Maintenance Hemodialysis Patients Microinflammation Reacted With Syndromes Relationship

Object:Observing maintenance hemodialysis(MHD) patients with micro-inflammatory state and TCM syndrome types, analyzing the regularity of TCM syndrome distribution of MHD micro-inflammatory state summarizing the etiology and pathogenesis of it, expect to getting the theory base for the treatment in Chinese medicine for the MHD patients with micro-inflammatory state. Simultaneously, observing the relationship between CRP and Hb, ALB, Scr, KT/V, nPCR, and to explore the impact of micro-inflammatory state of anemia, nutrition, dialysis adequacy.Methods:Collecting MHD patients meeting the inclusion criteria in Beijing University of Chinese Medicine Dong Fang Hospital dialysis unit, testing before a single hemodialysis CRP, Hb, Hct, ALB, Scr, Urea, Ca, P, PTH, CO2CP, after a single hemodialysis CRP,and calculating KT/V, nPCR.①Comparing the above indicators in Microinflammatory group (predialysis CRP>5mg/L) and Normal group (predialysis CRP<5mg/L) each other. Comparing the correlation between CRP and Hb, Hct, ALB, Scr, Urea, Ca, P, CO2CP, PTH, KT/V, nPCR. Comparing the differences of CRP between before and after dialysis.②By TCM methods of diagnosis to record symptoms, tongue and pulse, according to the Ministry of Health,"Chinese medicine clinical research guidelines,"2002edition of the syndrome of chronic renal failure, analyzing the predialysis CRP>5mg/L group of patients with TCM syndrome, statistical analysis, exploring the regularity of TCM syndrome distribution of MHD micro-inflammatory state.Results:①46.58%of73MHD patients was in micro-inflammatory state.②Microinflammatory group of Hb, HCT, ALB,Kt/V,nPCR was significantly lower than Normal group, with a significant difference (P<0.05). Normal group of predialysis CRP,Scr,Urea,P,Ca*Pwas significantly higher than Microinflammatory group, with a significant difference (P<0.05). There is no significant difference in Ca, PTH, CO2CPbetween Microinf lammatory group and Normal group (P>0.05).③Between predialysis CRP and Hb, Hct, ALB,Kt/V,nPCR was negatively correlated (P<0.05). Between predialysis CRP and Scr, Urea was positively correlated (P<0.05). Between predialysis CRP and Ca, P, Ca*P, PTH, CO2CP was no significant correlation (P>0.05).㏄ostdialysis CRP was higher than predialysis CRP in a singal, with a significant difference (P<0.05).⑤In MHD patients with micro-inflammatory state, deficiency syndrome to designate the most Qi-Yin Deficiency Syndrome, followed by the spleen and kidney Yang Deficiency Syndrome, Spleen and kidney Qi Deficiency Syndrome,liver and kidney Yin Deficiency Syndrome, Yin and Yang Deficiency Syndrome. Standard Positive syndrome to designate the most dampness Syndrome, followed by stasis, damp-heat, water-gas, wind permits Syndrome. The Qi-Yin Deficiency Syndrome mostly with damp-heat, stasis. The spleen and kidney Yang Deficiency Syndrome was particularly prevalent in dampness, stasis.Conclusions:①MHD patients are in Micro-inflammatory state.②Micro-inflammatory state associated with anemia, malnutrition and dialysis adequacy,the more severe micro-inflammation, the more serious anemia malnutrition and dialysis inadequacy.③Hemodialysis play a role on producing inflammatory factors CRP.④The most common deficiency syndrome of MHD patients micro-inflammation is Qi-Yin Deficiency Syndrome, and the most common standard positive syndrome is dampness syndrome.⑤The pathogenesis of MHD patients micro-inflammation is characterized by Qi-Yi deficiency, dampness and blood stasis, and dampness is an important pathological factor.