.05).2.In terms of clinical symptoms,limb numbness,limb pain,limb chill,fatigue,dry throat and mouth,shortness of breath and lazy speech,dysphoria in chestpalms-soles,insomnia and dreaminess,are correlated with qi-yin deficiency and blood stasis syndrome DPN(P<0.05).There is no correlation with qi-yin deficiency and blood stasis syndrome DPN(P>0.05),including thirsty and found of drinking,scaly dry skin,dark purple oral,more sweat,anemophobia,soreness and weakness of waist and knees,dizziness and tinnitus,chest tightness and palpitations,dry stool,diarrhea,frequent urination.3.In terms of tongue picture and pulse condition,tongue coating color,tongue coating thickness and pulse condition are correlated with qi-yin deficiency and blood stasis syndrome DPN(P<0.05),while tongue color has no correlation with qi-yin deficiency and blood stasis syndrome DPN(P>0.05).4.In terms of objective indicators,alanine aminotransferase(ALT),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and uric acid(UA)are correlated with qi-yin deficiency and blood stasis syndrome DPN(P<0.05),while hemoglobin A1c(Hb A1c),,aspartate aminotransferase(AST),total cholesterol(TC),lowdensitylipoprotein cholesterol(LDL-C)and creatinine(Cr)are not correlated with qi-yin deficiency and blood stasis syndrome DPN(P>0.05).5.As a result,syndrome diagnosis model model P= 1/(1+exp(-(-0.248*BMI+0.429*limb pain+0.501*shortness of breath and lazy speech +0.823*dysphoria in chestpalms-soles+1.845*white moss+1.884*thin moss+1.609*stringy pulse+1.805*thin pulse)).Conclusion:1.DPN of qi-yin deficiency and blood stasis syndrome are older,more likely to be overweight.2.Limb numbness,limb pain,limb cooling,fatigue,dry throat and mouth,shortness of breath and lazy speech,dysphoria in chestpalms-soles,insomnia and dreaminess are important clinical manifestations of DPN of qi-yin deficiency and blood stasis syndrome.3.DPN of qi-yin deficiency and blood stasis syndrome are mostly characterized by thin white moss,stringy pulse,thin pulse or stringy and thin pulse..4.In DPN patients with qi-yin deficiency and blood stasis syndrome,TG is more likely to be slightly elevated.5.The differentiation,calibration and consistency of DPN of qi-yin deficiency and blood stasis syndrome are good,which have certain clinical reference value.6.BMI of general information,limb pain,shortness of breath and lazy speech and dysphoria in chestpalms-soles of clinical symptoms,white moss,thin moss,stringy pulse and thin pulse of tongue picture and pulse condition have predictive value of DPN of qi-yin deficiency and blood stasis syndrome and may become predictive indicators of DPN of qi-yin deficiency and blood stasis syndrome.