The Cross-sectional Analysis Of Risk Factors And Clinical Study In Intervention Of Traditional Chinese Medicine On The Early Stage Of Diabetic Feet

Objective:1.Analyze the related risk factors of patients on the early stage of diabetic feet to induct the early screening,diagnosing and treating of DF.2.To investigate the effect of Jianpiqinghua particle and Wentong powder on the treatment of patients on the early stage of diabetic feet and establish a standardized clinical prevention program integrated traditional Chinese medicine on diabetic feet.Methods:1.The cross-sectional analysis of risk factors on the early stage of diabetic feet:investigate clinical data related of 40 cases of DF and 45 cases of early diabetes in patients to statistically analyze risk factors related to the DF,make a focus on comparison of plasma carboxymethyl lysine(CML) in the changes between the two groups and their impact factors.2 Clinical Research:Take a randomized blind placebo-controlled add-on trial:The treatment group of 20 was given with "Jianpi qinghua particle" (oral),"Wentong powder"(foot washing),the control group of 20 was given placebo in same methods.The course in both groups wasl6 weeks.Evaluate the change of total effect body and foot symptoms,MDNS,electro-neurophysiological examination and ankle/brachial ratio.Results:Cross-sectional analysis:1.Age,course of diabetes,low levels of education,lack of knowledge of diabetes-related foot care and attention are risk factors of DF.2.Electroneurophysiological examination:The positive rate of Sural nerve SCV and SNAP amplitude is highest especially the sensitive of SCV.In particular, the sural nerve SCV is the most sensitive.3.DF in patients with early stages more significantly increased plasma levels of CML than the early diabetes,there was a significant difference(306.3±67.1ng/mL vs 279.0±50.4ng/mL,P＜0.05) 4 Plasma levels of CML in patients with poor glycemic control(HbA1c＞7.0%) increased significantly,related to HbA1c and 2hPG positively(r=0.44,P＜0.01 and r=0.41,P＜0.05).The clinical total effective rate(89.47%) in treatment group was significantly higher than control group (36.84%),which was a significant difference(P＜0.01);especially in improving the body and feet clinical symptoms,nerve conduction velocity,evoked potential amplitude,the ABI index,reducing the MDNS points (P＜0.05)。Conclusion:1.In the patients with DPN,amplitudes of Sural nerve SCV and SNAP are not only for early screen of DPN,but also reflecting the early restoration of neuropathy.2.CML significantly increased in the early DF plasma,is related with glucose metabolism,which shows Advanced glycation end products and bad blood sugar control may be an important risk factor in the occurrence and development of DF。CML possibly is an early diagnosis of DF predictor.3.3.Jianpiqinghua particle and Wentong powder have significant clinical effect in patients on the early stage of diabetic feet,especially in improving the symptoms.