Based On Epidemiological Investigation To Researh The Pathogenesis Of "Stagnant Heat" Of Chronic Kidney Disease

Research Objective:Professor Zhou Zhongying puts forward the view that "damp,heat,stasis and toxic" is the basic pathogenesis of chronic kidney disease (CKD) on the basis of his years of clinical practice. According to Professor Zhou’s theory,the research is meant to using the method of clinical epidemiological investigation to establish a clinical epidemiological database of "stagnant heat" in CKD,and to explore the law of "stagnant heat" at different stages of CKD, to seek the inner relation of "stagnant heat" and its evolution law in chronic kidney disease, so as to deepen the theoretical understandings of chronic kidney disease.Research Methods:By surveying of 444 cases of hospitalized CKD patients at Chinese Medicine Hospital of Jiangsu Province from July to December in 2012 and March to December in 2014,establishing CKD epidemiological investigation database about "stagnant heat". and then using the SPSS 17.0 statistical analysis software to explore the distribution and evolution of "stagnant heat" in CKD,and to further study other factors related with it.Research Results:The pathogenesis of 132 cases of patients with CKD in this survey belongs to the "stagnant heat", account for 29.73% of the total, among which 71 cases are male, while 61 cases female, by chi-square test, P>0.1,indicate that gender makes no sense to the incidence of stagnant heat in CKD. And by chi-square,there’s no difference in statistcs in the aspect of age. Comparing the incidence of "stagnant heat" in different CKD stages, chi-square= 4.927, P> 0.05, meaning that therei’s no statistical significance. But "stagnant heat" in CKD 5 phase is significantly higher than that in other stages,indicating that "stagnant heat" mainly exists in the advanced stage of CKD.Analysis of the relationship between poor diet habits and "stagnant heat" in CKD, chi-square= 19.449, P< 0.01; Further analysis of the influence of different personal habits such as tobacco, alcohol, high-salt food, high-fat food calculates chi-square= 2.584, P> 0.05,indicating that poor diet habits including tobacco, alcohol, high-salt food,high-fat food all have a certain influence on "stagnant heat" in CKD. Among the 132 cases of CKD,the accompanied diseases with "stagnant heat" order from high to low is:SLE 81.25%, gout 57.89%,32.79% of coronary heart disease, hypertension 30.98%, cerebral infarction of diabetes by 24.14%,diabetes 18.55%, calculated chi-square= 23.353, P< 0.01; Further analysis of SLE compared with other disease of CKD, the influence of incidence rate of "stagnant heat’: calculated chi-square is 24.869, P= 0.000,indicating that different concomitant diseases have different influences on "stagnant heat" in CKD,and the effect of SLE is particularly significant. Analyzing the relationship between renal replacement therapy and the incidence of "stagnant heat" in CKD, chi-square equal to 6.610, P< 0.05; Futher exploring the difference thal peritoneal dialysis and hemodialysis acting on the incidence rate of "stagnant heat" in CKD. chi-square equal to 2.727, P= 0.090, P> 0.05,indicating that Drain and hemodialysis both have significant influence on "stagnant heat"in CKD. Analysis "blood stasis", "hot" and "stagnant heat" in different periods of CKD distribution rule, the CKD1 period "hot" accounted for 34.62% significantly higher than the rest, both CKD5 period "stasis hot" the proportion of the highest, 36.50%. According to statistics, "wet" and "stagnant heat" phase and the highest rate of 71.97%, followed by "deficiency", accounted for 65.15%.Research and clip stagnant heat CKD in different stages of its distribution, the chart shows that with the increase of CKD stage, the incidence of the clamp and pathogenesis are on the rise; In CKD1 stage and two stage, and pathogenesis of the highest incidence of are in "qi deficiency",17.30%and 18.49% respectively; Stage CKD3 and 5 the highest incidence and pathogenesis was the "wet", accounted for 21.79%; In CKD4 period "wet" and "qi-deficiency" tied for the highest incidence, with 20.69%,indicating that "stagnant heat" accompanied with "qi-deficiency" always exist at the early stage,and later damp,heat,stasis,toxic and other pathological factors gradually increased. According to the frequency of major clinical symptoms from more to less are urine in foam, lower extremity edema, poor appetite, dry mouth, irritated heat, face red, reduced the volume of urine, oral, onyx, dark purple and so an, tongue and pulse with fat tongue, purple tongue, whitish, thready pulse mainly.Research conclusions:(1) The main clinical manifestations of stagnant heat syndrome of chronic kidney diseases are as follows:vexed hot, dry mouth, flushing, urine volume reduction, purple lips dark, sweating dark purple nails, somewhere in the stabbing pain, mental irritability, urine bubble, lower extremity edema, and so on.(2) In statistical terms, poor diet habits, concomitant diseases and renal replacement therapy all have significant effect in the incidence of " stagnant heat" in chronic kidney disease (CKD); While gender, age, chronic kidney disease (CKD) stage has no obvious relativity with the incidence of "stagnant heat".(3) The chief distinguishing feature of " stagnant heat" in chronic kidney disease is that it always accompanied with "wet", and in clinical manifestation wet performances more often and prominent than stagnant heat.(4) The basic pathogenesis of chronic kidney disease is deficiency in origin and excess in superficiality. On the excess hand,wet,stasis and stagnant heat are the most common,and On the deficiency hand,qi-deficiency syndromes are in the majority.