Problems And Countermeasures In TCM Syndrome Differentiation Of Diabetic Foot

Purpose:Through a comprehensive cross-comparison of various authoritative literature on Syndrome differentiation and treatment of diabetic foot with academic literature on Syndrome differentiation and treatment of diabetic foot,this paper reveals the complex manifestations and basic causes of syndrome differentiation of diabetic foot in Chinese medicine,the countermeasure and method of syndrome differentiation standard of diabetic foot in TCM were put forward.Material and method:1.To collect the authoritative documents of TCM Syndrome differentiation of diabetic foot,including 14 authoritative documents such as the standard of diagnosis and treatment of Tcm Syndrome,the textbook of TCM surgery,etc.2.Chinese medical literature of Diabetic Foot based on clinical differentiation of symptoms and signs published in Chinese journals in the past 10 years was searched by CNKI,Weipu and Wanfang databases.3.To compare the differences of syndrome differentiation,symptoms,symptoms and syndromes of diabetic foot among the authoritative literature on Syndrome differentiation of diabetic foot,the literature on Syndrome differentiation and treatment of clinical diabetic foot and the two literature,in order to fully reveal the disorder of syndrome differentiation of this disease,causes and re-standardized thinking and methods.Results:1.The number of differentiation of symptoms and signs of diabetic foot varies from 3 to 5,and the total number of differentiation of symptoms and signs is up to 19 in 14 authoritative literatures There are many problems of the same syndrome(blood stasis syndrome and blood stasis syndrome,blood stasis syndrome,blood stasis syndrome,blood stasis syndrome,cold dampness syndrome,cold dampness syndrome,heat toxin syndrome,heat toxin excess syndrome,damp heat stasis syndrome,blood stasis syndrome,damp heat stasis syndrome,blood stasis syndrome,Yin deficiency and blood stasis syndrome,Yang deficiency and blood coagulation syndrome),degree difference syndrome,etc.,lacks the dialectical standard and the standard basic condition.2.Analysis of the symptoms of each certificate in the authoritative literature shows that the symptoms of the same certificate with different names in different versions of the authoritative literature vary from one to another,foot pain and color of the text description of a variety of local symptoms and signs of incomplete description of the existence of symptoms unrelated to diabetic foot;there are also signs and symptoms not entirely consistent with the jurisdiction,the main symptoms of different syndromes are the same but the boundary is not clear and so on.3.After summing up and sorting out the TCM Syndrome differentiation of diabetic foot in 64 papers of academic circles,33 syndromes were obtained by combining the syndromes of the same syndrome and different names,therefore,the problem of syndrome differentiation in authoritative literature(same syndrome different name,upper and lower syndrome,degree difference syndrome)also exists in the academic circles.In addition,among the 15 syndromes expanded by the academic circles,the disease localization is not only the spleen and kidney which appear in authoritative literature,also increased the liver,gallbladder,stomach,lung,different disease-based treatment led to the academic community,the number of syndrome differentiation is too much,a greater degree of dispersion.4.There are four types of syndrome differentiation of diabetic foot in academic circles: the first type is based on the standard of syndrome differentiation of authoritative literature,the Name of syndrome and its symptoms are consistent with authoritative literature;The second type comes from appropriate changes on the basis of syndrome differentiation of authoritative literature,which is different from the name of syndrome in comparison with authoritative literature,and the symptoms are mostly similar and belong to the Anomie of syndrome name;the third type is divorced from authoritative literature,self-made Syndrome differentiation,the names and symptoms of these syndromes are quite different from those in authoritative literature,and belong to the Anomie of syndrome differentiation;the fourth type is to combine the two names as one syndrome,this type of syndrome differentiation is mostly the combination of the two syndromes by the clinician based on his own experience.The symptoms of this type of syndrome are more complicated and belong to the disorder of symptoms.The above four situations lead to the excessive number of syndrome differentiation in TCM of diabetic foot in the academic circle,with different names,it has caused the confusion of TCM Syndrome differentiation of diabetic foot in academic circles.5.In academic circles,there is no unified standard for the symptoms and description of each syndrome of diabetic foot;the symptoms of the whole body,the color of the local limbs,the condition of the wound surface,and the tongue and pulse all overlap;the symptoms are excessive,it contains symptoms that are partly inconsistent with the syndrome,and symptoms that are only for the existence of the syndrome rather than the disease itself.Conclusion:1.The number,name and symptoms of differentiation of symptoms and signs in tcm of diabetic foot are not uniform among the authoritative literatures,which causes the differences of differentiation of symptoms and signs,such as the same syndrome but different names,upper and lower syndrome,different degree syndrome,etc.,there is no unified standard for differentiation of symptoms and signs in tcm of diabetic foot because of the similarities and differences between different literatures and different versions of the same literature.2.The differentiation of symptoms and signs in the authoritative literature of Diabetic Foot is so different that there is no standard of differentiation of symptoms and signs that can be implemented uniformly in academic circles,the clinical differentiation of symptoms and signs of diabetic foot has the problems of subjectivity,randomness and diversity.3.The Syndrome of diabetic foot in TCM is characterized by excessive number of symptoms and serious overlapping;the symptoms of Diabetic Foot are quite different from those of diabetic foot,and the systemic symptoms used in syndrome differentiation may not be related to the disease,these problems lead to the difference of clinical differentiation of symptoms and signs,and reduce the accuracy of clinical differentiation of symptoms and signs diagnosis of diabetic foot,and then affect the judgment of clinical treatment effect and the popularization of clinical experience.4.The standardization of differentiation of symptoms and signs of diabetic foot should focus on resolving the norms of syndrome name,appellation of symptoms and constitution,resolving the contradiction between the symptoms of diabetic foot and the symptoms of syndromes under the jurisdiction of the disease,eliminating the symptoms of unknown origin and unrelated to the disease,furthermore,the number of symptoms and syndromes can be reduced substantially in accordance with reality,and the diabetic foot can be separated from gangrene for differentiation of symptoms and signs alone or divided into three stages for differentiation of symptoms and signs,fundamentally solve the disorder of syndrome differentiation in TCM of diabetic foot.