Font Size: a A A

Preliminary Study On Body Composition, TCM Syndrome Types And Tongue Image Of Patients With Chronic Kidney Disease Stage 3-5

Posted on:2022-02-17Degree:MasterType:Thesis
Country:ChinaCandidate:Z P LiuFull Text:PDF
GTID:2514306329464854Subject:Traditional Chinese Medicine
Abstract/Summary:PDF Full Text Request
Objective:1.Bioelectrical impedance analysis was used to measure the body composition of CKD stage 3-5 non-dialysis patients,and to explore the body fluids and nutritional status of patients with different stages,so as to provide some reference for capacity management and nutritional treatment in the middle and late stages of CKD.2.To study the distribution of TCM syndrome types of CKD stage 3-5 patients,so as to explore the evolution of pathogenesis in the middle and late stages of CKD,and combine staging with syndrome differentiation,so as to provide new ideas for the follow-up medication,and to improve the therapeutic effect of traditional Chinese medicine.3.To study the distribution regular of TCM tongue picture of CKD stage 3-5 patients,in order to provide the basis for the objectification and standardization of tongue diagnosis,and provide help for TCM syndrome differentiation and treatment and prediction of disease prognosis.Method:In this study,95 patients who met the inclusion criteria of CKD stage 3-5 from January 2020 to January 2021 in the Department of Nephrology and endocrinology,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine were included.The general clinical data of the patients were collected,and the patients were classified according to the syndrome differentiation criteria of chronic renal failure in the guiding principles for clinical research of new Chinese medicine edited by Zheng Xiaoyu in 2002 Syndrome differentiation.Body composition was measured by body analyzer and body composition index was recorded.Zmt-1a digital analysis system of TCM tongue image was used to take and save tongue image photos,and the tongue color,tongue shape,tongue coating and tongue coating quality were recorded.All the data were input into the database,and SPSS20.0 was used for statistical analysis of the data to explore the TCM syndrome types,tongue distribution and changes of body composition of CKD patients in different stages.Result:1.95 patients with CKD stage 3-5 were included in this study,including 54 males and 41 females.The oldest patients were 88 years old and the youngest were 24 years old.The top three primary diseases of CKD patients included were diabetes,chronic glomerulonephritis and hypertension.With the aggravation of renal function damage,renal anemia,renal osteopathy,metabolicacidosis,hyperkalemia and other complications gradually increased.More than 95%of CKD stage 5 patients had renal anemia.2.The distribution of TCM Syndrome Types in different stages of CKD patients is different.This deficiency syndrome:in CKD stage 3,spleen and kidney qi deficiency syndrome(27.6%)and liver and kidney yin deficiency syndrome(27.6%)are the most common,followed by spleen and kidney yang deficiency syndrome(20.7%),qi and yin deficiency syndrome(13.8%)and yin and yang deficiency syndrome(10.3%);in CKD stage 4,spleen and kidney yang deficiency syndrome(38.9%)is the most common,followed by yin and yang deficiency syndrome(27.8%)and qi and yin deficiency syndrome(16.7%),liver and kidney yin deficiency syndrome(11.0%),spleen and kidney qi deficiency syndrome(5.6%);In CKD stage 5,spleen and kidney yang deficiency syndrome(41.7%)was the most common,followed by spleen and kidney qi deficiency syndrome(25.0%),yin and yang deficiency syndrome(20.9%),Qi and yin deficiency syndrome(6.2%)and liver and kidney yin deficiency syndrome(6.2%).Standard syndrome:in CKD stage 3,damp heat syndrome(38.0%)was the most common,followed by wet turbidity syndrome(20.7%),blood stasis syndrome(20.7%),water vapor syndrome(10.3%),wind syndrome(10.3%);in CKD stage 4,blood stasis syndrome(44.4%)was the most common,followed by damp heat syndrome(22.2%),wet turbidity syndrome(16.7%),water vapor syndrome(16.7%),wind syndrome(0.0%);in CKD stage 5,damp heat syndrome(31.2%)was the most common,followed by blood stasis syndrome(27.1%),wet turbidity syndrome(18.8%),water vapor syndrome(14.6%),wind syndrome(8.3%)3.There were differences in some body components in different CKD stages:① body fluid indexes:ECV%,ECV/TBW,ECV/ICV%of CKD stage 4 were significantly higher than those of CKD stage 3 and CKD stage 5(P<0.05),and the average edema index(ECV/TBW)of CKD stage 4 and CKD stage 5 patients was greater than 0.390,indicating that there was volume overload in CKD stage 4 and CKD stage 5 patients.② Nutritional indicators:there were no significant differences in protein%,inorganic salt%,muscle mass%,fat free body weight%,body fat%,body cell mass and body mass index among patients with different CKD stages(P>0.05),but there were differences in phase angle among patients with different CKD stages(P<0.05).Compared with CKD stage 3,CKD stage 4 and CKD stage 5 were significantly lower(P<0.05).It is suggested that with the aggravation of renal function damage,the number of cells and the function of cell membrane in patients will be damaged,and the nutritional status of patients will be worse and worse.4.The correlation between body composition and some laboratory indexes,total body moisture and ALB were negatively correlated,body fat and Hb were positively correlated,and BUN were negatively correlated.BMI was negatively correlated with Hb and BUN;extracellular water was negatively correlated with ALB;extracellular water ratio was negatively correlated with ALB;phase angle was positively correlated with Hb and ALB;visceral fat area was positively correlated with Hb;abdominal circumference was positively correlated with Hb.5.Different stages of CKD patients with different tongue distribution:① tongue color:CKD satge 3-5 patients with purple tongue is the most common,and with the progress of the disease,the proportion of light white increased.② moss color:yellow mosses were the most common in CKD stage 3-5,white mosses increased gradually,and burnt yellow mosses decreased.③Tongue shape:fat tongue was the most common in 95 patients with CKD,but with the progress of the disease,the proportion of thin tongue increased.There was no significant difference in the distribution of tooth mark tongue,prick tongue and crack tongue among different stages of CKD patients(P>0.05).④ Moss quality:95 cases of CKD patients with thick moss,and with the progress of the disease,the proportion of thick moss gradually increased.More than half of the CKD patients were greasy fur,and from CKD stage 3 to CKD stage 5,the proportion of normal fur decreased,while the proportion of greasy fur and rotten fur increased.Only 4 patients with CKD were involved in this study.Conclusion:1.From CKD stage 3 to CKD stage 5,the deficiency syndrome gradually develops from spleen and kidney qi deficiency and liver and kidney yin deficiency to spleen and kidney yang deficiency and Yin and yang deficiency.CKD stage 3-5 syndrome is mainly damp heat syndrome and blood stasis syndrome.2.Fluid overload is common in CKD stage 4 and CKD stage 5 patients.With the aggravation of renal function damage and the decrease of phase angle,the nutritional status of patients is getting worse and worse.3.There is a correlation between body composition and some laboratory indexes.When the ALB of CKD patients decreases,the ratio of total body water,extracellular water and extracellular water of CKD patients increases,while the phase angle of the whole body decreases.When Hb decreased,body fat,phase angle,visceral fat area and abdominal circumference decreased.However,there was no correlation between serum creatinine level and body composition.4.The tongue color of CKD stage 3-5 patients was mainly purple tongue,and the moss color was mainly yellow moss;fat tongue was more common in CKD3 patients,and moderate tongue was more common in CKD stage 4 and 5 patients;there was no significant difference in the distribution of tooth mark tongue,prick tongue and crack tongue in CKD stage 3,4 and 5 patients;with the aggravation of renal function damage,the proportion of thick,greasy and rotten fur increased.
Keywords/Search Tags:CKD stage 3-5, body composition, bioelectrical impedance analysis, tongue picture, TCM syndrome
PDF Full Text Request
Related items