| Objective: This study is due to investigate the relationship between ultrasound sonogram feature of renal, lab-measuing indexes, ascites of patients with liver cirrhosis and syndrome differentiation of TCM, approach the correlation between "syndromes" of TCM and modern medical objective indexes, and assess the value of earlier diagnosis and prognosis in happening renal damage for patients with liver cirrhosis.Methods: forty-five cases of liver cirrhosis with different syndromes and twenty-five cases of normal subjects as the contral group were included in the study. The diagnostic standard of patients with liver cirrhosis referred to the standard of the International Ascites Club(IAC) and syndrome differentiation of TCM refered to the standard that was formulated by the fifth Chinese academy of integrated traditional and western medicine on special committee of disease of digestive system, including six syndromees, stagnation of liver Qi, internal accumulation of damp-heat, stagnation of Qi and blood stasis, asthenia of liver and kidney Yin, retained fluid and asthenia of spleen and kidney Yang syndrome. The study selected the five common syndromees , including stagnation of liver Qi, internal accumulation of damp-heat, stagnation of Qi and blood stasis, asthenia of liver and kidney Yin and retained fluid syndrome. The largest occipitomental diameter and anteroposterior diameter of the maximal coronal section of right and left renal, the thickness of renal cortical part, the blood flow spectra of the main renal arteries, segmental and cortical arteries, which including the systolic maximal velocity (Vmax), the diastolic minimal velocity (Vmin), the average blood flow velocity (TAMX), the pulsatility index (PI), the resistent index (RI) and the depth of ascites were measured by color Doppler sonarography. As well as the depth of ascites were calculated. Lab-measuing indexes included alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total bilirubin (STB), serum total protein(STP),albumin(ALB), A/G, the levels of serum creatinine(Scr) and urea nitrogen(BUN). The quantitated indexes were analyzed with one-factor analysis of variance of statistical software of SPSS11.5 edition.Results: 1. To study the size and the thickness of renal cortical part of renal in liver cirrhosis patients with different syndromes showed and normal subjects as the contral group: The largest occipitomental diameter and anteroposterior diameter of the maximal coronal section of right and left renal and the thickness of renal cortical part in patients with liver cirrhosis were not different.2. To study the blood flow spectra of the main renal arteries, segmental and cortical arteries in patients with different syndromes showed and normal subjects as the contral group: The rule of successive decreased in renal arterial resistent index (RI) from renal hilum to renal cortex disappeared. The blood flow spectra of all renal artery grades in stagnation of liver Qi was nonsense vs in the control group (P> 0.05). The pulsatility index (PI) in internal accumulation of damp-heat and stagnation of Qi and blood stasis was significantly increased as compared with those in the controls (P<0.05). The pulsatility index (PI) in asthenia of liver and kidney Yin and retained fluid syndrome and the resistent index (RI), diastolic minimal velocity (Vmin) and TAMX of all the renal arteries were increased significantly in internal accumulation of damp-heat, stagnation of Qi and blood stasis, asthenia of liver and kidney Yin and retained fluid syndrome compared with those in the control group(P<0.01).3. To study liver function,renal function and ascites in cirrhosis patients with different syndromes showed and the normal subjects: ALT and AST were both increased, and those in patients with internal accumulation of damp-heat syndrome were highest. ALB in patients with asthenia of liver and kidney Yin and retained fluid syndrome were different to that of the normal subjects,stagnation of liver Qi and internal accumulation of damp-heat syndromes (P<0. 05). The levels of serum creatinine and urea nitrogen and the ascites in asthenia of liver and kidney Yin and retained fluid syndrome was significantly increased vs in the control group and stagnation of liver Qi (P< 0.05), while no difference could be found between stagnation of liver Qi, internal accumulation of damp-heat, stagnation of Qi and blood stasis and the control group(P>0.05).Conclusion: The ultrasound sonogram feature of renal and lab-measuing indexes had an important guide sense to the syndrome differentiation of liver cirrhosis. The types of syndrome in liver cirrhosis patients were different, as well as the degree of renal lesion was inequality, the blood flow spectra of all the renal arteries, renal function and ascites changed correspondingly. And those changes were coincident to the changes of syndromes in liver cirrhosis patients. In earlier period, the patients with liver cirrhosis were mainly in stagnation of liver Qi, later the patients with liver cirrhosis were mainly in internal accumulation of damp-heat, stagnation of Qi and blood stasis. In advanced stage, the patients with liver cirrhosis were mainly in liver and kidney Yin and retained fluid syndrome. The diameters of all the renal arteries were gradually narrowen, and the blood flow velocity of renal arteries slowed down gradually. According to the changes of Pathogenetic condition and the development of syndromes, renal function of patients was gradually aggravated, the filterability of renal glomerulus was descended as well, at last the patients with liver cirrhosis would appear hepatorenal syndrome(HRS).
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