The Study On Clinic Rule Of TCM Syndrome Type Before And After Continous Ambulatory Peritoneal Dialysis In Renal Hypertension Patients

Objective: To study the TCM axiom of renal hypertension patients before and after continous ambulatory peritoneal dialysis, which are the types of syndrome, and the relationship between PWV and different classification of syndrome differentiation.Methods: According to the diagnosis of hypertension and chronic renal failure in the clinical research guideline of Chinese medicinal materials, either be hospitalization or follow-up, we divided the patients into three groups by TCM syndrome differentiation. 110 patients were enrolled from The Peritoneal Dialysis Center, Division of Nephrology, Peking University Third Hospital. We collected the clinical data by using the four physical examinations, namely, inspection, auscultation and olfaction, inquiring and palpation. And we tested the PWV of each patient when they were hospitalization and followed up. We analyzed the clinical data by SPSS 13.0th version statistical software. Continuous variables were expressed as mean±SD, while categorical variables were expressed as ratio or percentage. The comparison of continuous variables between groups was analyzed using t test, and among groups was analyzed using ANOVA (for post hoc analysis, SNK was performed if equal variance was assumed and Tamhane's T2 test was performed if equal variance was not assumed). The comparison of ratio or percentage among groups was performed by chi square test. The evaluation of multiple factor was performed by hierarchical cluster. P value less than 0.05 was considered statistically significant.Results: There were three types of TCM syndrome differentiation in renal hypertension in-patients , which were deficiency of qi of both the spleen and kidney, deficiency of both yin and yang, deficiency of yang of both the spleen and kidney with damp. Deficiency of both yin and yang, deficiency of both qi and yin and deficiency of yin with stagnant blood were the types of TCM syndrome differentiation of renal hypertension patients when they were followed up. There was no difference in PWV among the three groups neither they were hospitalization or followed up. The PWV in deficiency of yin with stagnant blood group was significantly higher than deficiency of both yin and yang group of hospitalization (P<0. 05). The PWV of patients who were under continous ambulatory peritoneal dialysis was significantly higher than hospitalization (P<0.05).Conclusion: The clinical rule of TCM syndrome type is: deficiency of qi of both the spleen and kidney appears firstly, and yang is weaker and weaker because of the deficiency of qi, then deficiency of yang results in weakness of yin and then deficiency of both yin and yang occurs. When patients are under continous ambulatory peritoneal dialysis, the rule should be: deficiency of qi results in weakness of yin and then deficiency of qi and yin, mostly, stagnant blood is concomitant. Of the total, deficiency of yin and yang is the most. It occurs when patients were both hospitalization and follow-up. It is believed that deficiency of yin and yang is the last stage. Deficiency type is considered to be the most important characteristic of renal hypertension, while evil concomitantly mostly. However, the relationship between PWV and TCM syndrome type should be tested in future studies. In conclusion, the result can be made reference for TCM syndrome differentiation of renal hypertension in end stage renal disease or continous ambulatory peritoneal dialysis.