| Objective:To explore the distribution and clinical efficacy of TCM syndromes in patients with abnormal blood lipid metabolism in CKD stage3-4 in real world,and provide more evidence for intervention of chronic kidney disease.Methods: According to the inclusion criteria and exclusion criteria,242 patients with chronic kidney disease stage 3 and chronic kidney disease stage4,the blood lipids(TC,TG,LDL,HDL)were divided into dyslipidemia group and non-lipidemia group.The distribution of TCM syndromes in CKD stage 3 and CKD stage 4 dyslipidemia group and non-dyslipidemia group at 0weeks,compared with e GFR changes in CKD stage 3 and CKD stage 4dyslipidemia group and non-lipidemia group after 24 weeks.According to the actual situation of 242 patients in clinical practice,they were not randomly divided into Chinese medicine treatment group,Chinese patent medicine treatment group,Chinese medicine + Chinese medicine treatment group,Western medicine basic treatment group,Chinese medicine + Western medicine basic treatment group,Chinese patent medicine + Western medicine basic treatment group,Traditional Chinese medicine + Chinese patent medicine + Western medicine basic treatment group,which in turn corresponded to group A,group B,group C,group D,group E,group F,group G,and monitored total cholesterol(TC)and triglyceride once every 8 weeks(TG),low-density lipoprotein cholesterol(LDL),high-density lipoprotein(HDL),serum creatinine(Scr),estimated glomerular filtration rate(e-GFR)by CKD-EPI formula,for e-GFR,TC,TG,LDL recorded values ? ? in 0,8weeks,16 weeks,24 weeks and other follow-up windows.After 24 weeks,the clinical effects of blood lipids,TCM syndrome scores,TCM syndrome efficacy,comparison,and comparison were compared before and after treatment.Total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL),glomerular filtration rate(e-GFR).Results:(1)Distribution of syndromes in patients with CKD 3-4 dyslipidemia:242 cases of CKD 3-4 patients had 172 cases(71.1%)with abnormal blood lipid metabolism,71 cases(41.3%)with spleen and kidney qi deficiency syndrome Next,51 cases(29.7%)of spleen and kidney yang deficiency syndrome,19 cases of liver and kidney yin deficiency syndrome(11.0%),17 cases of pulmonary and kidney qi deficiency syndrome(9.9%),and 14 cases of qi and yin deficiency syndrome(8.1%);At the same time,133 cases(77.3%)were labeled,of which 53 cases(39.8%)were blood stasis syndrome,51 cases(38.4%)were wet phlegm syndrome,and 29 cases(21.8%)were damp heat syndrome.The distribution of CKD3 and CKD4 dyslipidemia were significantly different in this syndrome(P<0.05),CKD3 was mainly spleen-kidney qi deficiency syndrome,and CKD4 was more common in spleen-kidney yang deficiency syndrome.(2)Blood lipid index of different syndromes of different stages of CKD:From the point of view of this card,TC and LDL of CKD stage 3dyslipidemia were the highest in spleen and kidney qi deficiency syndrome,and there were differences between the other four syndrome types(P<0.05).TC and LDL in CKD stage 4 dyslipidemia were the highest in spleen and kidney yang deficiency syndrome,and were different from the other four syndrome types(P<0.05).CKD 3-4 patients with dyslipidemia were lowest in TC and LDL.According to the standard,TC and LDL in CKD stage 3dyslipidemia were the highest in wet turbidity syndrome,damp heat syndrome was the second,and blood stasis syndrome was the lowest(P<0.05).CK and LDL in CKD stage 4 dyslipidemia were the highest in blood stasis syndrome,followed by damp heat.Card,wet turbidity card(P<0.05).(3)TCM syndrome scores: The scores of TCM syndromes in group E,F and G were lower than those before treatment(P<0.05).There was no significant difference between group E and group G after treatment(P>0.05),the E group was different from the F group and the G group,which was statistically significant(P<0.05).The E group and the G group were better than the F group in improving the TCM syndrome scores(P<0.05).(4)Clinical efficacy: After treatment,the total effective rate of group G was 86.21%,the total effective rate of group E was 86.11%,and the total effective rate of group F was 83.33%.The clinical efficacy of the three groups before and after treatment was statistically significant(P<0.05).There was no significant difference between the E group and the G group(P>0.05).There was significant difference between the G group and the E group and the F group(P<0.05).Therefore,the G group and the E group were obtained.The improvement of TCM syndromes in the group was better than that in the F group(P<0.05).(5)Clinical efficacy of blood lipids: The total effective rate of group G after treatment was 89.66%;the total effective rate of group E was 88.89%;the total effective rate of group F was 83.33%.There was a statistically significant difference between the three groups(P<0.05).There was no significant difference between the G group and the E group(P>0.05).The G group was compared with the F group,the E group and the F group.The difference was statistically significant(P<0.05);the clinical efficacy of G group and E group in improving blood lipids was higher than that in F group(P<0.05).(6)Efficacy of blood lipid index: TC,TG,LDL decreased in the E group,F group and G group before and after treatment,the difference was statistically significant(P<0.05);after treatment,the three groups were compared,E The decrease of TC and TG in group and G group was significantly higher than that in group F(P<0.05),but there was no difference in the treatment of LDL group(P>0.05).(7)EGFR efficacy: There were significant differences in the E group,F group and G group before and after treatment(P<0.05).After the three groups were treated,the EGFR in the E group and the G group was significantly improved compared with the F group(P<0.05)..(8)The dyslipidemia group and the non-lipidemia group were compared before and after treatment.The difference was statistically significant(P<0.05).After treatment,the increase of e GFR in the non-dyslipidemia group was significantly higher than that in the dyslipidemia group(P<0.05).Conclousion:1.CKD stage 3-4 patients with dyslipidemia,the spleen and kidney qi(yang)deficiency syndrome and the syndrome of wet turbidity and blood stasis syndrome accounted for the largest proportion.As the condition progresses from CKD stage 3 to CKD stage 4,the highest syndrome type of blood lipid index TC and LDL is changed from spleen and kidney qi deficiency and dampness syndrome to spleen and kidney yang deficiency and blood stasis syndrome.2.Chinese medicine + Chinese patent medicine + Western medicine basic treatment group and Chinese medicine + Western medicine basic treatment group in reducing CKD stage 3-4 patients with TCM syndrome scores,improving the clinical efficacy of Chinese medicine,blood lipids and e GFR,reducing TC and TG values.Western medicine basic treatment group.3.During the course of treatment,the level of e GFR in the non-dyslipidemia group was significantly higher than that in the dyslipidemia group.It is speculated that there may be a correlation between blood lipids and e GFR changes. |
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