| Objective: By analyzing the distribution patterns of TCM syndromes in chronic kidney disease(CKD)patients in multicenter,and by exploring the correlationship between TCM syndromes and clinical indicators in CKD patients,the ultimate goal is that provided ideas for the standardized diagnosis and treatment of kidney disease by integrating traditional Chinese and western medicine.Methods:In this study,a retrospective method was used,and a total of1033 patients with stage 2-4 chronic kidney disease patients were selected,treated in the outpatient clinics and inpatient wards,from this center and Shanghai partner institutions between July 2017 and October 2019.They were differentiated by traditional Chinese medicine combined based on their symptoms,pulse signs,and tongue signs.Then they were divided into five groups: kidney and liver yin deficiency group,spleen kidney qi and yin deficiency group,spleen and kidney qi deficiency group,spleen and kidney yang deficiency group,and yang and yin deficiency group.All of their basic data and clinical indicators were recorded.SPSS 25.0 statistical software was used to analyze the distribution characteristics of TCM syndromes in CKD patients,and the correlation between TCM syndromes and clinical indicators.Results: 1.Among the 1033 patients,there were 597 males(57.8%)and 436 females(42.2%).The male to female ratio was 1.3: 1,and the age range was 21-80 years,with an average(55.1 ± 16.2)years.Among them,the spleen and kidney qi deficiency syndrome is the most,with a total of 395cases(38.2%),followed by the spleen and kidney yang deficiency syndrome and liver and kidney yin deficiency syndrome,which are 248 cases(24.0%)and 218 cases(21.1%),respectively.There were relatively few patients in the deficiency group and the yin-yang deficiency group,91(8.8%)and 81(7.8%),respectively.2.According to the stage of chronic kidney disease,375 cases were in CKD2,accounting for 36.3%;475 cases were in CKD3,accounting for46.0%;183 cases were in CKD4,accounting for 17.7%.With the gradual progress of CKD,the proportion of patients with deficiency syndromes of yin and yang has an increasing trend(5.3%,5.7%,18.6%,respectively),while that of patients with deficiency syndrome of spleen and kidney has a downward trend(48.8%,32.5%,31.5%).The distribution of different TCM syndrome groups in different CKD stages was different(P <0.05).3.The estimated glomerular filtration rate(e GFR-EPI value)of the yinyang deficiency syndrome is lower than that of other syndrome groups(P<0.01、P<0.01、P<0.05、P<0.05);and the serum creatinine,uric acid,uric nitrogen and 24-hour urine protein levels of the yin-yang deficiency syndrome were higher than other groups.The blood cholesterol level of spleen and kidney qi deficiency group was higher than that of spleen and kidney yang deficiency,spleen and kidney qi and yin deficiency,liver and kidney yin deficiency and yin and yang deficiency groups(P<0.01、P<0.05、P<0.01、P<0.01).In addition,the hemoglobin in the yin-yang deficiency group was significantly lower than other TCM syndrome types(all P <0.05).Conclusion: The spleen and kidney qi deficiency syndrome is more common in the early stage of CKD.As the disease progresses,the yin and yang deficiency syndrome gradually increases,suggesting that the yin and yang deficiency syndrome may be the terminal syndrome type of chronic kidney disease,which has a guiding effect on the diagnosis and treatment of traditional Chinese medicine.TCM syndrome types and clinical indicators of chronic kidney disease may be related.The renal function indicators of patients with yin-yang deficiency syndrome are lower than other TCM syndrome groups,and complications such as anemia are more likely to occur,which may be related to disease progression.Patients with spleen and kidney qi deficiency syndrome have higher blood cholesterol than other syndromes,which is consistent with the theory of poor spleen and kidney movement in traditional Chinese medicine.Targeting this type of patients during treatment can provide spleen and kidney benefits while providing cardiovascular drug protection. |
