Study On The Relationship Between Protein-bound Uremic Toxins And TCM Syndromes In Non-dialysis Patients With 3-5 Stages Of CKD

Objective:Detection the level of protein binding uremia toxins in serum of the patients with 3-5 stages of Chronic kidney disease,such as indoxyl sulfate IS,p-cresyl sulfate PCS,homocysteine Hcy,3-carboxy-4-methyl-5-propyl-2-furanpropionic acid CMPF,Analyzing the relationship between these toxins and kidney function can provide a theoretical basis for our early intervention in the prevention of CKD.This paper further studies the relationship between the uremic toxins and the TCM syndromes of chronic kidney disease in the 3-5 stage,and provides an objective basis for the diagnosis and treatment of traditional Chinese medicine.Methods:In this study,a total of 64 patients with non-dialysis in chronic kidney disease were studied by cross-sectional survey.The control group was 21 healthy subjects in our hospital.To set up clinical observation tables,and collect test indicators such as kidney function,liver function and heart color,etc.First,the incidence of glomerular filtration rate was estimated,based on the standard of Traditional Chinese medicine which can get on Chinese medicine classification.The serum of patients with CKD and healthy people was collected by the laboratory in the of centrifuge,and the serum IS,PCS,Hcy,CMPF levels were detected by the enzyme-linked biosorbent assay.Spass software was used to analyze the relationship between the levels of different stages of toxins and TCM syndromes.Results: 1.The relationship between the level of IS,Hcy,CMPF and PCS and renal function: Compared with the healthy control group,the levels of IS,Hcy,CMPF and PCS were significantly increased in CKD patients(P<0.05).The serum concentration of CKD3-CKD5,PCS,IS and Hcy decreased with the decrease of renal function(P <0.05),while the serum concentration of CMPF had no significant change(P>0.05).2.The relationship between TCM syndromes of CKD3-5 in IS,Hcy,CMPF and PCS levels :In the deficiency syndrome,the level of PCS of CKD3 period in lung and spleen deficiency syndrome group was higher than that in the rest of the proof groups(P <0.05).There was no statistical significant difference between the other groups in terms of what the level of CMPF、IS and Hcy(P>0.05).In the period of CKD4,there was no significant difference between the deficiency syndrome groups in terms of the level of CMPF、IS 、Hcy and CMPF(P>0.05).In the period of CKD5,spleen and kidney Yang deficiency syndrome group serum level IS higher than other syndromes(P< 0.05),There was no statistical significant difference in the levels of Hcy,PCS and CMPF between different types of deficiency group(P>0.05).In the excess syndrome,CKD3 stage of dampness-heat syndrome group PCS level is higher than other syndromes(P<0.05),different types of excess syndrome group between Hcy,PCS,CMPF horizontal comparison,there was no significant difference(P>0.05).The comparison between the level of IS,Hcy,PCS,and CMPF in different types of standard excess syndrome groups of CKD4,CKD5 is no statistical significance(P>0.05).3.The relationship between the level of IS,Hcy,CMPF,PCS and the left ventricular index: In CKD3,IS was positively associated with the left ventricular index(P<0.05),and In CKD5,Hcy left ventricular index was positively correlated(P<0.05),and there was no statistical significance difference between toxin level and left ventricular index.Conclusion: 1.The levels of uremia toxins are associated with Renal function,and may be involved in the occurrence of cardiovascular disease in chronic kidney disease;2.In the stage of CKD3,the level of PCS in lung and spleen deficiency syndrome group was higher than the other syndromes.The level of IS in spleen and kidney deficiency syndrome group was the highest in CKD5.In the stage of CKD3,the level of PCS in dampness-heat syndrome group were higher than those in other excess syndrome groups;3.There may be a certain correlation between the different stages of chronic kidney disease which the variation of the expression with their serum levels of IS,PCS,CMPF and Hcy and of the traditional Chinese traditional Chinese syndromes.