| Objective: To investigate the relationship between different stages of CKD and blood stasis syndrome score by cross-sectional investigation,master the severity and change rule of blood stasis in the development of CKD,analyze the relationship between blood stasis syndrome scores and different physical and chemical testing indicators,to provide objective evidence for judging the prognosis of CKD by the combination of traditional Chinese and Western medicine and treating CKD with the method of activating blood circulation,and to summarize Professor Che Shuqiang's clinical experience in the treatment of CKD.Methods: Collect CKD patients who meet the inclusion criteria in the nephrology ward of the Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Through cross-sectional research methods,Fill in the questionnaire "inclusion of patients with chronic kidney disease" and "Blood Stasis Integral Scale",General situation,medical history,personal history,relevant physical and chemical examination,serum cystatin level,blood stasis syndrome score and other data were counted and the database was established,Use spss software for analysis,To judge the correlation between different stages of chronic kidney disease and the blood stasis syndrome score,And summarize Professor Che Shuqiang's clinical experience.Result:1.A total of 106 effective cases were obtained in this investigation.Patients were grouped according to different CKD stages,including 11 in G1,17 in G2,23 in G3(including 3a and 3b),25 in G4,and 30 in G5.There were no significant differences in gender,BMI,smoking and drinking history,diabetes mellitus,hypertension,and duration of CKD among the groups(P > 0.05).2.In all the cases included in the study,the minimum value of blood stasis syndrome score was 2,the maximum value was 15,and the average value was 8.52 + 3.181.According to the diagnostic criteria of blood stasis syndrome referred to in this study,all patients had blood stasis syndrome score(>2),it suggests that blood stasis runs through the course of CKD,Spearman correlation analysis between CKD staging and blood stasis syndrome score showed that the two were significantly correlated(r=0.577,P<0.01),The blood stasis scores of different stages of CKD,the blood stasis scores of G2 stage are higher than those of G1 stage(6.12±1.867 and 5.55±3.045,p<0.05).G3,G4 and G5 stages were significantly higher than G1 stage(7.09±2.151,9.20±1.803,11.17±2.679 and 5.55±3.045,P < 0.01).It is suggested that the blood stasis syndrome score of CKD increased steadily and slowly in the G1 and G2 phases,and showed a significant increase in the G3 phase,which is the key node for the significant aggravation of blood stasis in CKD patients.3.Pearson correlation analysis showed that Cys-C and blood stasis syndrome score were significantly correlated(r = 0.667,P < 0.01);using Pearson correlation analysis,bun was significantly positively correlated with blood stasis syndrome score(r = 0.540,P < 0.01),LDL had a weak negative correlation with blood stasis syndrome score(r =-0.193,P < 0.05);using Spearman correlation analysis,SCR was significantly positively correlated with blood stasis syndrome score(r = 0.564,P < 0.01),FIB was positively correlated with BSS score(r = 0.201,P < 0.05),D-DI was positively correlated with BSS score(r = 0.383,P < 0.01).The increase of bun,SCR,FIB and DDI was accompanied by the deepening of blood stasis,while the LDL was decreased and the degree of blood stasis was aggravated.Conclusion:1.Blood stasis,as a pathological product of CKD,is also its pathogenic factor.With the whole process of CKD,blood stasis is aggravated with the progress of CKD.In ckd3 stage,that is,the early stage of chronic failure,the degree of blood stasis is more serious than before.In this stage,we need to strengthen the treatment of promoting blood circulation,alleviate the progression of CKD and improve the prognosis.2.Cys-C can be significantly abnormal in the early stage of CKD(G1,G2),which can reflect the real situation of GFR more stably,more sensitively and objectively,which is conducive to the early prevention and treatment of CKD.It has a significant positive correlation with the blood stasis syndrome score.It suggests that in the clinical treatment of chronic kidney disease,we can change the use of blood activating drugs according to the value of cystatin,and evaluate the curative effect according to the change of its value.FIB and D-DI,which reflect the blood coagulation state of human body,are also positively correlated with the blood stasis syndrome score,which can guide the clinical application of blood activating drugs and evaluate the curative effect.3.Cys-C can appear obvious abnormalities in the early stage of CKD(G1 stage,G2 stage),which is more stable,more sensitive and objective than renal function indicators such as serum creatinine to reflect the true situation of GFR.It is an important index for early detection,early diagnosis and early treatment of CKD,and it is closely related to blood stasis syndrome score.This indicates that Cys-C can be combined with blood stasis syndrome score and other related physical and chemical examinations to comprehensively evaluate the progress of CKD in multiple ways,so as to achieve the goal of timely interventional treatment,delay the development of CKD and improve Professor Che Shuqiang attaches great importance to the pathogenesis of blood stasis in the clinical treatment of chronic kidney disease.He often analyzes and judges the development of CKD and the degree of blood stasis according to the relevant physical and chemical indicators and symptoms of patients.He knows disease differentiation in western medicine and differentiation in traditional Chinese medicine,and reasonably used different methods of promoting blood circulation,that is,harmonizing blood circulation to promote blood stasis,promoting blood circulation to remove blood stasis,breaking blood and removing blood stasis,etc.,to carry out targeted treatment on CKD,delay its progress,improve the quality of life and prognosis. |
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