Study On The Correlation Between TCM Syndrome And Diet Nutritional Status In Chronic Kidney Disease Non-dialysis Patients

Objectives: To explore the Correlation between TCM Syndrome and normal information,nutritional status,Dietary elements in Chronic Kidney Disease(CKD)patients at stage 2-5,By observing 106 chronic kidney disease non-dialysis patients.And furthermore to underlie clinical guidance of CKD diet,improve the CKD patients?nutritional status and prognosis and clinical treatment of CKD with combination of traditional chinese and western medicine.Methods: We collected the normal information,laboratory indicators,Malnutrition-Inflammation Score(MIS),Diet questionnaire of 106 patients with CKD at stages 2-5 who followed up in Nephrology outpatient and inpatient of Hubei Provincial Hospital Of TCM from October 2015 to October 2016.By following up regularly,we recorded outcome events.Once an outcome event occurs,we stop following up the patient.We considered the censored data as did not appear the outcome or lost.According to the GFR,TCM syndromes,MIS,intake of protein species,we divided the patients with CKD in different groups.Under different grouping conditions,we compared the normal information,laboratory indicators,MIS,dietary nutrient intake of CKD patients at stage 2-5,and observed the distribution of TCM Syndrome.Results: 1.There were 106 cases of patients with CKD at stage 2-5,including 61 males(57.5%)and 45 females(42.5%),the mean age was(59.83±15.80)years old and the average follow-up time was(6.7±1.26)months.15 cases occurred maintain hemodialysis,16 cases of serum creatinine doubled.2.In the distribution of TCM Syndrome type of 106 patients,there were 53 cases spleen and kidney qi deficiency,accounting for 50%,followed by spleen and kidney yang deficiency(25 cases,23.58%),qi and yin deficiency(21 cases,19.82%),liver and kidney yin deficiency(7 cases,6.6%).The spleen and kidney qi deficiency was the most in the deficiency syndrome type.In real evil signs,blood stasis syndrome appear most frequently(41 cases,38.68%),followed by wet heat syndrome(37 cases 34.91%),wet muddy syndrome(12 cases,11.32%),water qi syndrome(6 cases,5.66%).3.Comparison of normal information,Diet nutritional status of 106 patients with CKD,the difference of gender,BMI,systolic blood pressure,diastolic blood pressure of different stages was not statistically significant(P>0.05),only the difference of age was statistically significant(P<0.05).And the Hb of CKD patients decreased gradually with the decline in renal function,the PTH increased gradually with the decline in renal function,the difference was statistically significant(P<0.05).4.Compared with poor nutrition group,better nutrition group was higher in TC,urine protein,the number of urine erythrocytes,CRP,and lower in Hb,Alb,the percentage of dietary supplement intake,protein intake and the percentage of blood stasis syndrome,the difference was statistically significant(P<0.05).5.Compared with mainly animal protein intake group,mainly plant protein intake group was higher in CO2,and lower in the number of urine erythrocytes,protein,sodium and water intake,qi and yin deficiency,the difference was statistically significant(P <0.05).6.Compared with qi and yin deficiency,spleen and kidney qi deficiency patients were more common in males;compared with spleen and kidney yang deficiency,liver and kidney yin deficiency patients were higher in Hb,TC,LDL-C,and lower in protein intake;compared with spleen and kidney yang deficiency,spleen and kidney qi deficiency patients were higher in Alb;compared with spleen and kidney qi deficiency,liver and kidney yin deficiency patients were higher in salt intake;compared with qi and yin deficiency,spleen and kidney yang deficiency patients were higher in scr;the difference was statistically significant(P<0.05).Conclusions: 1.Spleen and kidney qi deficiency and blood stasis syndrome was the most common syndrome in the TCM Syndrome type(50% and 38.68%);while in the early stage of CKD,qi and yin deficiency and wet heat syndrome were the most common syndrome,in the end stage renal disease spleen and kidney yang deficiency and blood stasis syndrome were the most common syndrome.2.The poor nutritional status of CKD patients may have an effect in the formation of blood stasis syndrome,so we can add promoting blood circulation and removing blood stasis traditional Chinese medicine into tonic traditional Chinese medicine to treat the Malnourished patients of CKD;To use MIS to evaluate CKD patients?nutritional status and inflammation state is of great credible,it is also more sensitive,reliable and simple method to evaluate the status of malnutrition in CKD patients.3.With the progress of CKD,mainly animal protein intake patients were more likely to manifest as Qi and Yin Deficiency,so we can use tonifying qi and yin to treat this kind of CKD patients,according to the patient's diet partial.And plant protein is better than animal protein in improving metabolic acidosis,reducing hematuria,controling of sodium and water intake.4.Males were more common in Spleen and kidney qi deficiency patients(71.7%),females were more common in qi and yin deficiency patients(61.9%);with the progress of CKD,more sodium intake patients were more likely to manifest liver and kidney yin deficiency;and water qi syndrome patients had a great chance to have a higher diastolic blood pressure level.