The Clinical Observation Of Relationship Between Nutritionalstatus And Symp-toms Of Tcm In Patients With Main-tenance Hemodialysis

Purpose:To observe the symptoms-sign of Maintenance hemodialysis and research the relationalship between symptoms-sign and malnutrition.To provide basis for Traditional Chinese medicine (TCM)Methods:Collect case strictly in accordance to the standards from the maintenance hemodialysis patients in our hospital.Record the patient's symptoms by using the designed information-collecting table.According to the diagnostic criteria of syndrome of TCM, diagnose each Patient's syndrome of TCM before inviting two attending physicians to make sure the diagnosis.Research the relationship between the nutritional status and syndrome differentiation of TCM by studying after maintenance hemodialysis six months later on the result of laboratory tests.Results:(1)The distribution of TCM syndrome type in 60 cases before hemodialysis treatment were:23(38.3%) cases of Qi-deficiency of the spleen and kidney type,19(31.7%) cases of Yang-deficiency of the spleen and kidney type,8(13.3%) cases of Qi-Yin Deficiency type,6(10%) cases of yin-Yang deficiency type,4(6.7%) cases of Yin-deficiency of the liver and kidney type.after hemodialysis treatment were:23(38.3%) cases of Qi-Yin Deficiency type,14(23.3%) cases of Yang-deficiency of the spleen and kidney type,12(20%) cases of Qi-deficiency of the spleen and kidney type,6(10%) cases of yin-Yang deficiency type,5(8.3%) cases of Yin-deficiency of the liver and kidney type.Two qroup TCM symptom-complex compare between before and after dialysis teatment,Qi-deficiency of the spleen and kidney type reduction,Qi-Yin Deficiency type increase,they had remarked difference with before hemodialysis treatment(P<0.05).(2)The distribution of TCM syndrome type in 60 cases before hemodialysis treatment were:22(36.7%) cases of damp-turbidity,21(35%) cases of damp,7(11.6%) cases of blood-stasis,6(10%) cases of Wind-dry,4(8.3%) cases of damp-heat.after hemodialysis treatment were:21(35%) cases of blood-stasis,13(21.7%) cases of Wind-dry,10(16.7%) cases of damp,11(18.3%) cases of damp-turbidity,5(8.3%) cases of damp-heat.Two group TCM symptom-complex compare between Before and after treatment.A group TCM symptom-complex,which defieiency of Wind-dry and blood-stasis had remarked difference with before dialysis treatment(P<0.05).(3)The relationship between symptom-sign and nutrition status:there are 3 cases of Yang-defieiency of the spleen and kidney type and 20 cases of Qi-Yin deficiency type in malnutrition group.The afrer group have remarked difference(P<0.05).(4)There are 9 cases of Wind-dry in nutrition and 3 cases in malnutrition group;There are 3 cases of blood-stasis type in nutrition and 18 cases in malnutrition group.The afrer group have remarked difference(P<0.05).(5)The relationship between symptom-sign and biochemical indexes of blood:compared with Qi-defieiency of the spleen and kidney type, the cases of Qi-Yin defieiency type have lower indexes in Alb. There are remarked difference between The two types(P<0.05).BUN and Scr have no remarked difference in every symptom-sign(P>0.05).(6)Compared with wind-dry type, he cases of blood-stasis has lower indexes in Alb.There is remarked difference between the two types(P<0.05).BUN and Scr have no remarked difference in every symptom-sign(P>0.05).Conclusion:(1)Before dialysis treatment,23(38.3%) cases of Qi-deficiency of the spleen and kidney type and 22(36.7%) cases of damp-turbidity are the most type in TCM Syndrome types.After dialysis treatment, Qi-Yin deficiency type and blood-stasis are the most type in TCM Syndrome types The distribution of TCM sydrome type in 60 cases after dialysis treatment:23(38.3%) cases of Qi-Yin deficiency type, 21(35%) cases of blood-stasis.(2)After dialysis treatment,Qi-deficiency of the spleen and kidney type,damp-turbidity,damp were Less than before; Qi-Yind deficiency type and blood-stasis type and Wind-dry type were more than before.(3)The syndromes of TCM will changed after dialysis treatment.(4)The syndromes of TCM before dialysis have not impact on the statua of nutrition.(5)Damp and Qi-deficiency of the spleen and kidney type are the most type in the better nutrition group.blood-stasis and Qi-Yin deficiency type are the most type in malnutlition group.