| ObjectiveTo observe the distribution of TCM syndrome types of renal anemia in single-center maintenance hemodialysis(MHD)patients,and analyze the correlation between TCM syndrome types and general clinical information and laboratory examination,so as to provide certain clinical reference for TCM syndrome differentiation in the treatment of renal anemia in maintenance hemodialysis patients.MethodsIn this cross-sectional study,276 patients who met the inclusion criteria were screened from the Blood Purification Center of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine.General clinical information,such as gender,age,dialysis age,vascular access,TCM syndrome types,and related laboratory tests of hemoglobin and serum albumin were collected.The collected data were input into Excel table and imported into SPSS 26.0 software for data processing.The distribution of TCM syndrome types and their correlation with general clinical information and laboratory examination were statistically analyzed,and then sorted out,summarized and discussed.Results1.Among the 276 patients in our center,149 were males(53.79%)and127 were females(45.85%),with a male to female ratio of 1.1:1;Mean age58.43±13.422 years;The primary diseases were chronic glomerulonephritis(34.06%),followed by diabetic nephropathy(23.19%),hypertensive nephropathy(15.58%),polycystic kidney disease(6.52%),gouty nephropathy(5.43%),henoschlein purpura nephritis(3.62%),other and unknown primary diseases(11.60%).2.The distribution frequency of TCM syndrome types of renal anemia in MHD patients in our center is as follows: the syndrome of spleen and kidney qi deficiency accounted for the most(42.75%),followed by spleen and kidney Yang deficiency(23.55%),liver and kidney Yin deficiency(17.03%)and Qi and Yin deficiency(16.67%);Blood stasis syndrome accounted for the most(27.54%),followed by dampness-turbidity syndrome(24.28%),damp-heat syndrome(23.91%),water-qi syndrome(13.41%)and no concurrent syndrome(10.87%).The most frequent syndromes combined with concurrent syndromes are spleen and kidney qi deficiency syndromes combined with dampness-heat syndromes.3.(1)Gender and distribution of syndromes and concurrent syndromes:there was no statistical significance in the distribution among different syndromes(P > 0.05).(2)Age and distribution of the syndrome and concurrent syndromes:the number of elderly people > 65 years old in the spleen-kidney Yang deficiency syndrome group was significantly more than that in the other two groups,and the number of elderly people > 65 years old in the liver-kidney Yin deficiency syndrome group was less than that in the other two groups(P <0.05);There was no statistical significance in age distribution among syndromes(P > 0.05).(3)Dialysis age and distribution of primary syndrome and concurrent syndrome: there was no statistical significance in distribution among different syndrome types(P > 0.05).(4)Distribution of primary disease,primary syndrome and concurrent syndrome: the proportion of chronic nephritis in spleen-kidney qi deficiency group was the highest(47.87%);the proportion of hypertensivenephropathy in liver-kidney Yin deficiency group was the highest(37.21%);the proportion of diabetic nephropathy in Qi-yin deficiency group was the highest(34.38%)(P< 0.05);There was no statistical significance in the distribution of primary disease among the syndromes(P > 0.05).(5)Distribution of vascular access,primary syndrome and concurrent syndrome: in spleen-kidney Yang deficiency syndrome group,dialysis catheter with tunnel and polyester sleeve accounted for more(58.33%)(P <0.05).There was no statistical significance in the distribution of vascular access among syndromes(P > 0.05).4.(1)The distribution of hemoglobin in each syndrome,the hemoglobin level in spleen-kidney Yang deficiency group was significantly lower than that in Qi and Yin deficiency and liver and kidney Yin deficiency groups(P <0.05);There was no significant difference in distribution among all syndromes(P > 0.05).(2)The serum albumin was distributed among the syndromes.The serum albumin level in spleen-kidney Yang deficiency group was significantly lower than that in Qi and Yin deficiency and liver-kidney Yin deficiency groups(P < 0.05).There was no significant difference in distribution among all syndromes(P > 0.05).(3)The distribution of C-reactive protein in each syndrome,the level of C-reactive protein in spleen-kidney Yang deficiency syndrome group was significantly higher than that in the other three groups(P < 0.05);There was no significant difference in distribution among all syndromes(P > 0.05).(4)The urea clearance index was distributed among the primary syndrome and concurrent syndrome.The urea clearance index of spleen-kidney Yang deficiency group was significantly lower than that of Qi and Yin deficiency group,and the urea clearance index of damp-heat syndrome group was significantly lower than that of moist-turbidity syndrome group(P < 0.05).(5)The serum calcium was distributed among the main syndroms.The serum calcium level in spleen-kidney qi deficiency and spleen-kidney Yang deficiency groups was significantly lower than that in liver-kidney Yin deficiency group(P < 0.05);There was no significant difference in distribution among all syndromes(P > 0.05).(6)There was no statistical significance in the distribution of serum ferritin,parathyroid hormone and serum phosphorus in each syndrome and concurrent syndrome(P > 0.05).Conclusion1.Chronic glomerulonephritis is the most common primary disease of MHD renal anemia patients.2.MHD renal anemia patients are mostly characterized by syndrome of deficiency and insufficiency,in which spleen and kidney qi deficiency syndrome is the most common syndrome,and blood stasis syndrome is the most common concurrent syndrome.3.The age,primary disease and vascular access of MHD renal anemia patients are related to TCM syndrome types to a certain extent.In the elderly group,the syndrome of spleen-kidney Yang deficiency was more than that of liver-kidney Yin deficiency.The TCM syndrome differentiation of patients with chronic glomerulonephritis was mostly spleen and kidney deficiency;the TCM syndrome differentiation of hypertensive nephropathy was liver and kidney Yin deficiency;the TCM syndrome differentiation of diabetic nephropathy was qi and Yin deficiency.The syndrome differentiation of patients with dialysis catheter with tunnel and polyester sleeve for vascular access is mostly spleen and kidney Yang deficiency syndrome.4.The hemoglobin,serum albumin,C-reactive protein,urea clearance index and serum calcium of MHD renal anemia patients are related to TCM syndrome types to a certain extent.TCM syndrome differentiation of patients with low hemoglobin,serum albumin and urea clearance index values are mostly spleen-kidney Yang deficiency syndrome,while TCM syndrome differentiation of patients with low urea clearance index values are mostly damp-heat syndrome.The syndrome differentiation of spleen and kidney Yang deficiency in patients with high C-reactive protein level and spleen and kidney qi deficiency and spleen and kidney Yang deficiency in patients with low serum calcium level. |
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