Clinical study on test of sympathetic skin response and its relationship with syndrome of traditional Chinese medicine in patients with type 2 diabetes mellitus

Objective To investigate the diagnostic value of sympathetic skin response(SSR)test in peripheral neuropathy of patients with type 2 diabetes mellitus(T2DM) and analyze its relationship with syndrome of traditional Chinese medicine.Methods One hundred and ninety-two patients with T2DM were selected to receive SSR test and were classified as syndromes of traditional Chinese medicine Qi-deficiency(气虚),Yin-deficiency(阴虚),Yang-deficiency(阳虚),blood-stasis(血瘀) and phlegm-dampness(痰湿).Five grades were used for evaluation of score.Results The total rate of SSR abnormality was 73.4%(141/192);the abnormal rate was 71.5%(27/38) in patients without symptoms of peripheral nerve injury and 68.8%(11/16) in patients without symptoms of autonomic nerve injury.Gender,age and disease course had no influences on the rate of SSR abnormality as well as whether having symptoms of automatic nervous damage(all P0.05).There were positive correlations between the amplitude of upper extremities and lipoprotein(Apo) B,low density lipoprotein-cholesterol(LDL-C) and cholesterol(CHO).Meanwhile there were positive correlations between the latency of lower extremities and 2 hour-postprandial blood sugar(2 h PBG) and diastolic blood pressure(DBP).Besides,there were positive correlations between the amplitude of lower extremities and ApoA1,ApoB,LDL-C,CHO(P0.05 or P0.01).The frequency of Yin-deficiency and blood-stasis was over 50%.The proportion and score of Yang-deficiency were significantly higher in the elder-age(60 ages) group than those in the younger-age(≤60 ages) group(P0.05 and P0.01).The scores of blood-stasis and Yang-deficiency evidently increased in the patients with longer-course(both P0.01).The scores of Qi-deficiency and Yindeficiency in the patients with symptoms of autonomic nerve functional injuries were markedly higher than those without such symptoms(both P0.01).The score of Yin-deficiency in abnormal SSR group was obviously lower than that of normal SSR group(P0.05).The analyses of correlation showed that there were negative correlations between the latency and the score of Qi-deficiency(0.316r-0.157,P0.05 or P0.01) as well as between the amplitude of right upper limb and the score of Yang-deficiency or blood-stasis(Yang-deficiency: r=0.207,P=0.006;blood-stasis: r=-0.162,P=0.032).Conclusion SSR is beneficial for detection of sub-clinical diabetic neuropathy,which can serve as a sensitive index for evaluation of early autonomic lesion or fibril functional state of peripheral nerves in T2DM.The blood glucose,blood pressure and lipids have influences on the parameters of SSR.Yang-deficiency and blood-stasis in patients with diabetic peripheral neuropathy aggravated with longer course and older age.The disease situation of Qi-deficiency,Yang-deficiency and blood-stasis has certain effects on the parameters of SSR.