Clinical Study On TCM Identification Of Diabetic Nephropathy And Its Correlation With Some Laboratory Indicators

Objects:Increasing popularity of the diabetic kidney disease (DKD) witnesses the progress of modern society since the first clinical evidence on pathogenesis of DKD in 1900.Together with the increasing influence on our life, large amount of investigation into DKD has been performed and thus fruitful results have been obtained in the past decades. This research is designed to further the understanding of the characteristics of various types of DKD syndromes, characteristics of traditional Chinese medicine (TCM) on pathogenesis syndromes and correlation between TCM syndromes and clinical parameters, based on analyses of the clinical medical cases of DKD in renal department of internal medicine in Beijing integrated traditional Chinese and Western Medicine Hospital.Methods:This research is conducted by designing monitoring tables with 150 clinical cases of DN during 2014 and 2015 together with the application of the analysis software SPSS20.0 to analyze and mine data. Intuitive investigation into the TCM clinical pathogenesis syndromes with the core theory built by Prof. Li Jianmin is made and the correlation between the TCM syndromes and their treatment laws of DKD and the western laboratory parameters by Logistic regression analysis in SPSS 20.0 is included in this project.Results:It clearly demonstrates in this research that among the 150 patients suffering DKD, the blood stasis takes the most part (76.7%) in analysis of the positive pathogenesis. The following significant syndromes include the damp-heat syndrome with 40.7%, hot junction syndrome with 38.7%, wet card with 20.7% and phlegm with 18%. In addition to the positive pathogenesis, negative pathogenesis also attracts much attention in analysis. Among the syndromes of the negative pathogenesis, Qi deficiency takes such a large percentage as 90%; others include Yin deficiency (51.3%), Yang deficiency (20%) and blood deficiency (2%). Summation indicates that Qi-Yin deficiency and the spleen Qi deficiency are the most common negative pathogenesis, taking 42.67% and 30% of the patients respectively. They are followed by the syndrome of deficiency of Qi and deficiency of Yang (14.67%)、liver and kidney Yin deficiency syndrome (6.67%)、syndrome of deficiency of kidney (4%)、Yang deficiency of spleen and kidney (2%). Performing Logistic regression analysis in SPSS20.0 reveals the correlation between the TCM syndromes and their treatment laws of DKD and the western laboratory parameters and the results indicates the three parameters urinary protein in 24h, uric acid and serum creatinine are in relation with TCM syndromes and that the relative risk coefficient is larger than one, which implies a clear correlation.Conclusions:1. DKD patients were manifested as the syndrome of deficiency and excess. In which the most common positive syndrome is blood stasis syndrome, which followed by damp heat syndrome, heat syndrome, damp heat syndrome, phlegm turbidity syndrome. The most common deficiency syndrome is Qi deficiency syndrome,which followed by the Yin and yang deficiency, blood deficiency.2. Summary of the results of traditional Chinese medicine in a single patient showed that the patient was more than two and more positive at the same time. The most common syndrome is deficiency of Qi and yin deficiency, spleen and kidney qi deficiency, followed by qi deficiency involving Yang Syndrome, spleen kidney yin deficiency, kidney deficiency syndrome, Yang deficiency of spleen and kidney.Patients suffering DKD III demonstrate high percentage in Qi-Yin deficiency and heat stagnation and blood stasis syndrome while spleen and kidney Qi deficiency and syndrome of blood stasis and damp heat syndrome take the most part among those suffering DKD IV; and for patients suffering DKD V, syndrome of deficiency of kidney and syndrome of dampness and blood stasis and phlegm turbidity are the main syndromes.3. Using Logistic regression analysis:The conclusion concentrates the clear correlation between the three parameters and TCM syndromes. The larger value of the 24h urinary protein, the larger possibility of the wet card will be. Larger value of the uric acid leads to higher possibility of the damp-heat syndrome; and, the larger value of the serum creatinine results in the increasing yang deficiency.