Investigation And Analysis On Distribution Law Of Chinese Medicine Syndrome In Non-dialysis Chronic Kidney Disease Patients At Stage3～5

Objective:In order to a better understanding of non-dialysis chronic kidney disease patients at stage3-5, we observe and discuss about basic information of them, the distribution law of Chinese Medicine syndromes, the relationship between syndromes and clinical laboratory indexes and so on.Method:We collect all the clinical data of patients participating in the survey, and divide them into different stages according to glomerular filtration rate. We ask all the clinical data is accurate and carry out the same diagnose criteria. The content of the survey includes basic information and clinical data of the patient. We establish a database according to the information and use statistical methods to analyse them. We mainly use the chi-square test in the count data and variance analysis in the measurement data.Results:1. There are110patients aged from21to94and mean age is61.85±14.80. Most of them lie in50-79years old, accounting for75.4%.68patients are beyond60years old, the age distribution is negative skewness. The number of male patients is62while female is48, the ratio is1.29to1. The most common seen cause of CKD is chronic glomerulonephritis(46), followed by diabetic nephropathy(23), renal arteriolar sclerosis(21) and other causes(20).2. The number of cases from stage G3a to G5is23,28,23,36and there is no statistical difference among each stage in both age and gender.64patients who are mostly in G4and G5have a proteinuria>1.0g/d. There is a significant statistical difference among G3a, G3b and G5in proportion of urinary protein divided by1.0g/d. The urinary protein difference between G4and G5is statistical. There are72cases whose blood pressure are uncontrolled, the proportion of each stage from G3a to G5is56.5%,53.6%,60.9%,83.3%, and there is also a statistical difference among each stage. As to clinical laboratory indexes, there is significant statistical difference among each stage in blood nitrogen, serum creatinine, hemoglobin and serum albumin. A statistical difference exists in blood uric acid while no statistical differences exist in total cholesterol, serum triglycerides, blood low-density lipoprotein and high-density lipoprotein.3. Among the110patients, the most common seen deficiency syndrome is Spleen and Kidney Qi Deficiency(57), followed by Qi and Yin Deficiency(31). There is an increasing tendency in distribution of Liver and Kidney Yin Deficiency(12), Spleen and Kidney Yang Deficiency(9) with the advanced kidney function. There is just1case diagnosed as both Yin and Yang Deficiency which appears in stage G5. There are36patients who are diagnosed as deficiency syndrome with only one sthenia syndrome, while74patients are with2or more. The descending order of sthenia syndromes is damp-heat(76), stagnation of blood(57), damp-turbidity(48), water-pathogen(14) and heat-toxin(9). There is no statistical difference among each deficiency syndrome in both age and gender whereas a statistical difference exists in age among sthenia syndromes. Elderly patients seem less in only one sthenia syndrome.4. There are significant statistical differences among deficiency syndromes excluding Yin and Yang Deficiency in blood nitrogen, serum creatinine and hemoglobin. Significant statistical differences exist in blood nitrogen and serum creatinine between any two of them expecting Spleen and Kidney Qi Deficiency and Qi and Yin Deficiency, Liver and Kidney Yin Deficiency and Spleen and Kidney Yang Deficiency. There are also statistical differences in hemoglobin between any two of those deficiency syndromes expecting Liver and Kidney Yin Deficiency and Spleen and Kidney Qi Deficiency. The differences among sthenia syndromes in blood nitrogen, serum creatinine, serum albumin and proteinuria are statistical significant. Statistical difference exists in hemoglobin. In detail, there are significant statistical differences in blood nitrogen and serum creatinine between damp-turbidity syndrome and any other while statistical difference exists in serum albumin between water-pathogen and any other. Statistical differences exist in damp-heat syndrome and any other in proteinuria while heat-toxin and water-pathogen in serum creatinine. Statistical differences exist in damp-turbidity syndrome compared with damp-heat syndrome, heat-toxin and stagnation of blood syndrome in hemoglobin as well as water-pathogen and stagnation of blood syndrome in hemoglobin.Conclusions:1. Male and middle-elderly take an advantage portion among non-dialysis chronic kidney disease patients at stage3-5. The common seen causes of CKD are chronic glomerulonephritis, diabetic nephropathy and renal arteriolar sclerosis. The management of proteinuria and blood pressure in G5behaves less perfect than other stages while the complications of CKD such as anemia, hyperuricemia and dyslipidemia have high incidences.2. The most common seen deficiency syndrome is Spleen and Kidney Qi Deficiency, followed by Qi and Yin Deficiency among stage3-5CKD patients. Liver and Kidney Yin Deficiency, Spleen and Kidney Yang Deficiency and both Yin and Yang Deficiency are less appeared and more likely to come with the advanced kidney function. Damp-heat, stagnation of blood, damp-turbidity are the common seen sthenia syndromes. Damp-turbidity syndrome comes together with advanced kidney function. Water-pathogen is usually seen in patients with lower serum albumin and Damp-heat syndrome is often seen in patients with proteinuria.