Tinnitus And Deafness Prevalence Of Chronic Kidney Disease And Its Tcm Syndrome Characteristics Study

Background:《SU WEN》say:"kidney governing bones.... the orifice of being ear " in the opening pointed out the function of ear is moderated by the kidney and raised by the essence of kidney.As a disease while a symptomatic, Tinnitus deafness can appear in a variety of disease, deafness may caused by constant tinnitus. In recent years, lots of scholars have made multilateral observation and exploration by applying modern science to the kidney dominating ears theory which has obtained certain progress. The research indicates that the location-distant anatomical organ, have some similarities in organization and enzyme content and distribution, in water and electrolyte balance and physiological mechanism of certain drugs and two organs on the pharmacological response are similar. Moreover, in the clinical study,researchers have found that many chronic kidney patients are suffering or once suffered obvious tinnitus deafness symptoms, in which includes middle-aged patients or even younger ones. What is more, part of sufferers have experienced by symptoms get worse while the kidney disease worsen, and vice versa. Plenty of clinical practice shows that chronic kidney disease can be relieved by treatment based on syndrome differentiation through TCM theory. Meanwhile applying TCM therapy to kidney disease can also cure the tinnitus deafness.Currently, research of the relationship between kidney and ears have made some achievements. It is reported kidney sufferers especially patients with renal failure, have high rate morbidity of 40%-80%[5,8-10] in sensorineural deafness. ChenYan's clinical performance analysis on 77 cases nephritis patients for clinical performance analysis of nose pharynx ministry ear, found out there are 20 cases (acute nephritis 15 cases, chronic nephritis 5 cases) have an ear disease 25.8%),25 patients (accounted for 32.5%) suffered tinnitus or tinnitus aggravating [15]. So far research about tinnitus deafness morbidity of CKD patient studies are scarce, By doing clinical investigation and scientific statistical analysis, this thesis has definite reference value in evaluation and design of preventing and treating CKD patients with tinnitus or deafness from the two points of view traditional Chinese and western medicine. Patients in Xiyuan Hospital are more diverse in this kind of disease and thus provides sufficient cause data for this study.Objective of the studyepidemiological cross-sectional study method is used1. Research on the CKD patients who are suffering or once suffered tinnitus and deafness2. Research on the distribution in CKD patients of tinnitus and deafness, and their different diagnosis of Western medicine3. Research on the characteristics and regularity of TCM symptoms on CKD patients with tinnitus and deafnessResearch method:Cross-sectional survey research methods is used, collecting TCM syndrome four diagnostic material of Patients, Western medicine clinical diagnosis of CKD, pathological diagnosis and other related material along with tinnitus deafness properties and degree of patients with CKD, and then establish original material database. SPSS13.0 statistical software os used to reflect frequency analysis in CKD patients with tinnitus deafness and the distribution of different traditional Chinese medicine syndromes and chronic kidney disease.Research results: Having collected 223 CKD patients from chief physician YuRen huan of nephrology Department, Xiyuan hospital.These cases are from both outpatient and inpatient.1. The Prealence situation of CKD Patients with tinnitus deafness223 cases patients with CKD, tinnitus morbidity is 51.6%,tinnitus deafness prevalence is 28.7%. Tinnitus frequency is mainly high-frequency, and deafness with mild hearing damage sensorineural neuropathic deafness accounts for a large number.2. Relationship between gender and tinnitus deafnessResults show that no difference distribution between sexes and tinnitus deafness.3. Different age distribution of deafness morbidityIn young period (15 to 44 years old), the prevalence of deafness is 25.3%, while the middle-aged (45-64 years)is 59.4%. Deafness for increases with age, the prevalence of deafness is significantly rising trend.4. Relationship between cause of kidney disease and tinnitus deafness morbidityTinnitus in different ways of the morbidity is of no difference in distribution,while deafness and tinnitus+deafness in the different cause of kidney diseases of distribution are different. Secondary kidney patients morbidity of tinnitus deafness is higher than primary glomerular disease patients.5. Relationship between clinical pathologic diagnosis and tinnitus deafness morbidity(1) Relationship between clinical diagnosis and tinnitus deafness morbidityThe prevalence of tinnitus in different clinical diagnosis is no difference in distribution,while deafness and tinnitus+deafness in the pathogenesis of the prevalence of distribution are different except for renal vascular disease and hepatitis b virus associated nephritis. The highest morbidity of deafness occurrs in diabetic nephropathy, secondly for hypertensive renal disease and unknown original disease.The prevalence of tinnitus+deafness reach to their highest point in hypertensive renal disease, and then diabetic nephropathy.(2) Relationship between pathologic diagnosis and tinnitus deafness morbidityThe morbidity of tinnitus deafness in different pathologic diagnosis shows no difference in distribution.6. Relationship between renal function and tinnitus deafness morbidity(1)Relationship between renal function and tinnitus deafness morbidityThe morbidity of tinnitus in different renal function has no different distribution;Deafness and tinnitus+deafness in different renal function have different distribution.The tinnitus deafness patients with kidney failure rates significantly higher than normal renal function(2)Relationship between chronic renal failure stage and tinnitus and deafness morbidityMorbidity of tinnitus and the tinnitus+deafness has no different distribution in different renal failure stages; There is some difference in morbidity of deafness at different renal failure stages, and the highest point of morbidity appears in uremia and are markedly increased with raising the stage of chronic renal failure.7. Relationship between CKD stage and morbidity of tinnitus and deafnessTinnitus morbidity has no different distribution in CKD stages; Morbidity of deafness and tinnitus+deafness in different CKD stages have some differences, the highest point of deafness morbidity appears in CKD5 period, and is significantly rising with the increase of CKD stage, the rest of these have no obvious changes.8. Relationship between TCM syndrome and morbidity of tinnitus and deafness(1) Relationship between the deficiency symptom and morbidity of tinnitus and deafnessDistribution has differences in the different deficiency symptom, Tinnitus morbidity appears highest in Deficiency of Yin of both Liver and Kidney, Deficiency of yang of the spleen and kidney and both QI and yin rank secondly; deafness morbidity appears highest in deficiency of both yin and yang, deficiency of Yang of the spleen and kidney rank secondly; Tinnitus +deafness morbidity is also highest in deficiency of Yang of the spleen and kidney.(2) Relationship between the empirical symptom and morbidity of tinnitus and deafnessDistribution of tinnitus and deafness morbidity has differences in the different empirical symptom, tinnitus morbidity appears highest in blood stasis syndrome, dampness-heat syndrome and heat toxin syndrome rank secondly;Deafness and tinnitus+deafness morbidity both are highest in blood stasis syndrome, dampness-heat syndrome ranks secondly.9. Relationship between TCM syndrome and tinnitus frequency(1) Relationship between the deficiency symptom and tinnitus frequencyCKD patients with tinnitus symptoms are in the majority of High-frequency tinnitus, the number reaches to 62.5%. Different distribution of Tinnitus frequency occurs in the different deficiency symptom, the highest frequency of High-frequency tinnitus appears in deficiency of both QI and Yin, the second is in deficiency of Yin of both liver and kidney; While the highest frequency of Low-frequency tinnitus appears in deficiency of both Yin and Yang, the second appears in deficiency of spleen and kidney.(2) Relationship between the empirical symptom and tinnitus frequencyIn the 115 CKD patients with tinnitus symptoms, with its standard the empirical symptom, the frequency of High-frequency tinnitus appears most with the total percentage of 74.1%. Tinnitus frequency distribution varies in different the empirical symptom, the highest frequency of High-frequency tinnitus appears in heat toxin syndrome, the second are blood stasis syndrome and dampness-heat syndrome; While the highest frequency of low-frequency tinnitus appears in syndrome of Qi stagnation and damp-turbidity, the second appears in Water and Dampness Retention.10. Deafness character of CKD Patients 44 CKD patients'pure tone audiometry showed that 42 are bilateral deafness with the rest of monaural deafness. Sensorineural deafness reaches its highest point of 89.3%,mixed type deafness for 10.7%, no case is conduction deafness.11. Relationship between CKD stage and deafness degreeDeafness degree varies in different CKD stages, with the increasing of CKD stages, the deafness frequency increased significantly.Conclusion:1. The morbidity of CKD patients in tinnitus accounts for 51.6%, while the morbidity of deafness is 44.8%. Tinnitus frequency is mainly High-frequency, and deafness with mild hearing damage sensorineural neuropathic deafness accounts for a large number.2. No gender difference in the morbidity of CKD patients with tinnitus and deafness.3. With the increasing age of CKD patients, the morbidity of deafness shows clear rising trend.Young period (15 to 44 years old) accounts for 25.3%,while middle-aged (45-64 years old) accounts for 59.4%.4. The deafness morbidity of CKD patients have differences in the different cause of kidney diseases, secondary kidney patients morbidity of deafness is higher than primary glomerular disease patients. 5. The deafness morbidity of CKD patients have differences in the different clinical diagnosis, and distribution of diabetic nephropathy and hypertensive renal disease are the main influence factors.6. The morbidity of CKD patients with tinnitus deafness has no difference in different pathological diagnosis.7. The morbidity of CKD patients with deafness varies in different chronic renal failure stage and CKD stage. The highest point appears in Uremia period and CKD 5 period. The tinnitus deafness patients with chronic renal failure rates significantly higher than normal renal function ones.That improves the morbidity of CKD patients with deafness is closely related to the renal function state and glomerular filtration rate.8. The morbidity of CKD patients with tinnitus deafness varies in different the deficiency and empirical symptom. In the deficiency symptom, kidney Yin deficiency syndrome is the main factors of influence tinnitus morbidity; Deficiency of both Yin and Yang of the kidney is the main factors of influence deafness morbidity. In the empirical symptom, blood stasis syndrome and dampness-heat syndrome are the main factors of influence tinnitus deafness morbidi ty.9. The frequency of tinnitus of CKD patients in the different deficiency and empirical symptoms is different. In the deficiency symptom, the highest frequency of High-frequency tinnitus appears in deficiency of both QI and Yin;The highest frequency of Low-frequency tinnitus appears in deficiency of both Yin and Yang. In the empirical symptom, the highest frequency of High-frequency tinnitus appears in heat toxin syndrome；The highest frequency of low-frequency tinnitus appears in syndrome of Qi stagnation and damp-turbidity.