Study On The Relationship Between Urinary Mindin And Diabetic Nephropathy Stages And TCM Syndromes

PurposeFrom diabetes mellitus (DM),the early diabetic nephropathy(DNIII) period to the clinical stage of diabetic nephropathy (DNIV) period of development, gradually increase as the illness, treatment effect is poor, poor prognosis. Found that some patients with DM or early DN patients in clinical progress has become highly susceptibility of clinical stage of DN. So how to found early, so early intervention is the difficulty and key prevention and cure of DN. This paper relies on the Beijing science and technology plan projects chronic secondary prevention of traditional Chinese medicine, diabetic nephropathy, explore mindin urine protein for early diagnosis of early diabetic nephropathy accurate value, and the DM, DNⅢ period, DNIV period and correlation of each factor to study the predict the clinical significance of the progress of diabetic nephropathy.MethodThis study into three cooperation of Beijing hospital (Beijing university of Chinese medicine dongzhimen hospital, Beijing university of Chinese medicine dongzhimen hospital east, the third affiliated hospital of Beijing medical university) and Beijing dongcheng community health management center of the 208 patients,37 cases of DM patients,126 patients with early DN, three groups of 45 patients with clinical stage of DN. First of all the previous data (literature review, the usual subject basis, the relevant specification) and several rounds of expert consultation table syndromes was developed. Then the researchers assessed the syndrome factor table after the training, TCM syndrome factor information, to return blood in the urine samples, using liquid chemical analysis testing physical and chemical indicators, using Elisa method to detect the urine mindin level, collect data, establish a database; Using descriptive analysis of patients’ general information, TCM syndrome factor data statistical analysis; Measurement data using multiple independent samples nonparametric test; In counting the data by chi-square test.Results1 age and gender:DM group, the DN group stage Ⅲ group, the DNIV no statistical difference between genders (P>0.05), age was statistically difference between three groups (P<0.05). Compared with the DNIV period group, higher average age of DNⅢ period group (P<0.05).2 Laboratory physical and chemical indicators:Each laboratory indexes overall comparison shows:blood urea nitrogen (BUN), uric acid (UA), total cholesterol (TC), low-density lipoprotein cholesterol (Idl-c)-c (LDC) no statistical difference (P>0.05), serum creatinine (Scr), fasting plasma glucose (FPG), triglycerides (TG), glycosylated hemoglobin (HbAlc) was statistically difference (P<0.05). Between group comparison shows:compared with DM group, DNⅢ period FPG, HbAlc was significantly higher than that of DM group (P<0.01); DNIV period group had a significantly higher Scr, TG DNⅢ group (P<0.01).3 Urine mindin’s relationship with the urine trace albumin:Urine mindin and characteristics of the amount of albumin on correlation analysis of the results found that both exist significant correlation (P<0.05), the spearman coefficient= 0.284), but thought they were positively correlated. 4 Content comparison of urinary mindin in three groups:Urine mindin value differences between three groups (P<0.05). After comparing the two stage in DNⅢ groups with DNⅣ group difference was statistically significant (P<0.01), DN stage Ⅳ urine mindin value is significantly higher than the DNⅢ group.5 Each card characteristics research:Each factor in the highest rate of all is the deficiency of the qi deficiency syndrome and Yin deficiency syndrome, and each group standard empirical material and blood stasis syndrome, phlegm dampness syndromes, hot and humid most see more, DNIV period set of water stop card appear more frequently than before a significant increase in the two groups; Yin deficiency, blood deficiency, heat syndrome factor in each group were significantly lower.Syndrome factor distribution between groups, according to qi deficiency syndrome, Yin deficiency and Yang deficiency syndrome, Yin deficiency, blood stasis syndrome, phlegm dampness syndromes, hot and humid and muggy syndrome, water stop, not all the same between groups (P<0.05), blood deficiency syndrome, heat knot, and qi stagnation syndrome distribution did not differ significantly between groups (P>0.05). Compared with DNⅢ period group, DM group muggy syndrome, phlegm damp syndrome, blood stasis, deficiency syndrome, Yin deficiency ratio significantly higher than the DNIII period group (P<0.01); And water stop certificate, damp heat syndrome, Yin deficiency and Yang deficiency syndrome difference (P>0.01); Compared with DNⅢ period, water stop issuing DNIV period group, damp and hot, wet phlegm syndrome, blood stasis syndrome, qi deficiency, Yang deficiency syndrome is significantly higher than Ⅲ period group (P<0.01), while the wind-cold syndrome, Yin deficiency syndrome, Yin deficiency syndrome difference (P>0.01).6 The correlation between urinary mindin and different TCM syndrome factor:Among the deficiency syndrome element distribution, according to five kinds of this deficiency syndrome element level of urine mindin have difference (p<0.05), from low to high followed by both Yin and Yang deficiency syndrome, Yin deficiency syndrome, qi deficiency, Yang deficiency syndrome, blood deficiency. Among the empirical element distribution, according to the urine of 7 kinds of standard empirical element mindin levels have difference (p<0.05), from low to high followed by and qi stagnation syndrome, muggy syndrome, heat knot, damp heat syndrome, blood stasis and phlegm damp syndrome, water stop.Conclusion1 High blood glucose, HbAlc is DN in progress (DM for DNⅢ) risk factors; High serum creatinine, blood triglycerides is DN progress stage (Ⅲ to Ⅳ) risk factors.2 Urine mindin was positively correlated with urine trace albumin, if a combination of both can be found more accurately the early DN.3 Muggy syndrome, phlegm damp syndrome, blood stasis, qi deficiency syndrome, Yin deficiency syndrome is DN (DM progress for DN III period) of high-risk factor; Water stop certificate, hot and humid, wet phlegm syndrome, blood stasis syndrome, qi deficiency, Yang deficiency syndrome is a DN progress stage (Ⅲ to Ⅳ) risk factor.4 Urine mindin distribution is different in different syndrome factor.