Mia Syndrome Of Tcm Syndrome In Chronic Kidney Disease Preliminary Study

In recent years, malnutrition, inflammation and atherosclerosis of causal relationship among each other was gradually known by people, Stenvinkel etc found that 22 percent of 109 before dialysis patients with end-stage renal failure existing malnutrition, inflammation and atherosclerotic three kinds of cases. Subsequent research suggests the presence of malnutrition, inflammation and atherosclerosis syndrome (MIAs).MIAs affects the survival of patients with chronic renal failure quality and prognosis. Traditional Chinese medicine in CRF patients MIAs research mainly is very active, chronic renal failure with Chinese medicine treatment of MIAs achieved good curative effect, so combining traditional Chinese and western medicine treatment to MIAs may have good prospects. But now MIAs Traditional Chinese medicine research is still at a Preliminary stage, So it is very important to explore the etiology, pathogenesis, differential diagnosis of CKD-MIAs to give it target treatmentsObjective: to summarize. traditional. Chinese medical syndrome distribution law and main syndrome features of CKD-MIA syndrome; to explore the relationships among MIAs syndrome types, clinical nutrition, inflammation and atherosclerosis; to provide the clinical based data for Traditional Chinese medicine in order to instruct dialectical legislation and the oprescription of CKD-MIA syndromes.Methods:cross-sectional survey was adopted to collect materials and differ ential diagnosis of 41 CKD-MIAs patients with the inclusive criteria and the ir degrees of excessive-syndromes and deficiency-syndrome were scored, and S GA score, dialysis patients by MIS score simultaneously. Explore the relatio nship between the scores and various clinical index such as blood urea nitro gen (BMI= BW/height2), blood pressure, personal hobby, past medical hist ory, serum creatinine, urea nitrogen, serum albumin, former albumin, transfe rrin, cholesterol, triglyceride, calcium, phosphorus, the entire section of parathyroid hormone, hemoglobin, high-sensitivity C-reactive protein, interl eukin-6, tumor necrosis factor-αand carotid ultrasound determination abnor mal carotid intimal-media thickness;Record previous diagnosis cerebrovascula r and peripheral artery disease. hemodialysis patients take blood Before dial ysis. Spearman Correlation and Rank Sum Test were used. P< 0.05 is consid ered significant. Results:1. clinical symptoms of chronic kidney disease: the most common symptom were lassitude and weakness, waist sour knee soft, shortness of breath and lazy to talk,dim complexion, chills limb cold, numbness of the limbs,poor appetite, Bosom frowsty breath-holding, mouth parched and throat scorched, Head body trapped heavy.2. clinical syndrome of chronic kidney disease:The most common deficiency-syndrome among MIAs patients was Qi-deficiency in spleen and kidney, accounting for 43.9% and the most common excessive-syndrome among them was blood-stasis, accounting for 73.17%, and various dampness syndromes such as retention of dampness, damp-heat, pathogenic dampness, and phlegm-damp. among MIAs patients, The type of Qi-deficiency in spleen and kidney is more common in Mild-to-moderate malnutrition kidney and Yin and Yang deficiency syndrome is more common in Severe malnutrition.Scores of deficiency-syndrome had a positive correlation with that of excessive-syndrome3. The relationship among Malnutrition, inflammation and the arteriosclerosis: CRP levels had a positive correlation with MIS score, CRP levels might be negatively correlated to PA levels, CRP levels might be negatively correlated to CHO and LDL levels among them, explain that micro inflammation is the important reasons for causing malnutrition and atherosclerosis.4. The relationship between the syndromes and Malnutrition, inflammation and atherosclerosis index:1) Scores of deficiency-syndrome had a nagative correlation with ALB levels, suggesting served patients for clinical symptoms and the firm with albumin levels lower and heavier. suggesting that the deficiency-syndrome might tend to increase as the level of albumin levels decreased.2) Inflammatory factor IL-6 had a positive correlation with dampness and damp-heat.3) IMT had a positive correlation with damp-heat and blood-stasis. indicates that the damp-heat and blood stasis were mutual resistance in vascellum, may be one of the pathogenesis of atherosclerosis.The above results indicate the following conclusions:The characteristic syndrome of ARAS patients was deficiency in the origin and excess in superficiality, with Qi-dificiency of spleen and kidney as its most common clinical deficiency-syndrome, and blood-stasis and pathogenic dampness as its most common pathogenic factors. After Analysing to the clinical indicators of malnutrition,inflammation,atherosclerosis and deficiency-syndrome or excessive-syndrome. Proved by MIA patients, existing the two kinds of pathological changes that it is closely relation between coexistent deficiency and excess. According to patients with existing of deficiency-syndrome and excessive-syndrome, centralizer exorcisms is still one important rule for treatment, and Strengthening spleen, nourishing kidney, promoting blood circulation and removing dampness may be mainly Treatment for MIA syndrome.