| Objective:In this study,we investigated the relationship between syndrome differentiation and stage of type 2 diabetic nephropathy,and explored the relationship between blood stasis syndrome of type 2 diabetic nephropathy and ABI,baPWV and sublingual collaterals,and analyzed the correlation between the various stages of diabetic nephropathy and ABI,baPWV and scores of subglossal collateral vessels.This study clarified whether ABI or baPWV can be used as a diagnostic basis for blood stasis syndrome.This study explored the correlation between subglossal collateral vessels and ABI,baPWV.This study can help clinicians with syndrome differentiation,predict the progression of disease through ABI and baPWV,and indirectly understand the trends of ABI and baPWV by observing the subglossal collateral vessels,and infer the progression of type 2 diabetic nephropathy.Methods:We observed outpatients and inpatients who were diagnosed with type 2 diabetic nephropathy from July 2017 to February 2019 in our hospital.The age ranged from 30 to 90 years old,male or female.Diagnostic criteria for diabetic nephropathy refer to the 2007 NKF-K/DOQI guidelines and the "Expert Consensus on Clinical Diagnostics of Chinese Adult Diabetic Nephropathy" promulgated by the Endocrine Society of the Chinese Medical Association in 2016.The TCM syndrome differentiation was formulated with reference to the 2007 Diabetes Nephropathy Diagnosis,Syndrome Differentiation and Efficacy Evaluation Criteria(Trial Program)and the 2002 edition of the Guiding Principles for Clinical Research of New Drugs in Traditional Chinese Medicine.The specific contents include:the basic information of the patient includes gender,age,height,weight,etc.At the same time,fill in the case questionnaire,judge the patient's syndrome type,collect the subglossal collateral vessels information of the patient,and score according to the scoring standard.The special examination items include ABI and baPWV.Results:1?Distribution of syndrome types in type 2 DKD patientsIn terms of incidental syndrome distribution,blood stasis syndrome accounted for 37.1%,followed by damp heat syndrome accounted for 28.4%,phlegm damp syndrome accounted for 21.6%,and cold dampness syndrome accounted for 12.9%.In the ? phase,damp heat syndrome accounted for 36.6%,blood stasis syndrome accounted for 31.7%,phlegm damp syndrome accounted for 19.5%,and cold dampness syndrome accounted for 12.2%.In the ?phase,damp heat syndrome accounted for 29.5%,and blood stasis syndrome accounted for 27.3%,phlegm damp syndrome accounted for 27.3%,and cold dampness syndrome accounted for 15.9%.In the ? phase,blood stasis syndrome accounted for 58.1%,phlegm damp syndrome accounted for 16.1%,damp heat syndrome accounted for 16.1%,and cold dampness syndrome accounted for 9.7%.In terms of fundamental symptom distribution,qi and yin deficiency syndrome accounted for 42.2%,spleen and kidney qi deficiency syndrome accounted for 30.2%,Yin deficiency and heat syndrome accounted for 15.5%,and Yin and Yang deficiency syndrome accounted for 12.1%.In the ? phase,qi and yin deficiency syndrome accounted for 48.8%,Yin deficiency and heat syndrome accounted for 26.8%,spleen and kidney qi deficiency syndrome accounted for 19.5%,and Yin and Yang deficiency syndrome accounted for 4.9%.In the ? phase,spleen and kidney qi deficiency syndrome accounted for 47.7%,qi and yin deficiency syndrome accounted for 31.8%,Yin deficiency and heat syndrome accounted for 11.4%,and Yin and Yang deficiency syndrome accounted for 9.1%.In the ? phase,qi and yin deficiency syndrome accounted for 48.4%,Yin and Yang deficiency syndrome accounted for 25.8%,spleen and kidney qi deficiency syndrome accounted for 19.4%,and Yin deficiency and heat syndrome accounted for 6.5%.2?Comparison of baPWV,ABI and subglossal collateral vessels scores between blood stasis syndrome and non-blood stasis syndromeThe average baPWV of the blood stasis syndrome group is 2088.42±268.518cm/s,and the average baPWV of the non-blood stasis syndrome group is 1875.931281.712cm/s.The difference between the two groups is statistically significant(P<0.05).The average ABI of the blood stasis syndrome group is 0.6002±0.11132,and the average ABI of the non-blood stasis syndrome group is 0.6807±0.11889.The difference between the two groups is statistically significant(P<0.05).The average score of subglossal collateral vessels in the blood stasis syndrome group is 16.60±4.083,and the score of subglossal collateral vessels in the non-blood stasis syndrome group is 14.33±3.682.The difference between the two groups is statistically significant(P<0.05).3?Comparison of baPWV,ABI and sublingual collateral integrals of type 2 DKD different stagesTest the baPWV of each stage of DKD by Kruskal-Wallis and get P<0.001,so the levels of baPWV in the three groups is considered to be different.After compare each group with the other two groups,there is no difference in baPWV levels between stage ? and ?.There is a difference in the level of baPWV between stage ? and ?.There is a difference in the level of baPWV between stage ? and ?.Test the ABI of each stage of DKD by Kruskal-Wallis and get P<0.001,so the ABI levels of the three groups are considered to be different.After compare each group with the other two groups,there are differences between any two groups.Test the subglossal collateral vessels scores of each stage of DKD by Kruskal-Wallis and get P<0.001,so the level of subglossal collateral vessels scores in the three groups is considered to be different.After compare each group with the other two groups,there are differences between any two groups.4.?Correlation between type 2 DKD subglossal collateral vessels scores and baPWV,ABI,SBP,DBP and ageAccording to Spearman correlation analysis,there is a correlation between subglossal collateral vessels scores and baPWV(rs=0.806,P<0.001),and there is a very high positive correlation between the two.There is a correlation between subglossal collateral vessels scores and ABI(rs=-0.762,P<0.001),and there is a high negative correlation between the two.There is a correlation between subglossal collateral vessels scores and age(rs=0.308,P<0.001),and there is a moderate positive correlation between the two.There is no correlation between subglossal collateral vessels scores and SBP(rs=-0.155,P=0.096>0.05).There is no correlation between subglossal collateral vessels scores and DBP(rs=0.039,P=0.680>0.05).Conclusion:1?In stage ? of type 2 DKD,the TCM fundamental symptom is mainly for Yin deficiency and heat syndrome,Qi and Yin deficiency syndrome.Most of the incidental syndrome are damp heat syndrome and blood stasis syndrome.The main fundamental symptom of stage ? is Qi and Yin deficiency syndrome,spleen and kidney qi deficiency syndrome.Most of the incidental syndrome are damp-heat syndrome,blood stasis syndrome,and phlegm damp syndrome.The main fundamental symptom of stage V is qi and yin deficiency syndrome,yin and yang deficiency syndrome,spleen and Kidney qi deficiency syndrome.Most of the incidental syndrome is blood stasis syndrome.2.?In type 2 DKD,baPWV,ABI and subglossal collateral vessels can be used as a dialectical basis for blood stasis syndrome.3?Subglossal collateral vessels,ABI and baPWV can monitor the progression of diabetic nephropathy.4?For patients with type 2 DKD,the changes in baPWV and ABI can be indirectly observed by observing the subglossal collateral vessels,thus predicting the progression of diabetic nephropathy. |
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