Study On The Distribution Of Tcm Syndrome Types,micro-inflammatory State And Nutritional Status In Elderly Diabetic Nephropathy

Objective: Through the analysis of TCM syndrome types,micro inflammatory status and nutritional status of elderly patients with diabetes nephropathy(non dialysis),this paper discusses the correlation between TCM syndrome types,micro inflammatory status and nutritional status,so as to provide evidence-based medical evidence for clinical evaluation and individualized treatment of elderly patients with diabetes nephropathy(non dialysis).Methods: From November 2020 to December 2021,174 elderly diabetic nephropathy(non-dialysis)patients,30 elderly patients with simple T2 DM,and 30 health checkups were enrolled in the Department of Geriatrics,Nephrology,and Endocrinology,Shandong Provincial Hospital of Traditional Chinese Medicine.The elderly were selected as the research objects,and clinical data such as main signs and laboratory-related indicators were collected,and two or more attending physicians conducted TCM syndrome differentiation.DKD patients were screened for nutritional risk using the Malnutrition-Inflammation Score(MIS)scale.SPSS statistical software was used for data analysis,and the relationship between TCM syndrome types,micro-inflammatory state and application status was summarized.Results: 1.Among the 174 elderly DKD(non-dialysis)patients included in the study,the most patients were 60-74 years old,with 132 cases,accounting for 75.90%;there were 106 males and 68 females,with a male-female ratio of 1.56:1,males more patients than women.The patients included in the study were classified according to GFR and UACR: 19 patients with low risk,49 patients with intermediate risk,44 patients with high risk,61 patients with very high risk,and the most patients with very high risk.The frequency of each syndrome type of this syndrome: 61 cases of Qi and Yin deficiency syndrome,54 cases of spleen and kidney deficiency syndrome,41 cases of liver and kidney yin deficiency syndrome,18 cases of Yin and Yang deficiency syndrome;concurrent syndromes: 43 cases of blood stasis syndrome,phlegm stasis syndrome There were 38 cases,36 cases of damp-turbidity syndrome,30 cases of damp-heat syndrome,and 27 cases without concurrent syndrome;the common syndrome was Qi-yin deficiency and blood stasis syndrome.There was no significant difference in the distribution of TCM syndrome types,age and gender(P>0.05),but there was a significant difference with the distribution of risk classification(P<0.01).2.The deficiency of yin and Yang Syndrome accounted for 72.05% and the deficiency of yin and Yang Syndrome accounted for 43.05% respectively;There was no significant difference in nutritional status among syndrome types(P>0.05).3.According to the index of micro inflammation: there was significant difference in far and NLR levels among the syndrome types of DKD(P<0.05).The NLR level of spleen and kidney deficiency syndrome was the highest,and the far level of Yin-Yang deficiency syndrome and spleen and kidney deficiency syndrome was significantly higher than that of the other two syndrome types.The NLR level of dampness turbidity syndrome was higher than that of other syndrome types,the NLR level of phlegm and blood stasis syndrome was the lowest,and the far level of concurrent syndrome types was not significantly different.4.According to nutritional indicators,the HGB and ALB levels of TCM syndroms were significantly different(P<0.05).The HGB and ALB levels of liver-kidney Yin deficiency syndrome and Qi-Yin deficiency syndrome were higher,and the ALB level of Yin and Yang deficiency syndrome was the lowest.HGB level of damp-heat syndrome was higher than other syndrome types.The HGB level of hygroturbidity syndrome was the lowest,which was at the level of mild anemia.The ALB level of phlegm and blood stasis syndrome was the lowest.5.There was no significant difference in BMI,FPG,Hb A1 c,TG,LDL and TC among TCM syndrome types.Conclusion: 1.For elderly patients with DKD(non dialysis),the common clinical syndromes are Qi and yin deficiency syndrome and spleen and kidney deficiency syndrome,and the concurrent syndromes are blood stasis syndrome and phlegm and blood stasis syndrome.There is a certain correlation between this syndrome and concurrent syndrome,and the syndrome of deficiency of Qi and Yin and blood stasis is the most common.2.There is a certain correlation between the syndrome types of elderly DKD(non dialysis)patients and the status of micro inflammation and nutrition.The micro inflammatory state and nutritional status of patients can be inferred according to TCM syndrome types.At the same time,far,NLR,malnutrition inflammation score(MIS)scale,HGB and ALB can be used as objective quantitative tools of TCM syndrome types to provide valuable objective basis for TCM syndrome differentiation and treatment.3.Patients with liver and kidney yin deficiency syndrome and Qi and blood deficiency syndrome have lower far level and higher HGB level,accompanied by mild malnutrition,but patients with Qi and yin deficiency syndrome have lower NLR level than the normal low value.Patients with spleen kidney deficiency syndrome and Yin Yang deficiency syndrome have higher far level,lower HGB level,lower ALB level than normal,with moderate malnutrition,but patients with spleen kidney deficiency syndrome have higher NLR level.The NLR level in dampness and turbidity syndrome is higher and HGB level is the lowest;the NLR level in phlegm-stasis syndrome is lower and ALB level is the lowest.The level of NLR in blood stasis syndrome was low.