| Objective: The purpose of this topic is to analyze the key syndrome elements of traditional Chinese medicine in patients with diabetic retinopathy of different pathological stages,to explore the law of disease progression,to refine the syndrome differentiation of traditional Chinese medicine,and to explore the key syndrome elements of the transition from non-proliferative phase to proliferative phase of diabetic retinopathy.The relationship with the relevant biochemical indicators such as blood glucose and blood lipids in patients provides theoretical ideas for clinical delay of the disease and further treatment based on syndrome differentiation.Methods: From November 2020 to November 2021,205 patients with type 2diabetic retinopathy and type 2 diabetic retinopathy were diagnosed in the Department of Endocrinology,The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine and the Health Management Department of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine.20 diabetic non-retinopathy patients were surveyed to complete the collection of demographic characteristics,general conditions,medical history,complications,biochemical indicators and information on the four diagnoses;fundus images of all cases were collected using a non-mydriatic fundus camera.Excel 2013 and SPSS Statistics 23 were used for data sorting and analysis.Results: The ratio of male to female in the 205 diabetic retinopathy patients was 1:1.33,and there was no difference in the gender ratio of patients with different stages by the chi-square test(p=0.928>0.05).There were 11 young patients,76middle-aged patients,and 118 elderly patients.There were significant differences in the age distribution of patients in different stages(p=0.000<0.01).The patients in different stages were significantly different in disease course(p=0.000<0.01),BMI(p=0.000 < 0.01),glycosylated hemoglobin(p=0.002 < 0.01),total cholesterol(p=0.003<0.01),triglyceride(p=0.013<0.05),high density lipoprotein(p=0.000<0.01),creatinine(p=0.006<0.01),and urinary microalbumin(p=0.009<0.01),there were significant differences in low density lipoprotein(p=0.920>0.05)were not significantly different.Diabetic retinopathy patients and type 2 diabetic non-diabetic retinopathy patients were significantly different in disease course(p=0.007<0.01),glycosylated hemoglobin(p=0.002 < 0.01),total cholesterol(p=0.014 < 0.05),triglyceride(p=0.032<0.05),high density lipoprotein(p=0.005<0.01),and urine microalbumin(p=0.023<0.05),there were significant differences in BMI(p=0.867>0.05),low density lipoprotein(p=0.920>0.05)and creatinine(p=0.121>0.05),there was no significant difference.The overall disease location of diabetic retinopathy,in descending order of occurrence frequency,is: liver,kidney,spleen,heart,mind,stomach,meridian,gallbladder,muscle and bone,lung,surface,large intestine,and uterus.There were significant differences in the distribution of disease-position syndrome elements(p=0.000 < 0.01),and there were significant differences in disease-position syndrome elements in different grades(p=0.032<0.05).The overall disease location of diabetic retinopathy syndrome element deficiency syndrome elements in descending order of occurrence frequency: Yin deficiency,blood deficiency,Qi deficiency,Yang deficiency,Yang hyperactivity,Jing deficiency,Qi deficiency,Qi depression,Jin deficiency,DR There was a significant difference in the distribution of different deficiency syndromes(p=0.000<0.01),and there was no significant difference in the distribution of different levels of deficiency syndromes(p=0.712 > 0.05).The overall disease location syndrome elements of diabetic retinopathy are: phlegm,dampness,qi stagnation,blood stasis,heat,and cold in descending order of occurrence frequency.There were significant differences in the distribution of DR on different levels of the phenotypes(p=0.000<0.01),and there were significant differences in the distribution of different grades of the DRs(p=0.000<0.01).There are significant differences in the distribution of yang deficiency syndrome elements in different stages(p=0.000<0.01),and there are significant differences in the distribution of yang deficiency syndrome elements in different grades(p=0.002<0.01).The correlation between "yang deficiency" syndrome elements and different stages Sex was not significant(p=0.084>0.05).There were significant differences in the course of diabetes(p=0.003<0.01)in patients with different degrees of "Yang deficiency" syndromes,but no significant differences in gender(p=0.172>0.05),BMI(p=0.701>0.05).There were significant differences in fasting blood glucose(p=0.023<0.05)and glycosylated hemoglobin(p=0.012<0.05)in patients with different degrees of "Yang deficiency" syndrome,but there was no significant difference in blood glucose 2 hours after meals(p=0.469>0.05).There were significant differences in total cholesterol(p=0.001<0.01),triglyceride(p=0.030<0.05),and high-density lipoprotein(p=0.012<0.05)in patients with different degrees of "Yang-deficiency" syndrome.There was no significant difference in lipoproteins(p=0.657>0.05).There were significant differences in serum creatinine levels(p=0.043<0.05),but no significant differences in urine microalbumin levels(p=0.809 > 0.05)among patients with different degrees of "yang deficiency" syndrome.Conclusion: There are differences in glycated hemoglobin,total cholesterol,triglyceride,high-density lipoprotein,creatinine,and urinary microalbumin between patients with type 2 diabetes without diabetic retinopathy and patients with diabetic retinopathy;age,course of disease,BMI,glycation of diabetic retinopathy patients Hemoglobin,total cholesterol,triglyceride,creatinine,and urinary microalbumin were correlated with the stage of diabetic retinopathy in parallel,and high-density lipoprotein was negatively correlated with the stage of diabetic retinopathy.There was a significant difference between the non-proliferative stage and the late-stage proliferative stage.In diabetic retinopathy,liver,kidney,spleen,and heart are the main disease sites,and there are differences in the distribution of different disease sites at different levels.The main deficiency syndromes are "Yin deficiency","Blood deficiency","Qi deficiency" and "Yang deficiency";"Yin deficiency" ranks first in the proportion of different stages;"Yang deficiency" gradually increased with the progress of the disease.Syndrome elements of solid STD mainly include "phlegm","dampness","qi stagnation" and "blood stasis";"phlegm" occupies the first place in different stages,and is mainly concentrated in severe(grade 3);syndrome element "phlegm" The proportion of "blood stasis" in disease progression gradually increased;there were differences in different grades of solid syndrome elements.The proportion of "yang-deficiency" syndrome elements increases with the progression of the disease,and is mainly concentrated in mild to moderate(grade 1,2)in the non-proliferative stage,and is mainly concentrated in severe(grade 3)in the proliferative stage;Fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,and creatinine were correlated in parallel,and negatively correlated with high-density lipoprotein,which was in line with the hypothesis that "yang deficiency" was the key factor for the development of diabetic retinopathy from non-proliferative to proliferative stages. |
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