| Objective To discuss the characters of syndrome elements and syndrome of early diabetic early diabetic microangiopathy from both literature research and clinical investigation,we analyzed the magazines about early diabetic microangiopathy at first to comprehend the distribution of general syndrome elements,syndrome and symptoms,then set down questionnaire of symptoms based on its symptoms and expert consultation.The purpose of the section of clinical investigation is to apply the evaluated questionnaire to investigate the general symptoms in clinical,then set up database and used various multivariate statistical analysis to discuss the combination rule of symptoms and distill syndrome elements.Then according to the thinking of"dimension reduction,ascending order",to build up the syndrome elements and study often witness and the main symptoms,so as to provide reliable basis for establishing a new system of syndrome differentiation method.Methods This study is a major research projects in medicine disease control and prevention of Zhejiang Province which name is " The clinical studies in medicine prevention of early diabetic microangiopathy ".1 Search the Published magazines related to early diabetic microangiopathy in the China Academic Journal Network Publishing Database and analyze its general symptoms,syndromes and syndrome elements.Summarize the distribution rule of symptoms,syndromes and syndrome elements.2 According to this study,the research group to develop a unified survey of early diabetic microangiopathy in patients with diabetes to investigate the acquisition,the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine Unit 6 Senate inquiry inclusion criteria in line with the general situation of patients with diabetic microangiopathy,four diagnostic information,etc.Be checked to ensure that the data entered is correct after locking the database,then Import SPSS 18.0 and AMOS 20.0 software(by Zhejiang Medical University of Preventive Medicine,Department of Medical Statistics provided)for data checking and cleaning.Finally,we use the information for statistical analysis of the complete case.We use multivariate statistical methods(cluster analysis,factor analysis,structural equation moodel)for the distribution of TCM syndromes are analyzed and summarized and extract and determine early diabetic microangiopathy syndrome elements based on traditional Chinese medicine theory.Then the syndrome elements are combined into syndromes and we explore and validate its main symptoms.Results1 Through the analysis of modern literature of Chinese medicine of early diabetic microangiopathy from 2004 to 2013,we found that there are about 150 Chinese medicine symptoms appeared in the literature and the total frequence is 1564.The symptoms of frequence more than 25 are weakness,thready pulse,soreness and weakness of waist and knees,dry mouth,dizziness,tinnitus,thirst with desire to drink,rapid pulse,constipation,polyuria,edema,spiritlessness,red tongue,pulse weak,less fur,deep pulse,clouded vision,feverish sensation over the five centers,emaciation,spontaneous sweating,thin fur,white fur.The most common syndromes were syndrome of deficiency of both qi and yin,yin deficiency of liver and kidney,yang deficiency of spleen and kidney,yin deficiency,deficiency of both spleen and kidney,deficiency of both yin and yang,etc.Syndrome elements of disease location of early diabetic microangiopathy mainly include kidney,liver,spleen,stomach,lung and heart.Syndrome elements of disease nature of early diabetic microangiopathy include yin deficiency,qi deficiency,yang deficiency,blood stasis,dampness,phlegm,fire or heat,blood deficiency,turbid,toxicity,dryness,qi stagnation,qi depression,pathogenic water,cold,hyperactivity of yang and heat,etc.2 We conducted a survey of the common symptoms of early diabetic microangiopathy in patients with 531 cases from six hospitals in the province and established a symptom database for the use of a variety of multivariate statistical analysis of early diabetic microangiopathy common syndrome factors.3 Through the descriptive analysis of the 531 cases,we found that 306 cases are male and 225 cases are female and the Han nationality is the most.In age,the oldest is 83 and the youngest is 20,mean age is 60.The age distribution of 61 to 70 year age group the largest proportion,32.77%of the total number of cases.Now history and past history in diabetic patients with hypertension who are at most,each with 19.59%,26.74%.Familial history of diabetes altogether 128 people,accounting for 24.11%.The frequency of symptoms of the first 15 followed:dry mouth,frequent urination at night,weakness,clouded vision,thirst with desire to drink,dry eyes,forgetfulness,obesity,dizziness,foamy urine,frequent micturition,rapid digestion of food and polyorexia,soreness of waist,insomnia,deep-colored urine.Physician experience syndrome results:syndrome of deficiency of both qi and yin is the most,followed respectively are syndrome of yin deficiency of liver and kidney,blood stasis,yin deficiency and interior heat,spleen deficiency with qi stagnation.Syndrome elements of disease nature include yin deficiency,qi deficiency,heat,blood stasis,phlegm,etc.Higher frequency of occurrence of disease-bit class syndrome elements are as follows:spleen,kidney,liver.When looked into the combination conditions of syndrome elements,qi deficiency+yin deficiency is the most,followed by yin deficiency+heat,qi deficiency+qi stagnation,which suggested that patients with the syndrome of deficiency of both qi and yin is the most.The most of the combination of syndrome elements or disease location is liver and kidney.Compared with the results of literature analysis,the frequency of syndrome elements of disease nature of qi deficiency,yin deficiency,blood stasis and syndrome elements is of disease location of kidney,liver and spleen are also more in the literature.4 The results of clustering analysis pointed out that the syndrome elements of disease location of early diabetic microangiopathy mainly include kidney,spleen,liver,stomach and lung.Syndrome elements of disease nature of early diabetic microangiopathy include qi deficiency,yin deficiency,yang deficiency,heat,dampness,dryness,blood stasis,qi stagnation,qi depression and reversed flow of qi,etc.5 The results of factor analysis pointed out that the syndrome elements of disease location of early diabetic microangiopathy mainly include kidney,liver,spleen,lung and stomach.Syndrome elements of disease nature of early diabetic microangiopathy include yin deficiency,qi deficiency,yang deficiency,heat,dampness,dryness,blood stasis,qi stagnation,qi depression and reversed flow of qi,etc.6 The results of structural equation modeling pointed out that he syndrome of disease include deficiency of both qi and yin,yin deficiency of liver and kidney,yang deficiency of spleen and kidney,spleen deficiency with qi stagnation,deficiency of both yin and yang,and dampness-heat in spleen,etc.After the higher contribution of the syndrome symptoms were analyzed,we summarize the preliminary diagnostic criteria for each syndrome.Conclusions1 Through the analysis of literature and the research of clinical,we can suppose the common syndrome elements of disease nature of early diabetic microangiopathy include qi deficiency,yin deficiency,yang deficiency,blood stasis,dryness,dampness,qi stagnation and heat,etc.Syndrome elements of disease location of early diabetic microangiopathy mainly include kidney,liver,spleen and stomach.2 This study results express the syndrome of early diabetic microangiopathy is complex.Research from the perspective syndrome elements can perform efficiently and this provides a reliable basis for the standardization of syndrome.3 Application of multivariate statistical analysis methods Syndrome research has a certain significance.In this study a combination of a variety of data analysis methods,we think "dimension reduction,ascending order" and interdisciplinary research is feasible new ideas in syndrome research. |
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