Analysis On The Pathological Changes Of Traditional Chinese Medicine And Risk Factors In Diabetic Retinopathy And Its Progression

Objective:To explore Traditional Chinese medicine pathological changes and risk factors of diabetic retinopathy (DR) and its progression by using the syndrome element theory.Methods:395patients with type2diabetes were divided into three groups by fundus examination results:NDR group of92cases, NPDR group of190cases and PDR group of113cases. Three groups were compared in the general information, biochemical parameters, complications difference; Used the syndrome element theory to explore the Chinese medicine pathological changes of DR and its progression; And to analysis risk factors of DR and its progression.Results:1. Comparison of the general situation:For NPDR group age was higher than in NDR group (P<0.01):For NPDR and PDR group, BMI was lower than in NDR group (P<0.01or P<0.05), and course of disease was higher than in NDR group(P<0.01or P<0.05); There’re no significant difference among gender, systolic blood pressure and diastolic blood pressure(P>0.05).2. Comparison of the biochemical indicators:TC, TG and LDL-C in PDR group were higher than in NPDR group (P<0.05), but no significant difference with the NDR group (P>0.05):For NPDR and PDR group, HbAlc was higher than in NDR group (P<0.01or P<0.05); UA in PDR group was higher than in NDR and NPDR group; There’re no significant difference among HDL-C and FPG(P>0.05).3. Comparison of the complications:Abnormal of UAER in NDR was0.0%, it growed with DR’s occur and progress, there were significant differences among three groups(P<0.01). The prevalence of hypertension, hyperlipidemia in PDR group was significantly higher than in NDR and NPDR group (P<0.01).4. Comparison of the syndromes elements:The frequency of liver, kidney, lung, phlegm, blood stasis, qi stagnation, yin deficiency, blood asthenia, yang deficiency, qi asthenia, essence asthenia syndrome elements in NPDR and PDR group were higher than in NDR group(P<0.01or P<0.05); The frequency of liver, damp,heat,Yang excess, blood asthenia, essence asthenia syndrome elements in PDR group were higher than in NDR and NPDR group (P<0.01or P<0.05). Further comparison of the DR was divided into Ⅰ-Ⅵ phase:The frequency of liver and yin deficiency syndrome elements of the phase Ⅱ was significantly higher than phase I (P<0.01or P<0.05); The frequency of liver, heat, moisture syndrome elements of the phase IV was significantly higher than phase Ⅰ and Ⅲ(P<0.01or P<0.05); The frequency of blood asthenia syndrome elements of phase VI was significantly higher than phase Ⅰ-Ⅴ(P<0.01or P<0.05).5.The related syndrome elements in DR and its progression:Accompanied by the emergence of yin deficiency, liver, blood stasis and kidney syndrome elements of the likelihood of DR are increased3.459,2.583,1.268,1.042times. Accompanied by the emergence of the liver, essence asthenia, heat syndrome elements, and the likelihood of the PDR are increased4.030,1.255,0.789times.6.The risk factors of DR and its progression:As the BMI increased, the likelihood of DR may be reduced by0.125times; HbAlc was increased by1%, the likelihood of DR occurred maybe increased0.235times; With the abnormal of UAER and the emergency of hyperlipidemic, the likelihood of PDR were increased16.886,5.248timesConclusions:1. Age, course of disease, HbAlc, UA, blood pressure, high cholesterol, UAER maybe the risk factors of DR. UAER is parallel progress in the relationship with DR.2. Different pathological changes in different DR stages:Liver, kidney, lung, phlegm, blood stasis, qi stagnation, yin deficiency, blood asthenia, yang deficiency, qi asthenia, essence asthenia syndrome elements are the Chinese medicine pathological changes when DR occurred; Liver, damp, heat, Yang excess, blood asthenia, essence asthenia syndrome elements are the Chinese medicine pathological changes when PDR occurred; Liver is the main pathological changes of the phase II, yin deficiency the significant pathological features of phase Ⅱ; liver, heat, moisture are the main pathological changes in stage IV; blood asthenia is a significant pathological features of stage VI.3.Yin deficiency, liver, blood stasis, kidney syndrome elements maybe the risk factors of DR"occur, liver, essence asthenia, heat syndrome elements maybe the risk factors of PDR. Syndrome element of liver is a risk factor throughout DR and its progression.4.BMI is an affect factor of DR. HbAlc is a risk factor of DR. UAER and hyperlipidemia were the risk factors of PDR.