| Objective: Develop a diagnostic scale for common pathological factors of type 2 diabetes with integrated traditional Chinese and western medicine to provide guidance for the clinical diagnosis of type 2 diabetes,and explore ideas and methods for standardized research on TCM syndrome diagnosis.Methods:1.Through searching,establish a type 2 diabetes literature database,mine the symptoms,signs and physical and chemical indicators related to the diagnosis of type 2 diabetes,and organize the diagnosis items in a standardized way to form a type 2 diabetes diagnosis item pool.2.Based on the results of literature research,develop expert questionnaires,apply the Delphi method to conduct two rounds of expert questionnaires,statistically analyze the grade sum,arithmetic mean,unimportant percentage,standard deviation and coefficient of variation of each diagnostic item,and compare the diagnostic items To filter.3.Combining clinical investigation data and applying Logistic regression analysis method to weight the diagnostic items;and using receiver operating characteristic curve(ROC curve)to determine the diagnostic threshold,preliminary draft of the integrated Chinese and Western medicine diagnostic scale for common pathological factors of type 2 diabetes.Result:1.Literature research A total of more than 2,000 literatures were retrieved,101 were included,and 186 diagnostic items were extracted from the four main pathological factors of Qi deficiency,Yin deficiency,phlegm,and blood stasis.2.Through two rounds of Delphi expert consultation,the four main pathological diagnosis items of type 2 diabetes,namely Qi deficiency,Yin deficiency,phlegm turbidity,and blood stasis,were finally screened out as8,10,12,and 12 respectively.The diagnostic items for qi deficiency include "shen fatigue,fatigue,shortness of breath,low voice,easy cold,pale tongue,weak pulse,elevated glycosylated hemoglobin";yin deficiency includes "hot flashes,night sweats,hand,foot,and heart heat,chronic low fever,and bone evaporative fever,Zygomatic red,dry throat,red and crimson tongue,cracked tongue,thin pulse,insomnia and dreaminess,lower body mass index";turbid phlegm includes "high quality and thick phlegm,vomiting,phlegm salivation,body obesity,chest tightness,lethargy,pale tongue Tooth marks,greasy tongue coating,slippery pulse,elevated total cholesterol,elevated triglycerides,elevated body mass index,elevated low-density lipoprotein";blood stasis has "fixed pain,tingling,painful nighttime pain,bleeding color Darkness,dull complexion,dark purple tongue with petechiae,bruising of sublingual collaterals,purple lips,astringent pulse,skin nail,elevated D-dimer,elevated fibrinogen."3.Incorporate clinical survey data,apply mathematical analysis,and draw up a diagnostic scale of integrated traditional Chinese and western medicine for type 2 diabetes with Qi Deficiency Syndrome:(shen fatigue×6)+(fatigue and fatigue×5)+(low voice×9)+(light tongue×8)+(Deficiency of pulse×4)+(Elevation of glycosylated hemoglobin×5),score≥20,can diagnose Qi deficiency syndrome;Yin deficiency syndrome diagnostic scale:(Hot flashes×5)+(night sweats×5)+(low fever×4)+(red and crimson tongue×5)+(crack tongue×4)+(thin pulse×5)+(insomnia×4)+(BMI decreased×4),points≥25 points,the Yin deficiency syndrome can be diagnosed;the phlegm turbidity syndrome diagnostic scale:(multiple and thick sputum×5)+(vomiting,sputum,salivation×7)+(body obesity×5)+(greasy tongue coating×6)+(Slippery pulse×5)+(increased total cholesterol×6)+(increased triglyceride×5)+(increased body mass index×4),score≥30 points,can diagnose phlegm turbidity syndrome;diagnosis of blood stasis syndrome Scale:(Fixed pain×6)+(Tingling×7)+(Very painful at night×5)+(Purple tongue with petechiae×6)+(Purple lips×6)+(Astringent pulse×5)+(D-dimer increase×4)+(fibrinogen increase×4),score≥30 points,the blood stasis syndrome can be diagnosed.Conclusion : This study focused on pathological factors,and through literature research,excavated type 2 diabetes related diagnosis items of Qi deficiency,Yin deficiency,phlegm turbidity,and blood stasis,and collected expert opinions through the Delphi method expert consultation questionnaire,and finally screened out Qi deficiency,Yin deficiency,and blood stasis.There are 8,10,12,and 12 diagnosis items for 4 pathological factors of phlegm turbidity and blood stasis.Incorporate clinical investigation data and apply mathematical analysis to determine the weight of each diagnostic item and the diagnostic threshold of each pathological factor.An objective diagnostic scale of integrated traditional Chinese and Western medicine for different pathological factors of type 2 diabetes was initially developed.This scale provides guidance for the clinical diagnosis of 2 diabetes with integrated traditional Chinese and western medicine. |
