A Study Of Chinese Medicine Syndrome Type Distribution Of Patients Undergoing Continuous Ambulatory Peritoneal Dialysis In One-single Centre

Objective:To observe the Chinese medicine syndrom type distribution of patients undergoing continuous ambulatory peritoneal dialysis in Wuhan First Hospital dialysis center and characteristics of elderly and young patients in order to provide an evidence for Chinese medical therapy of peritoneal dialysis patients.Methods:1.240cases of patients undergoing continuous ambulatory peritoneal dialysis enrolled in the study were from Wuhan First Hospital department of Nephrology in2011, and average dialysis duration was more than3months.2. Chinese medicine syndrome type distribution referred to the criterion made by Nephropathy Branch of China Association of Chinese Medicine in2006and developed "the observation table of four diagnostic methods of TCM syndrome type".3. Every syndrome type of enrolled patients was differentated by a specific HerbDoctor corresponds to the time of biochemical tests, summarizing the characteristics of TCM symptoms and deviding into elderly group and young group by age. 4. To observe the overal patients’Chinese syndrome types, including the root syndromes and superficial syndromes.5. To compare the biochemical parameters of different Chinese syndrome type and observe difference and relationship between Chinese syndrome type and biochemical parameters.6. Statistical analysis:Data were mean±standard deviation (X±S), the measurement data by t-test, multivariate sample comparison using variance analysis, enumeration data using X2test, P<0.05was statistically significant.Results:1. The root syndrome distribution of the240patients:the Pi-Shen qi-deficiency71cases (29.6%), old age of17cases, middle-age in54cases; the Pi-Shen yang-def iciency,44cases (18.3%),21elderly patients, middle-age in23cases;38cases of Gan-Shen yin-deficiency (15.8%), in which elderly in four cases, middle-age in34cases; qi-yin deficiency syndrome in58cases (23.8%), old age in11cases, middle-aged in47cases; yin-yang deficiency of30cases (12.5%), old age,13cases,17cases of middle-aged. The syndromes were mainly the Pi-Shen qi-deficiency type, followed by qi-yin deficiency, Pi-Shen yang-def iciency which was statistically significant (P<0.05). Two different age groups were the elderly group mainly Pi-Shen yang-deficiency, young group to the Pi-Shen qi-deficiency. Significantly different types between the two groups were the Pi-Shen yang-deficiency, Gan-Shen yin-deficiency and yin-yang deficiency type.(P<0.05).2. The superficial syndrome distribution was no superficial syndrome in121cases (50.4%), in which old age in19cases, middle-aged in102cases; turbid-damp of62cases (25.8%), old age 18cases, young44cases; damp-heat syndrome of18cases (7.5%), old age of8cases, middle-aged in10cases; blood-stasis syndrome in37cases (15.4%),20elderly patients, middle-aged in17cases; air-driven type in2cases (0.8%) were middle-aged; hot-toxic type0cases (0.0%). Syndrome types based in no superficial syndrome, followed by turbid-damp and blood-stasis which was statistically significant (P<0.05). The two groups of syndrome type distribution were the elderly group mainly blood-stasis, middle-aged group to no superficial syndrome which was statisticaly significant.(P <0.05).3. The relationship between root syndrom and the duration of dialysis was mainly showed in the changes of Pi-Shen qi-deficiency, which<12months was mainly accounted for the Pi-Shen qi-def iciency (50.0%),12to24months, began to decline (37.7%),24to48months was stable but lower than the first,>48months was significantly decreasing (15.7%); the proportion of Pi-Shen yang-deficiency syndrome early was not high (14.3%), gradually increasing in later period of dialysis (22.2%); the proportion of yin-yang deficiency with the dialysis duration growth, later increased significantly (24.3%).The distribution was statistically significant (P<0.05).4. The root syndrom of the patients were compared with blood pressure, urine volume, ultrafiltration volume and different biochemical preameters, showing systolic blood pressure of the patients with Gan-Shen yin-deficiency higher than the Pi-Shen qi-deficiency syndrome which was statistically significant (P<0.05). The urine of patients with yin-yang deficiency was significantly lower than other patterns (P<0.05). Pi-Shen yang-deficiency ultraf iltration volume was significantly lower than Pi-Shen qi-deficiency type (P <0.05). Biochemical parameters of yin-yang deficiency, regardless of ALB or residual renal Kt/V、residual renal Ccr were significantly lower than the other syndromes, but CRP was significantly higher than the other syndromes. Other parameters did not show any significant difference.5. The distribution of patients of root syndrome with superficial syndrome was turbid-damp with Pi-Shen qi-deficiency card clipping the most, followed by Pi-Shen qi-deficiency syndrome, Damp-heat more mixed in Pi-Shen yang-deficiency syndrome, but no significantly difference in the distribution, may because of less number of this type. No superficial syndrome permitted the largest number, mainly located in the Pi-Shen qi-deficiency type. Blood-stasis was mainly mixed in the yin-yang deficiency.The difference was statistically significant (P<0.05).6. The comparence amomg different superficial syndromes of patients in blood pressure, urine volume, ultrafiltration volume, and biochemical preameters revealed that urine of patients with blood-stasis was significantly lower than the other superficial syndrome (P<0.05). The Hb in blood-stasis was significantly lower than the damp-heat syndrome (P<0.05), and other biochemical parameters were not suggested significant differences.Conclusion:1. The Pi-Shen qi-deficiency syndrome was the mainly root syndrom in CAPD patients,most conventional patients were no superficial syndrome.2. Being divided by age, the root syndrom of elderly group was mainly Pi-Shen yang-deficiency and the superficial syndrome was blood-stasis while the young group was Pi-Shen qi-deficiency and no superficial syndrome.3. With the dialysis duration being long, the conversion direction of the root syndrome in overal pationts was "Qi-yang-yin and yang".4. The yin-yang deficiency was worse than the other type, whether on the nutritional status or residual renal function. Ultrafiltration volume of Pi-Shen yang-deficiency was lower than the Pi-Shen qi-dificiency.5. The anemic condition of the blood-stasis syndrome was significantly worse than the other type. For patints with blood-stasis should reinforce treatment of anemia.