Characteristics Of TCM Syndrome And Its Relationship With FGF23 In Non Dialysis Patients With Chronic Kidney Disease Complicated With Calcium And Phosphorus Disorder

Purpose: To study the characteristics of TCM syndromes and its relationship with fibroblast growth factor 23(FGF23)in patients with chronic kidney disease(CKD3-5)complicated with calcium and phosphorus metabolic disorder.The characteristics of TCM syndromes are studied by factor analysis and cluster analysis.The relationship between TCM syndromes of calcium and phosphorus metabolic disorder as well as serum FGF23 are analyzed.To provide a new objective basis for the standardization of TCM syndromes of CKD combined with calcium and phosphorus metabolism disorder.Method: 187 non-dialysis patients with calcium and phosphorus metabolism disorder in CKD3-5 stage are selected to collect the basic information of patients,clinical symptoms of traditional Chinese medicine,and to detect laboratory indexes,calcium and phosphorus metabolism related indexes and FGF23 by cross-sectional investigation.The clinical symptoms of the patients are analyzed by factor and cluster analysis,and the characteristics of TCM syndromes are summed up.SPSS24.0 statistical software package is used to establish a database to compare the differences of laboratory indexes,calcium and phosphorus metabolism indexes and FGF23 among different TCM syndromes,and to analyze the relationship between TCM syndromes and laboratory indexes,calcium and phosphorus metabolism related indexes and FGF23.Outcome:1.The symptom factor scores of patients are systematically analyzed,and five common TCM syndromes of CKD combined with calcium and phosphorus metabolism are summarized,namely spleen and kidney qi deficiency combined with wind movement and dampness turbidity,liver and kidney yin deficiency and damp-heat syndrome,qi and yin deficiency syndrome,and blood stasis syndrome.Spleen and kidney yang deficiency with dampness and turbid wind movement syndrome.2.In laboratory indexes,the level of blood urea bun(BUN),the renal function index in Yin-Yang deficiency syndrome is higher.The spleen and kidney qi deficiency syndrome,the dampness syndrome and the blood stasis syndrome,the level of serum triglyceride triglyceride(TG)and total cholesterol(TC)are higher.The level of hemoglobin(HB)in qi-yin deficiency syndrome and the Yin and Yang deficiency syndrome is lower.3.Among the related indexes of calcium and phosphorus metabolism,the level of blood calcium(Ca)in wind movement syndrome,dampness turbid syndrome and blood stasis syndrome is lower.The level of blood phosphorus(P)and parathyroid hormone(PTH)in spleen and kidney qi deficiency syndrome,spleen and kidney yang deficiency syndrome,wind movement syndrome,blood stasis syndrome,dampness syndrome is higher.4.The serum FGF23 level of the patients with spleen and kidney qi deficiency,wind movement,blood stasis and dampness turbid syndrome is higher than that of the control group.There is a positive correlation between FGF23 and serum phosphorus and parathyroid hormone in the related indexes of calcium and phosphorus metabolism.Conclusion:1.The common TCM syndromes of CKD3-5 patients with calcium and phosphorus metabolism disorder are mainly spleen and kidney qi deficiency combined with wind-moving dampness syndrome,liver and kidney yin deficiency and damp-heat syndrome,qi and yin deficiency syndrome,blood stasis syndrome,spleen and kidney yang deficiency combined with dampness and wind movement syndrome.The disorder of calcium and phosphorus metabolism in spleen and kidney qi deficiency syndrome,spleen kidney yang deficiency syndrome,wind movement syndrome,blood stasis syndrome and dampness turbidity syndrome is more obvious.2.FGF23 is related to calcium and phosphorus metabolism disorder of CKD,which could be used to evaluate the correlation index of CKD non-dialysis patients with calcium and phosphorus metabolism disorder.The FGF23 of spleen and kidney qi deficiency syndrome,wind movement syndrome,blood stasis syndrome and dampness turbidity syndrome are significantly increased.