Study On The Comorbidity Of Anxiety And Depression In Type 2 Diabetic Peripheral Neuropathy And Their TCM Syndromes And Constitutions

Objective: Through clinical investigation cases,this study presents scientific evaluations of related factors which influence the comorbid anxiety and depression of type 2 diabetic peripheral neuropathy(DPN),and explores the distribution characteristics and correlation of TCM constitution types and syndrome differentiation in type 2 DPN patients with the comorbid anxiety and depression,in order to provide clinical reference for the prevention and treatment of type 2 DPN by TCM.Methods: Type 2 DPN patients are selected as research object from March 1,2018 to December 30,2019 in Affiliated Hospital of Chengdu University of Traditional Chinese Medicine endocrinology outpatient and inpatient.According to the diagnosis,inclusion,exclusion and exclusion criteria,questionnaire surveys are undertaken to type 2 DPN patients with comorbid anxiety and depression,collecting general information(including gender,age,course of disease of type 2 DPN,body mass index,educational background,marital status,living style,etc.)and involving in objective information in the questionnaire for the syndrome type of type 2 DPN,the Generalized Anxiety Disorder scale(GAD-7),the Patient Health Questionair with 9 items(PHQ-9)and the TCM constitution scale.Based on syndrome differentiation and constitution type,the data are sorted out and entered into the database.By using SPSS22.0 software for statistical analysis,corresponding results are obtained.Results: A total of 274 type 2 DPN patients are investigated,185 of which are access to the inclusion criteria.Due to the complexity of TCM constitution classification,z3 of 185 are excluded according to the exclusion criteria.A total of 182 cases are eventually available for this study.Among them,72 DPN patients have simple anxiety,accounting for 39.56%.61 cases with simple depression accounted for 33.52%.The rest of them with comorbid anxiety and depression is up to 26.92%.(1)Age and disease course and body mass index and marital status and monthly family income,all of them have relations with DPN comorbid anxiety and/or depression(p < 0.05).Among them,DPN patients with younger age,longer disease course,unmarried and low monthly family income are more prone to comorbidity anxiety.While patients with DPN who are older,have higher BMI,are unmarried and married,and have higher monthly family income are more likely to have comorbid depression.(2)The TCM syndrome types of DPN patients with comorbid anxiety and/or depression are from most to least: dampness-heat collateral-blocking syndrome(20.33%),cold coagulation syndrome of Yang deficiency(19.78%),phlegm-blood stasis syndrome(18.13%),Yin deficiency and blood stasis syndrome(18.13%),qi deficiency and blood stasis syndrome(17.58%),liver and kidney deficiency syndrome(6.04%).The types of TCM constitution of patients with DPN comorbidities anxiety and/or depression are from most to least: qi-deficiency constitution(24.18%),qistagnation constitution(20.88%),yang-deficiency constitution(17.58%),phlegmdampness constitution(13.74%),dampness-heat constitution(8.79%),yin-deficiency constitution(7.14%),blood-stasis constitution(4.95%),mildly constitution(2.20%),and allergic constitution(0.5%).(3)There is a correlation between TCM constitution distribution and syndrome type in DPN patients with comorbid anxiety and/or depression(p < 0.05).The positive correlation is performed between Qi deficiency constitution and qi deficiency-blood stasis syndrome(p < 0.05),Yang deficiency constitution and cold coagulation syndrome of Yang deficiency(p < 0.05),qi-stagnation constitution?dampness-heat constitution and dampness-heat collateral-blocking syndrome(p < 0.05),Yin deficiency constitution and Yin deficiency and blood stasis syndrome(p < 0.05),phlegm-dampness constitution and phlegm-blood stasis syndrome(p < 0.05).Conclusions:(1)The age,body mass index,disease course,marital status and monthly family income of DPN patients are closely related to comorbid anxiety and/or depression.(2)The syndrome types of DPN patients with comorbid anxiety and/or depression mainly include dampness-heat collateral-blocking syndrome,cold coagulation syndrome of Yang deficiency,phlegm-stasis collateral-blocking syndrome,yin-deficiency blood stasis syndrome,and qi-deficiency blood stasis syndrome.And constitution types of these patients mainly included qi deficiency constitution,qi stagnation constitution,Yang deficiency constitution and phlegm dampness constitution.(3)There is a correlation between TCM constitution distribution and syndrome type in DPN patients with comorbid anxiety and/or depression.Qi-deficiency constitution is common in qi deficiency and blood stasis syndrome,Yang deficiency constitution is often seen in cold coagulation syndrome of Yang deficiency,qi stagnation constitution and dampness-heat constitution are usually presented in dampness-heat collateral-blocking syndrome,phlegm-dampness constitution occurr frequently in phlegm-blood stasis syndrome,and yin-deficiency constitution is commonly seen in Yin deficiency and blood stasis syndrome.