The Study Of Diagnostic Criterion On Blood Stasis For Patients With Chronic Kidney Disease

Background/aims:CKD is a kind of disease, which has prolonged course and complex pathogenesis. Blood Stasis, the important reason of sustainable lesions and renal function deterioration, is throughout the CKD. Accuracy of differentiation has an effect on clinical efficacy. Currently there is no unified and accepted diagnostic criterion of blood stasis for CKD. The diagnostic criterion of blood stasis at home and abroad has many types and poor clinical operability. The study summarizes the clinical manifestations and physical indicators by arranging ancient medical records and modern clinical literature based on Evidence-based medicine concept and Data mining technology, aiming to establish a diagnostic criterion of blood stasis syndrome and provide the basis for clinical diagnosis and treatment of kidney disease.Method:1. By searching the Chinese medical book "cases", getting the related ancient cases of the whole body and CKD stasis and standardizing the name of disease, symptoms, signs, we establish information database and use frequency statistics, system cluster analysis to refine the most relevant clinical characterization of CKD and blood stasis syndrome.2. By retrieving1978-2014CKD published on TCM Syndromes associated with physical and chemical indicators of case-control or cross-sectional study of literature, based on inclusion, exclusion criteria relevant literature, we data extraction and systematic evaluation and Meta-analysis to obtain blood and CKD stasis relevant physical and chemical indicators.3. In ancient and modern clinical literature findings, combined with the expert discussion and analysis views, we explore the establishment of CKD and blood stasis syndrome diagnostic criteria.Results:1. The study of systemic blood stasis syndrome were included282ancient literature medical cases, a frequency of more than5%of the clinical characterization to Board Department sting the most common, followed by the pulse string, vomit (vomit) dark purple color blocks into blocks and intra-abdominal disease. Among them, local irritation and pulse astringent are together as a single class, to become the body and blood stasis syndrome first impact factor.2. The study of CKD blood stasis syndrome were included110ancient literature medical cases, afrequency of more than5%of the clinical characterization of edema most common. Cluster analysis puts back pain alone as a class, and the other two groups were deficient urination and cough, chills and pale tongue white.3. Modern research literature were included in37clinical literature, through a systematic review of blood stasis may be associated with CKD correlated physical and chemical indicators include: whole blood viscosity, plasma viscosity, erythrocyte sedimentation rate, erythrocyte aggregation index, plasma GMP-140, plasma FIB, blood FDP plasma PC, plasma tPA, plasma PAI-1, plasma ET, plasma TXB2, plasma6-keto-PGF1α, lipids, ECM components of blood and urine, renal pathology, kidney color Doppler ultrasound.4. Meta-analysis of the literature is included six cumulative with sample size568cases, the results showed:Compared with CKD non-BSS and the normal control group, CKD and blood stasis syndrome correlated with plasma ET [WMD=40.12,95%CI (26.99-53.24); WMD=102.98,95%CI (80.00-125.96)].Conclusion:1. Combining study of ancient and modern literature with expert advice, following clinical utility, sensitivity, easy detection of principles, we develop the diagnostic criteria of CKD blood stasis syndrome: a. Partial characterization:back pain, swarthy, edema, urine deficient, constipation. b. Overall characterization:local irritation, vomiting (vomit) into a dark purple color block, block intra-abdominal disease, wiry pulse, pulse astringent, thready pulse, pulse, pulse, dark purple tongue or with petechia and petechiae. c. Physical indicators:(1) Blood indicators:endothelin, total cholesterol, triglycerides, fibrinogen increased.(2) Urine indicators:IV collagen, laminin increased.(3) Renal pathology:See related pathological changes of renal fibrosis. Staging criteria:compliance of blood stasis a and c early as CKD, CKD advanced to meet the a b and c of blood stasis.2. The study of ancient and modern clinical research literature as the research object, is based on the concept of evidence-based medicine, clinical efficacy evidence to establish dialectical combination of macro and micro, clinical presentation and combination of physical and chemical indicators of blood stasis CKD staging criteria.3. The subject provides some ideas and methods for the research on syndrome diagnostic criteria by using data mining techniques in ancient medical case, a systematic review of modern clinical literature, research diagnostic criteria.