Correlation Analysis Of Traditional Chinese Medicine Symptoms And Prognosis Of Acute Kidney Injury On Chronic Kidney Disease

Objective:The study investigated the distribution pattern of TCM evidence types in patients with acute kidney injury on chronic kidney disease(AKI on CKD or A/C)through a retrospective study,analyzed the incidence and prognostic influencing factors of different TCM evidence types of A/C,and provided a reference basis for the prevention and treatment of A/C in TCM.Methods:Patients diagnosed with A/C from December 2018 to December2021 at the International Zhuang Medical Hospital affiliated to Guangxi University of Traditional Chinese Medicine were screened for inclusion after inclusion and exclusion criteria.The general data,underlying diseases,comorbidities,laboratory tests and clinical regression of patients were collected to analyze the distribution pattern of TCM evidence;SPSS25.0statistical software was applied to statistically analyze the data,analyze the prognostic influencing factors of A/C patients,and observe the incidence of TCM evidence and its impact on renal prognosis.Results:(1)A total of 187 A/C patients were included in this study,with a male to female ratio of 1.92:l;48 cases(25.7%)were ≤65 years old and 139cases(74.3%)were >65 years old.(2)The distribution of TCM evidence types in the 187 A/C patients was:spleen-kidney qi deficiency evidence > spleen-kidney yang deficiency evidence > liver-kidney yin deficiency evidence > qi-yin two deficiency evidence > yin-yang two deficiency evidence.the distribution of TCM evidence types in A/C patients was: damp-heat evidence > blood stasis evidence > dampness and turbidity evidence > drowning and toxicity evidence > wind movement evidence.There were no statistically significant differences among the TCM types in gender,hypertension,hyperlipidemia,hyperuricemia,cerebrovascular disease,tumor,anemia,proteinuria,electrolyte disorders,and co-infection,and statistically significant differences among diabetes mellitus,heart failure,surgery,and hypoproteinemia.(3)When comparing the TCM evidence type with the CKD stage,spleen-kidney qi deficiency evidence was predominant in stages 3 and 4,accounting for 43.28% and 25.88%,respectively,while spleen-kidney yang deficiency evidence was more frequent in stage 5 patients,accounting for31.43%;when comparing the TCM evidence type with the AKI stage,spleen-kidney qi deficiency evidence was predominant in stages 1 and 2,accounting for 46.88% and 26.74%,respectively,while spleen-kidney yang deficiency evidence was more frequent in stage 3 patients,accounting for29.63%.(4)Chinese medical evidence and prognosis: In this evidence,the proportion of unrecovered renal function was higher in patients with spleen-kidney-yang deficiency evidence,qi-yin two-deficiency evidence,and yin-yang two-deficiency evidence,accounting for 53.66%,65.38%,and 80%,respectively,while the proportion of unrecovered renal function was lower in patients with spleen-kidney qi deficiency evidence,accounting for 13.33%,and the prognosis was better.The proportion of unrecovered renal function was higher in patients with concurrent evidence of wind movement and drowning toxicity,accounting for 85.71% and 66.67%,respectively,and the proportion of unrecovered renal function was lower in patients with damp-heat evidence,accounting for 20.37%,with a better prognosis.(5)Comparison of the use of proprietary Chinese medicines in A/C patients with different TCM evidence : the commonly used proprietary Chinese medicines in A/C patients were Bailing capsule,Renkang injection,urinary toxicity Qing granules and Haikun Renxi capsule,among which the utilization rate of Bailing capsule and Renkang injection was higher.The results of the study showed that among patients with different TCM evidence types A/C,the proportion of patients with spleen and kidney Qi deficiency evidence using Bailing capsule and Renkang injection was higher,the proportion of patients with both Qi and Yin deficiency evidence using Bailing capsule and Renkang injection was lower;the P value of Bailing capsule and Renkang injection for each TCM evidence type was <0.05,and the difference was statistically significant.(6)The logistic regression analysis showed that heart failure,combined diabetes mellitus,and hypoproteinemia were independent risk factors affecting the prognosis of renal function in A/C patients.The factors affecting the prognosis of renal function in different TCM evidence types were different.In this evidence,the liver and kidney yin deficiency evidence was used as the reference comparison,and it was found that spleen and kidney qi deficiency evidence and spleen and kidney yang deficiency evidence,liver and kidney yin deficiency evidence,and qi and yin two deficiency evidence were the risk factors affecting the prognosis of renal function in A/C patients.In the concurrent evidence,wind-movement evidence was used as a reference comparison,and it was found that wind-movement evidence and dampness evidence were risk factors affecting the prognosis of renal function in patients with A/C.Conclusions:(1)A/C patients were mainly elderly,and the stage of CKD was correlated with the prognosis of A/C,and the proportion of unrecovered renal function gradually increased with the increase of the graded degree of CKD stage.(2)Age,anemia,hypoproteinemia,heart failure,hypertension,diabetes mellitus,hyperuricemia,infection,electrolyte disorders,and proteinuria were risk factors affecting the prognosis of A/C patients;regression analysis was performed with whether renal function was recovered as the dependent variable,and the results showed that heart failure,combined diabetes mellitus,and hypoproteinemia were independent risk factors affecting the prognosis of renal function in A/C patients.(3)Patients with A/C were predominantly with mixed deficiency and real evidence,and the TCM identified that this evidence was most commonly associated with spleen-kidney qi deficiency,followed by spleen-kidney yang deficiency,and the concurrent evidence was most commonly associated with damp-heat,followed by blood stasis and dampness.Comparison of the distribution of TCM evidence elements in A/C patients with different clinical transitions showed that patients with Spleen and Kidney Yang Deficiency Evidence,Qi and Yin Deficiency Evidence,and Yin and Yang Deficiency Evidence had a poor prognosis.