Tcm Syndromes Of Ischemic Diabetic Foot Ulcers

Objective:Diabetic foot is a common serious chronic complications of diabetes mellitus, which has a high maiming and mortality rate. It has become a serious threat to people's lives and health. Especially when there is limb ischemia, the refractory limb ulcer is easy to bring great economic and psychological burden for patients. TCM in the treatment of DF and DF ulcers has a unique advantage and a good effect. The key question is determining whether the wound is ischemia or not, then understanding the rise and fall of local Qi and blood, the extent of poison, the depth of lesion, on this basis, as the systemic syndrome to decide the internal and external treatment method. At present, most of the literature were not observed for patients with ischemic DF ulcer, so that this study through the observation for distribution and correlation of ischemic diabetic foot ulcer patients'symptoms, basic syndromes, preliminary discusses the Syndrome types of TCM for ischemic diabetic foot ulcer. In order to establish a more detailed standards of TCM for ischemic DF ulcer providing an objective basis, to further guide to the clinical medicine, to improve the treatment of ischemic diabetic foot ulcer.Method:This study is divided into two parts. The first part is the literature review. Through consulting inland literature in past five years, summarize the TCM disease name of DF, the etiology and pathogenesis of TCM, the syndrome of TCM, and the treatment. Then we can find the common problems, and put forward the solving methods. The second part is the clinical study. Review 72 cases of ischemic diabetic foot ulcer patients, collecting the clinical manifestations, partial syndrome of TCM, tongue and pulse and auxiliary examination indicators. Then calculate the frequency and other relevant data of all clinical manifestations and syndromes. Run the data by statistical analysis to gain the conclusion.Result:1.Blood deficiency, as one of the systemic syndromes, has the highest frequency in ischemic diabetic foot ulcers patients, followed by Qi deficiency, damp-heat, blood stasis. The highest frequency of partial syndromes is the HanNing card, followed by blood stasis, deficiency of Qi and blood, damp.2.In all of the systemic syndromes, Qi deficiency and blood deficiency are often accompanied, while Yang deficiency, Yin deficiency, phlegm, heat toxin syndrome, damp-heat are often accompanied.3.In all of the partial syndromes, heat toxin syndrome often appear alone, while HanNing card, deficiency of Qi and blood, wet retention syndrome, blood stasis, damp-heat often accompanied appear.4. No matter what kind of systemic syndromes, the partial syndromes can be the empirical, but also can be the deficiency, indicating that the syndromes of TCM for ischemic diabetic foot ulcers is more common mixed.5. In the damp-heat type, besides the damp-heat, there are also deficiency of Qi and blood, Yang deficiency, blood stasis, and Harming card. In the heat toxin type, there are also deficiency of Qi and blood, Yin deficiency, and blood stasis. In the deficiency of Qi and blood type, there are also blood stasis, deficiency of Yang and Yin, Hanning card and damp.Conclusion:The basic etiology and pathogenesis of ischemic diabetic foot ulcers is Qi and blood deficiency, blood stasis. The basic syndrome types are damp-heat type, heat toxin type, deficiency of Qi and blood type. The three types we set up are highlighted the etiology characteristic, fully reflects the evolution of the disease, consistent with statistical results. The main syndromes of ischemic diabetic foot ulcers are more common mixed by deficiency and empirical, cold and heat. To decide the syndrome type, we should first know the partial differentiation of local wounds, combined with the systemic syndromes. Treatment should be taken to solve the problem of the law to Qi and blood, promoting blood circulation-based, depending on the syndrome, due to heat and dampness, heat and detoxifying, warming yang and cold and other drugs.Most patients both have Qi deficiency and blood deficiency, which proves qi and blood deficiency often throughout the ischemic diabetic foot ulcer disease. The systemic Qi and blood deficiency would affect the rise and fall of local Qi and blood, the extent of poison, the depth of lesion. In this study,...