TCM Syndrome Research Of CKD From "Big Data Platform" Based On The Theory Of "Kidney Deficiency And Damp-Blood Stasis"

Objective:To explore the distribution pattern of TCM syndrome types,syndrome type combination,syndrome elements and the four diagnostic information of Chronic Kidney Disease guided by the theory of " Kidney Deficiency and Dampness-Blood Stasis",and to establish the diagnostic model preliminarily.Methods:With the help of "China Kidney Diseases Big Data Application Innovation Alliance Big Data Platform",1445 cases with complete information and syndrome diagnosis in accordance with chronic kidney disease(CKD)diagnosis standard during the actual outpatient diagnosis and treatment process of chief physician from September 1,2019 to September 30,2019 were collected for statistical analysis,and the common syndrome type distribution pattern,syndrome type and clip,syndrome element and symptom were obtained;and factor analysis was used to mine the syndromes from an objective perspective,and bivariate correlation analysis was used.Explore the relationship between tongue image and syndrome types,and build a traditional Chinese medicine diagnosis model of common syndromes of CKD based on factor analysis and bivariate correlation analysis results.Result:1.Through statistical analysis of 1,445 CKD patients who met the criteria,it was found that the ratio of male to female was close to 1:1,and the ratio was comparable.The youngest is 2 years old and the oldest is 94 years old.The age is mainly between 40-59-year-old(41.66%),and 72.66%are over 40 years old.It can be seen that the patients are mostly middle-aged and elderly people.The primary diseases was mainly chronic glomerulopathy such as chronic glomerulonephritis(61.9%),IgA nephropathy(10.4%),Membranous Nephropathy(4.2%)and so on.The secondary CKD such as diabetic nephropathy(6.8%),the proportion of hypertensive nephropathy(1.5%)was relatively small.The primary chronic glomerular disease was mostly in CKD 1-2 stage,and diabetic nephropathy and hypertensive nephropathy were mainly in CKD3-5 stage.2.In the distribution of syndrome types,the top five syndromes of deficiency were deficiency of spleen and kidney,deficiency of qi and yin,deficiency of spleen and kidney,deficiency of liver and kidney,deficiency of lung and kidney;the top five syndromes of evil spirit were blood stasis,damp turbidity,damp,damp-heat,and damp poison.The main disease syndromes include kidney,and spleen;the main disease syndromes include qi deficiency,yang deficiency,blood stasis,damp,turbidity,damp-heat,and poison.In the distribution of syndrome types,the deficiency of spleen and kidney qi in the deficiency syndromes dominates the stages of CKD and the major primary diseases.The frequency was above 85%,and the frequency of occurrence was far greater than that of other deficiency syndromes not exceeding 8%.The standard evidence was mainly blood stasis syndrome,damp turbidity syndrome and damp-heat syndrome.Among them,the blood stasis syndrome has the highest frequency,which can reach more than 70%in each stage and major primary disease,especially in CKD3-5 stage and diabetic nephropathy.The frequency of damp turbidity syndrome was more than 50%in each stage of CKD,with CKD4 being the most,reaching 71.1%,and CKD 1-2 being the least,being 52.5%.Among the major primary diseases,diabetic nephropathy was the most frequent.It reached 71.4%,followed by chronic nephritis(57.7%),and the frequency was similar in Membranous Nephropathy and IgA nephropathy,which was 48.3%.The frequency of damp-heat syndromes was more than 20%in stage CKD 1-4,but it was decreasing with the progress of CKD,and the frequency was 19.6%in stage CKD5;the frequency was more than 20%in the main primary disease,of which IgA nephropathy has the highest frequency.Up to 30.5%.It can be seen that the main evils of CKD were concentrated in stasis,damp,and heat.Damp syndrome has a higher frequency in Membranous Nephropathy(26.7%)and diabetic nephropathy(16.3%),and in chronic nephritis and IgA nephropathy,the frequency was less than 4%.Damp poison syndrome has a higher frequency only in patients with stage CKD5.The most common combination of syndrome type were the syndrome of spleen and kidney qi deficiency with damp turbidity and blood stasis,the syndrome of spleen and kidney qi deficiency with damp-heat and stasis.Symptoms of spleen and kidney qi deficiency and dampness such as fatigue,weakness of waist and knees,softness of urine,excessive back pain,lower extremity edema,etc.were more frequent in CKD 1-5 stage and each of the common primary diseases.3.In the four diagnosis information,the pulse-like pulse pulse-like pulses accounted for more than 90%in each stage of CKD and the main primary disease.From the perspective of the tongue,the tongue was mainly light or red,and fat or fat.This kind of tongue was mostly related to qi deficiency and wetness;the tongue coating was mostly white,thin or white,thin yellow or yellow.Mainly,it was mainly related to damp turbidity,damp-heat;sublingual tendon vein stasis and purple were obviously very common,and the frequency was more than 60%in each stage of CKD and common primary disease.4.Based on the bivariate correlation analysis of the correlation between tongue signs and syndrome types,it was found that the fur was white and greasy,the fur was yellow or greasy,and the sublingual tendon vein stasis and purple were shown in the wet turbidity syndrome,damp heat syndrome,and blood stasis syndrome.The level of P<0.01 was significantly closely related.Through factor analysis,it was found that the common pathological factors of CKD were in the spleen,kidney,liver,lung,and heart,and the pathological syndromes were in Qi deficiency,Yang deficiency,Yin deficiency,damp,damp turbidity,blood stasis,and damp-heat.Comprehensive factor analysis results and bivariate correlation analysis results,combined with TCM professional knowledge,obtained five syndrome diagnosis models:(1)Deficiency of Spleen and Kidney Qi:Main symptoms:fatigue and fatigue,weak waist and knees,frequent urination,spontaneous sweating,and poor appetite;Secondary symptoms:low back pain,warm hands and feet,lower limb edema.The diagnosis is established when there are more than two major symptoms or one major disease+two minor symptoms.(2)Deficiency of spleen and kidney yang:main symptoms:chills and cold,frequent nocturia,fatigue,weakness of waist and knees;secondary symptoms:poor stool,low back pain,edema of lower limbs,edema of the face,spontaneous sweating.Among them,because the physiological functions of yang and qi overlap,and the main feature of yang deficiency is coldness,the obvious chill and coldness are the necessary options,and the diagnosis is established when there is one major or two secondary symptoms.(3)Damp-heat syndrome:Main symptoms:dry mouth,bitter mouth,thin yellow or yellow greasy fur.The diagnosis is established when the three main symptoms have two main symptoms or the tongue picture matches.(4)Damp turbidity syndrome:main symptoms:anorexia,epigastric pain,white greasy for.The diagnosis is established when the three main symptoms have two main symptoms or the tongue picture matches.(5)Blood Stasis Syndrome:Main symptoms:numbness of limbs,pain in joints,obvious bruising of veins under tongue.The diagnosis is valid when two of the three main symptoms have two or the tongue match.Conclusion:CKD is mostly based on deficiency and standardization,and the condition is complicated.The core of this deficiency syndrome is the deficiency of spleen and kidney qi,and the core of the standard syndrome is blood stasis,dampness,and damp-heat.Deficiency,dampness,heat,and stasis are the important characteristics of CKD.Spleen and kidney,Qingli Heluo are the core of traditional Chinese medicine treatment of CKD.