Characteristics of first-ever foot ulcers of diabetic foot based on Yin-Yang syndrome differentiation and the cutaneous areas theory
WANG Tao,JU Shang,WANG Ning
Abstract:
Objective To explore the characteristics of the cutaneous areas and Yin-Yang syndrome differentiation in patients with the first-ever foot ulcer. Methods A total of 228 patients with the first-ever foot ulcer who were admitted to Dongzhimen Hospital Beijing University of Chinese Medicine between June 30, 2022 and June 30, 2024 were selected. To extract patient information from the hospital's His medical record system, including ulcer location, age, gender, duration of diabetes, medical history, four diagnostic methods (inspection, listening and smelling, inquiry, and palpation), specialized physical examination, and comorbid diseases. The cutaneous areas corresponding to the ulcer location were determined, and the Yin-Yang syndrome differentiation of the wound was assessed based on the patients' medical history, four diagnostic methods, and specialized physical examination. Results 70.2% of 228 patients with diabetes first-ever foot ulcer were included, and 98.2% were over 40 years old; 67.6% of the patients had diabetes for more than 10 years, 42.1% had hyperlipidemia, 67.5% had hypertension, 50% had ischemic heart disease, 20.2% had cardiac insufficiency, 48.2% had ischemic cerebrovascular disease, 26.3% had renal insufficiency, and 21.5% had anemia and hypoproteinemia. The most frequent occurrence of initial ulcers on the cutaneous areas of the sixth meridian of the foot is in the pubic area of the foot, with a total of 93 times, accounting for 40.8%. The least frequent occurrence is in the pubic area of the foot, with a total of 26 times, accounting for 11.4%. In the Yin-Yang syndrome differentiation of foot ulcers, the most frequent is the yin syndrome, with a total of 156 cases, accounting for 68.4%, and the least is the semi-Yin and semi-Yang syndrome, with a total of 34 cases, accounting for 14.9%. In the general demographic data, the proportion of patients with the first ulcer of the cutaneous areas of Foot Yangming was higher in the age groups of 20 to 39 and > 80, and the proportion of patients with the first ulcer of the cutaneous area of Foot Shaoyang was higher in the age groups of 20 to 39 and 60 to 79, and the difference was statistically significant (P <0.05); the proportion of female patients with the first-ever ulcer of the cutaneous area of Foot Taiyin was higher, and the difference was statistically significant (P <0.05); the proportion of patients with the first-ever foot ulcer of patients with the duration of diabetes ≤ 5 years and 10.01 to 15 years was higher in the syndrome of Yang syndrome and semi-Yin and semi-Yang syndrome, and the proportion of patients with the first foot ulcer of patients with the duration of diabetes 5.01 to 10 years and 15 years was higher in the Yin syndrome. Among the combined diseases, patients with hyperlipidemia had a lower proportion of first-ever foot ulcers in the cutaneous area of Foot Taiyin, and a higher proportion of first-ever foot ulcers in the cutaneous area of Foot Shaoyang, and the difference was statistically significant (P <0.05); patients with cardiac insufficiency and renal insufficiency had a higher proportion of first-ever foot ulcers in the cutaneous area of Foot Shaoyin, and the difference was statistically significant (P <0.05); patients with a history of hypertension had a higher proportion of first-episode foot ulcers differentiated as Yin syndrome and semi-Yin semi-Yang syndrome, and the difference was statistically significant (P <0.05). Conclusion The ulcer first in the cutaneous area of Foot Yangming was related to age, the ulcer first in the cutaneous area of Foot Shaoyang was related to age and combined hyperlipidemia, the ulcer first in the cutaneous area of Foot Taiyin was related to gender and combined hyperlipidemia, the ulcer first in the cutaneous area of Foot Shaoyin was related to combined cardiac insufficiency and combined renal insufficiency, while the Yin and Yang syndrome differentiation was related to the duration of diabetes and the history of hypertension.
