| Objective:To investigate the distribution of TCM syndromes in patients with stage 4 Chronic Kidney Disease as well as the correlation between intact parathyroid hormone levelsand renal anemia.Methods:A total of 213 patients diagnosed with chronic kidney disease(CKD)in stage 4 were selected in the Nephrology Department of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2018 to December 2020.According to whether they had renal anemia,they were divided into renal anemia group(n=180)and non-renal anemia group(n=33),collected patient general information,four-diagnosis data of traditional Chinese medicine,biochemistry,blood routine,and blood sugar,Blood lipids and other related laboratory indicators,statistics the distribution of TCM syndrome types of the disease,and analyze the correlation between TCM syndrome types and laboratory indicators.The differences in the distribution of intact parathroid hormone(iPTH)levels in patients with renal anemia were compared,and the correlation between iPTH levels and renal anemia was analyzed.Results:1.213 patients with CKD stage 4,180 patients with renal anemia,the incidence of renal anemia was 84.5%;33 patients without renal anemia,accounting for 15.5% of the total number.2.Distribution of anemia:Among 180 cases of renal anemia(105 males and 75females),130 cases of mild anemia(73 males and 57 females),accounting for 72.2%;46 cases of moderate anemia(There were 30 males and 16 females),accounting for 25.6%;4 cases of severe anemia(2 males and 2 females),accounting for 0.02%.3.There was no statistical difference between the two groups in gender,age,course of disease,etiology and distribution of anemia(P>0.05).4.Among the 213 cases of CKD stage 4 patients with the main deficiency syndrome,the most common were the deficiency of both Qi and Blood and the deficiency of Yang.There were50 cases of deficiency of both Qi and Blood,41 cases of Yang deficiency,and 11 cases of deficiency of both Yin and Yang.In the distribution of the syndromes of deficiency and excess,the most common were 75 cases of Yang deficiency and water dampness syndrome,followed by 10 cases of Qi and Blood deficiency damp-heat syndrome,and 6 cases of Yin and Yang deficiency damp-heat syndrome.5.Among the 180 cases of CKD stage 4 patients with this deficiency syndrome,49 cases of Qi and Blood deficiency were the most common,followed by 15 cases of Yang deficiency and 10 cases of Yin and Yang deficiency.In the distribution of deficiency and excess syndromes,68 cases of Yang deficiency and water dampness syndrome were the most common,followed by 8 cases of Qi and Blood deficiency damp-heat syndrome,and 4 cases of Yin and Yang deficiency damp-heat syndrome.6.Among the 33 cases of CKD stage 4 patients with this deficiency syndrome,6 cases of Yang deficiency syndrome appeared the most,followed by 4 cases of Qi deficiency syndrome and 1 case of Yin deficiency syndrome.In the distribution of syndromes of deficiency and excess,7 cases of yang deficiency and water dampness syndrome appeared the most,followed by 2 cases of Qi and Blood deficiency damp-heat syndrome,and 2 cases of Yin and Yang deficiency damp-heat syndrome.7.After Chi-square test(P=0.003),the difference in the distribution of syndrome types between the renal anemia group and the non-renal anemia group was statistically significant(P<0.01).8.The relationship between various syndrome types and related indicators in 213 CKD stage 4 patients:Among the deficiency syndromes,the HGB level of Yin deficiency and Yang deficiency syndromes is higher than that of blood deficiency syndromes,and the difference is statistically significant(P<0.05)blood deficiency The Cys C level of the syndrome and Yang deficiency syndrome was lower than that of the Qi deficiency syndrome,and the difference was statistically significant(P<0.05).Other indicators were not significantly correlated with this deficiency syndrome.In the standard empirical evidence,the levels of HGB,ALB,and Ca in the blood stasis syndrome were higher than those of the Qi deficiency syndrome.The difference was statistically significant in water-wetness syndrome(P<0.05).The Cys C level of damp-heat syndrome was lower than that of water-wetness syndrome,and the difference was statistically significant(P<0.05).Other indicators were not significantly related to the standard empirical evidence.9.Results of correlation analysis between IPTH and renal anemia:IPTH is positively correlated with blood phosphorus and Scr(r=0.164,0.172,P<0.05),and IPTH is negatively correlated with eGFR and HGB(r=-0.29,-0.155,P<0.05).Conclusions:1.Renal anemia is common in CKD stage 4 patients.The incidence of renal anemia is84.5%,and the main anemia is mild anemia,accounting for 72.2%.2.Chronic kidney disease is based on the deficiency syndrome.In this study,the syndrome of the deficiency is more common in the syndrome of deficiency of both qi and blood,and deficiency of both Yin and Yang,and the most common syndrome is the syndrome of water dampness;the syndrome of deficiency of both Qi and blood,and deficiency of both Yin and Yang are more common.There are many syndromes combining damp-heat syndrome and blood stasis syndrome;patients with CKD stage 4 renal anemia have a higher incidence of Qi and blood deficiency than those with CKD stage 4 without renal anemia.3.In patients with CKD stage 4,the early renal damage of Qi deficiency syndrome is more severe than other syndromes.The incidence of hypoproteinemia,calcium metabolism disorder and anemia of water-dampness syndrome are more serious than those of other standard syndromes.The early renal damage of those water-dampness syndrome is more severe than that of damp-heat syndrome.4.iPTH is positively correlated with blood phosphorus,that is,the higher the blood phosphorus,the higher the iPTH;iPTH is positively correlated with Scr,and iPTH is negatively correlated with eGFR,that is,the heavier kidney damage is,the higher iPTH is;iPTH is negatively correlated with HGB,that is,The more severe the renal anemia,the higher the iPTH. |
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