Study On The Correlation Between Type 2 Diabetic Peripheral Neuropathy And Its Risk Factors And TCM Syndrome Type

Objective:To explore the distribution characteristics of TCM syndromes between diabetic peripheral neuropathy(DPN)and non-DPN patients in type 2 diabetes,and compare the differences of syndrome elements,so as to provide evidence for clinical treatment;to explore the relationship between TCM syndrome type and general data of DPN,and provide ideas for TCM syndrome differentiation;to explore the risk factors of DPN,the correlation between TCM syndrome type and risk factors,and provide reference for the prevention and intervention of DPN.Methods:This study included 300 patients with type 2 diabetes mellitus in Dongzhimen Hospital Beijing University of Chinese Medicine,grouped according to the presence or absence of DPN,including 150 patients with DPN and 150 patients without DPN.General data,clinical physicochemical indicators,symptoms,and signs of patients in both groups were collected,and SPSS 26.0 software was applied to analyze the data.The distribution characteristics of TCM syndrome type in DPN and non-DPN patients were explored by factor analysis and syndrome element differentiation,and the differences in syndrome element distribution were compared by univariate analysis.The relationship between different syndrome types and general data of DPN was investigated by correlation analysis.The risk factors of DPN were investigated by combining single-factor analysis and multi-factor logistic regression,and the correlation analysis between TCM syndrome type and risk factors of non-DPN patients was conducted.Results:1.Distribution characteristics of syndrome elements and types of DPN:the pathogenic syndrome elements of DPN patients were blood stasis,qi deficiency,yang deficiency,cold,yin deficiency,phlegm,dampness,essence deficiency,and qi stagnation in order,and the location syndrome elements were kidney,spleen,and liver.The types of the syndrome in descending order of frequency distribution were kidney deficiency and cold coagulation syndrome,phlegm-dampness stasis syndrome,qi deficiency and blood stasis syndrome,kidney essence deficiency syndrome,qi stagnation and blood stasis syndrome,liver yin deficiency syndrome,spleen qi deficiency syndrome,liver and kidney deficiency syndrome.2.Comparison of general data of DPN TCM syndrome types:compared with other syndrome types,patients with qi stagnation and blood stasis syndrome were younger and patients with kidney essence deficiency syndrome were older.Patients with kidney essence deficiency syndrome had a longer disease duration,and the proportion of patients with a disease duration>10 years was higher.Patients with liver and kidney deficiency syndrome had a shorter disease duration,and the proportion of those with a disease duration of 6-10 years was higher.Body mass index(BMI)and proportion of obesity were higher in patients with phlegmdampness stasis syndrome than in those with non-phlegm-dampness stasis syndrome.3.Distribution characteristics of non-DPN syndrome elements and syndrome types:the pathological syndrome elements of non-DPN patients were yin deficiency,phlegm,dampness,qi deficiency,yang deficiency,blood stasis,heat and qi stagnation in order,and the location syndrome elements were kidney,spleen,liver and stomach.The syndrome types were phlegmdampness blocking syndrome,stomach heat-yin deficiency syndrome,phlegm-dampness stasis syndrome,kidney yin and yang deficiency syndrome,liver yin deficiency syndrome,spleen and kidney qi deficiency syndrome,spleen and kidney yang deficiency syndrome,yin and jin deficiency syndrome,qi stagnation and blood stasis syndrome in descending order of frequency distribution.4.Comparison of the distribution of DPN and non-DPN syndrome elements:among the pathogenic syndrome elements,heat was only found in non-DPN patients,and cold and essence deficiency were only found in DPN patients.Yin deficiency,phlegm and dampness syndrome elements were significantly lower in DPN patients than in non-DPN patients,while their blood stasis syndrome elements were significantly higher than in non-DPN patients.Among the pathological syndrome elements,both groups of patients had kidney,spleen and liver,and kidney was the main pathological syndrome element,and the spleen syndrome element was significantly higher in DPN patients than in non-DPN patients.5.Risk factor analysis of DPN:univariate analysis showed that the proportion of female,age,duration of diabetes,combined diabetic nephropathy,combined diabetic retinopathy,combined hypertension,high density lipoprotein cholesterol,neutrophil lymphocyte ratio(NLR)were higher in DPN patients than in non-DPN patients,and total cholesterol,low density lipoprotein cholesterol,lymphocyte,total bilirubin(TBIL)were lower than in non-DPN patients(P<0.05).Age,duration of diabetes,and diabetic retinopathy remained significantly different after performing multifactorial analysis and were independent risk factors for DPN.6.Correlation study between non-DPN TCM syndrome and risk factors:compared with other syndrome types,patients with spleen and kidney qi deficiency syndrome had a longer duration of diabetes and a higher proportion of combined hypertension.Conclusion:1.When progressing from non-DPN to DPN,the main pathogenesis changes from stomach heat and yin deficiency,phlegm and dampness obstruction to stasis and blood obstruction,yang deficiency and cold condensation,and kidney essence deficiency.The liver,spleen and kidney are the common disease locations of both,and the kidney is the main disease location.The distribution of the syndrome of DPN varies with age,disease duration,and BMI.2.DPN is associated with gender,age,duration of diabetes,diabetic retinopathy,NLR,TBIL,etc.Age,duration of diabetes,diabetic retinopathy are independent risk factors.Patients with non-DPN spleen and kidney qi deficiency syndrome have a longer duration of diabetes and are more likely to have hypertension in combination,so patients with this syndrome type are more likely to develop DPN.