Retrospective Analysis On TCM Syndrome And Clinical Relevant Factors Of Chronic Kidney Disease In The 3th Period

PurposeTo explore the TCM syndrome characteristic of the chronic kidney disease in the 3th period(CKD3),and the relation between different syndromes and clinical relevant factors,such as age,gender,primary disease,laboratory indicators,etc.It also provide the basis for diagnosis and treament of CKD3.MethodsFirst,sum up the common symptoms of CKD3 according to some related reference books,and then establish a form to collect the TCM symptoms. Second,search the hospitalized cases of chronic renal failure in Guangdong Hospital of Chinese Medicine during 2002-2008.Use the MDRD software to calculate glomerular rate(eGFR),then choose the CKD3(eGFR:30-59ml/min) hospitalized cases.Third,fill in the form for TCM symptoms collection,then record the general information(gender,age,course of disease,primary disease) and laboratory indicators(such as hemoglobin,creatinine,blood urea nitrogen, uric acid,cholesterol,triglycerides,calcium,phosphorus,24-hour urinary protein,etc.).Forth,use cluster analysis software to assort the TCM symptoms. According to the result of clustering,combined with clinical experiences, generalize the TCM syndrom of CKD3.Fifth,compare the general information and laboratory indicators among different TCM syndromes by using SPSS13.0 software,to find the relation between them.ResultsThis study collected 80 hospitalized cases of CKD3,the average age was 60.825±15.54 years old,the male to female ratio was 1.5:1.Its common primary diseases:28 cases of chronic glomerulonephritis,accounting for 35%,19 cases of essential hypertension,accounting for 23.75%,15 cases of diabetes, accounting for 18.75%.According to the result of cluster analysis and clinical experiences,the TCM syndrome of CKD3 can be divided into 4 types:①Qi deficiency in spleen,combined with wet and blood stasis syndrome;②Qi deficiency in spleen,combined with damp-heat syndrome;③Deficiency in spleen and kidney,combined with wet syndrome;④Deficiency in spleen and kidney combined with wet muddy and blood stasis syndrome.Each syndrome accuonted for 40%,7.5%,25%,27.5%.The gender,age,primary disease,liver function, lipid,calcium,phosphorus among 4 syndromes had no differences(P>0.05).On the course of disease,renal function and blood indicators,the deficiency in spleen and kidney combined with wet muddy and blood stasis syndrome was different(P<0.05).On the 24-hour urinary protein and uric acid,the Qi deficiency in spleen combined with damp-heat syndrome was different(P<0.05). On the FIB indicator,blood stasis syndrome was different from non-blood stasis syndrome(P<0.05).ConclusionTCM syndrome of CKD3 all belong to the deficiency and excess combined syndrome.The deficiency in spleen and kidney were most common,especially the Qi deficiency,and no Yang deficiency.There were wet,damp-heat,muddy and blood stasis syndromes in CKD3.The most common were wet and blood stasis syndrome.In CKD3,deficiency in spleen and kidney combined with wet muddy and blood stasis syndrome was related to the course of disease,renal function and anemia. Qi deficiency in spleen combined with damp-heat syndrome was related to 24-hour urinary protein and uric acid.FIB indicator was related to blood stasis syndrome.