Distribution of Traditional Chinese Medicine syndromes in diabetic kidney disease chronic kidney disease 1-5: a correlation study.

L I Shuang, Duan Shuwei, Dong Zheyi, Q U Yilun, Luo Yayong, K E Jianghua, Wang Conghui, Peng Yangzhi, Zhou Xuefeng, Chen Xiangmei
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引用次数: 0

Abstract

Objective: To analyze the distribution of Traditional Chinese medicine (TCM) syndromes in patients with diabetic kidney disease (DKD) and its related factors.

Methods: We enrolled 435 patients with DKD, who were not undergoing dialysis, admitted to the Department of Nephrology, First Medical Center, Chinese PLA General Hospital from April 2020 to August 2021. Analysis of their TCM syndromes and related factors was carried out.

Results: The 435 patients included 109, 117, 86, and 123 chronic kidney disease (CKD) 1-2, CKD3, CKD4, and CKD5 cases, respectively. With the progression of CKD1-5, the proportion of Yin deficiency and dry heat syndrome, and that of Qi and Yin deficiency syndrome showed a downward trend, whereas the proportion of spleen-kidney Yang deficiency, blood deficiency, blood stasis, water stagnation, and phlegm turbidity syndromes showed an upward trend; the differences were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that Yin deficiency and dry heat syndrome was positively correlated with hemoglobin [odds ratio (OR) = 1.022, P = 0.005], albumin (OR = 1.058, P = 0.006), and estimated glomerular filtration rate (eGFR) (OR = 1.020, P < 0.001) but negatively correlated with male sex (OR = 0.277, P = 0.004). Qi and Yin deficiency syndrome was positively correlated with albumin (OR = 1.056, P < 0.001) and eGFR (OR = 1.008, P = 0.022) but negatively correlated with age (OR = 0.977, P = 0.023). Liver-kidney Yin deficiency syndrome was positively correlated with age (OR = 1.028, P = 0.021) and glycosylated hemoglobin (OR = 1.223, P = 0.007) but negatively correlated with total cholesterol (OR = 0.792, P = 0.006). Spleen-kidney Yang deficiency syndrome was negatively correlated with hemoglobin (OR = 0.977, P < 0.001), albumin (OR = 0.891, P < 0.001), and eGFR (OR = 0.978, P < 0.001) but positively correlated with high density lipoprotein (OR = 3.376, P = 0.001).

Conclusion: With CKD1-5 progression, TCM syndromes changed from Yin deficiency and dry heat syndrome to syndrome of deficiency of both Qi and Yin, liver-kidney Yin, and spleen-kidney Yang deficiency syndromes. TCM syndromes were correlated with laboratory test results.

糖尿病肾病慢性肾病1-5期中医证候分布:相关性研究。
目的:分析糖尿病肾病(DKD)患者的中医证候分布及其相关因素:分析糖尿病肾病(DKD)患者中医证候的分布及其相关因素:方法:选取 2020 年 4 月至 2021 年 8 月中国人民解放军总医院第一医学中心肾内科收治的 435 例未接受透析治疗的糖尿病肾病患者为研究对象,分析其中医证候及其相关因素。结果:435例患者中,慢性肾脏病(CKD)1-2、CKD3、CKD4和CKD5病例分别为109例、117例、86例和123例。随着CKD1-5的进展,阴虚燥热证、气阴两虚证的比例呈下降趋势,而脾肾阳虚证、血虚证、血瘀证、水停证、痰浊证的比例呈上升趋势,差异有统计学意义(P<0.05)。多变量逻辑回归分析显示,阴虚燥热证与血红蛋白[几率比(OR)= 1.022,P = 0.005]、白蛋白(OR = 1.058,P = 0.006)和估计肾小球滤过率(eGFR)(OR = 1.020,P 0.001)呈正相关,但与男性性别(OR = 0.277,P = 0.004)呈负相关。气阴两虚综合征与白蛋白(OR = 1.056,P < 0.001)和 eGFR(OR = 1.008,P = 0.022)呈正相关,但与年龄(OR = 0.977,P = 0.023)呈负相关。肝肾阴虚综合征与年龄(OR = 1.028,P = 0.021)和糖化血红蛋白(OR = 1.223,P = 0.007)呈正相关,但与总胆固醇(OR = 0.792,P = 0.006)呈负相关。脾肾阳虚综合征与血红蛋白(OR = 0.977,P < 0.001)、白蛋白(OR = 0.891,P < 0.001)和 eGFR(OR = 0.978,P < 0.001)呈负相关,但与高密度脂蛋白(OR = 3.376,P = 0.001)呈正相关:结论:随着 CKD1-5 的进展,中医证候由阴虚燥热证转变为气阴两虚证、肝肾阴虚证和脾肾阳虚证。中医证候与实验室检查结果相关。
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