Clinical Study On The Correlation Between Serum Inflammatory Cytokines And TCM Syndromes Types In Patients With Chronic Kidney Disease

Objective:To investigate the relationship between serum inflammatory Cytokines CRP,IL-1β and TNF-a levels and TCM syndromes in patients with chronic kidney disease under microinflammation,analyzing the characteristics of the etiology and pathogenesis,Provide scientific and practical basis for TCM treatment of micro-inflammatory state in patients with chronic kidney disease.Methods:Collection of patients with chronic kidney disease who were eligible for inclusion in the inpatient and outpatient of the Department of Nephrology,Rui Kang Hospital,January 2018-December 2018.Blood samples and related examinations were collected under the same conditions,and the main symptoms,signs and tongues and pulse condition at the time of admission were recorded.The doctor of Associate chief physician or above performed syndrome differentiation and statistical analysis.Results:(1)160 patients with chronic kidney disease stage 2-5,and 72 of them had microinflammatory status,accounting for 45%.(2)In the state of microinflammation,Spleen-kidney qi deficiency syndrome is the most common deficiency syndrome.Accounting for 41.67%;Followed by Qi-Yin deficiency syndrome,accounting for 18.05%;Yin-Yang deficiency syndrome accounted for 15.28%;Spleen and kidney yang deficiency syndrome and Liver and kidney yin deficiency each accounted for 12.5%;water-dampness syndrome accounted for the largest proportion(38.89%),Secondly,blood stasis syndrome(27.78%),damp-heat syndrome(20.83%),drown-toxic syndrome(12.5%).(3)In the state of microinflammation,serum CRP and IL-1β levels were the highest in the Yin-Yang deficiency syndrome group.At the level of CRP and IL-1β,the difference between syndromes of the primary syndromes was statistically significant(P<0.05);TNF-a level was the highest in qi-Yin deficiency syndrome group,Qi-Yin deficiency syndrome group Compared with the other four groups,there was no statistical difference(P>0.05).(4)In the state of microinflammation,CRP and IL-1β level was the highest in the drown-toxic syndrome group,At the level of CRP and IL-1β,the difference between syndromes of the secondary syndromes was statistically significant(P<0.05);TNF-αlevels were significantly higher in the dampness-heat syndrome group,the difference of TNF-α level between dampness-heat syndrome and blood stasis syndrome was statistically significant(P<0.05).(5)Serum Hb,Scr and PTH levels were compared among the groups of the primary syndrome and secondary syndromes,but the differences were not statistically significant(P>0.05).(6)Serum CRP、IL-1β、TNF-α、BUN、SCr and PTH level in the microinflammatory group was significantly higher than that in the non-microinflammatory group(P<0.05).(7)Hemoglobin and hematocrit were significantly lower in the microinflammatory group than in the non-microinflammatory group(P<0.05),Hemoglobin and hematocrit were negatively correlated with CRP and TNF-α(P<0.05).(8)Parathyroid hormone(PTH)was positively correlated with CRP and IL-1β(P<0.05).Conclusion:(1)When patients with chronic kidney disease are associated with microinflammation,the most common syndrome is spleen-kidney qi deficiency,and the most common standard syndrome is water-dampness syndrome.(2)In the state of microinflammation,serum levels of inflammatory cytokines CRP,IL-1β and TNF-α in CKD patients were significantly higher than those without microinflammation;The higher the CKD stage,the higher the serum levels of inflammatory cytokines CRP,IL-1β and TNF-α.(3)In the state of microinflammation,Serum CRP and IL-1β levels correlated with Yin-Yang deficiency syndrome;And serum CRP and IL-1β associated with drown-toxic syndrome.(4)Microinflammatory status is associated with anemia,malnutrition,hyperparathyroidism and other related complications in patients with chronic kidney disease.