Cases300Interrelated Analysis Of Cystic Renal Disease Between Various Clinical Characteristics And Chinese Medicine Symptoms

BackgroundCystic renal disease is a large group of disease which appears one or more cysts in the kidney, among them with simple renal cyst is the most common, followed by polucystic kidney disease. The prevalence of simple renal cyst increased with age year by year. When the cysts is smaller, the bulk of them are commonly asymptomatic and easy to be ignaored. They are found in the health check-up, some of them may be appeared microscopic hematuria. Nevertheless, while the cyst is larger enough to oppress surrounding tissues, it can present waist pain or urinary tract infection. Generally, simple renal cyst grow slowly and won’t cause renal impairment. However, modern researchs have confirmed that some patients with renal cyst have higher serum creatinine level and lower creatinine clearance rate, and renal cyst also can lead to hypertension, which is the potential risk factors in end-stage kidney disease.Cystic renal disease in Traditional Chinese Medicine is thought the category with " Hematuria ","Waist Pain"," Abdominal Mass ","Accumulation". Recently the related researchs show that playing special advantage of traditional Chinese medicine, can alleviate clinical symptoms and reduce hematuria. it also delays renal cyst increased and protects renal function. But the correlation analysis in Traditional Chinese Medicine and simple renal cyst is still lesser. About the syndrome differentiation of the renal cyst, there is no unified conclusion, and it still reports with clinical cases primarily.ObjectivesThis subject through summing up the clinical data about the patients of simple renal cyst or polycystic kidney disease and studying related literature, to find out about morbidity trend, understand clinical characteristics of disease and the distribution characteristics of traditional Chinese medicine, analyse the connection between the simple renal cyst and the distribution of traditional Chinese medicine, in oder to explore the syndrome distribution in low of simple renal cyst, making the theory and treatment tend to be standardized, which giving full play to traditional Chinese medicine for the renal cyst’s unique advantages, and thereby protecting renal function.MethodsAdopting research approach of reviewing analyses that the300cases have be diagnosed for simple renal cysts or polycystic kidney diseases patients in October2008to February2012who from Guangdong Province institute of traditional Chinese medicine kidney department of outpatients. Because there i s no unified conclusion about the dialectical classification of cystic renal disease, the clinical manifestation in most patients with renal cyst is similar to chronic nephritis, therefore we reference the revised dialectical classification of Chinese medice about chronic nephritis in the second national nephropathy academic conference in1986and combine with the clinical manifestation of patients, then make the dialectical classification. According to the statistical frequency, appears our academy renal cyst patient clinical materials, clinical features and Chinese medicine distribution situation, then employ statistics method that relevance analyze differentiate Chinese medicine syndrome of disease and relevant clinical data, go on relevance analyze, analyze its concrete, inherent relevance connection.Results1. The epidemiology and clinical characteristics results in simple renal cyst patient:the material included300patients, including simple renal cyst patients278cases(92.7%), polycystic kidney diseases patients22cases (7.3%), with an anerage age in53.51+15.146years old, high-peak ages range from20to80years old(97%), the sex ratio(man vs women) is1.52:1. wi th a cyst in kidney192cases (64.0%), with two cysts in kidney50cases(16.7%),≥three cysts in kidney58casesC19.3%);wi th the cyst in left kidney116cases (38.7%), with the cyst in right kidney96cases (32%), with the cyst in bilateral kidney88cases (29.3%); with the bursa wall calcification35cases (11.7%); with merger renal calculus115cases (28.3%), with hypertension115cases (50. with normal renal function262cases (87.3%), with abnormal renal function38cases (12.7%); with normal urinalysis148cases (49.3%), with abnormal urinalysis152cases (50.7%).2. The traditional Chinese medicine diagnosis and the distribution of syndrome in the renal cyst patients:The traditional Chinese medicine diagnosis for backache in124cases(42.3%), hematuria in27cases(9.0%), stranguria in21(7.0%), edema in5cases (1.7%), chronic renal failure in37cases (12.3%), others (such as product cerficate ect) in86cases (28.7%). In dialectical classification,300cases are all for the syndrome of deficiency-excess complication, the most common is the syndrome of deficiency of qi and yin, moist heat and blood stasis. In the deficiency syndrome, the most common is the syndrome of deficiency of qi and yin in95cases (31.7%), second respectively for the syndrome of qi deficiency of sleen and kidney in93cases (31.0%), the syndrome of yin deficiency of liver and kidney in56cases (18.7%), the syndrome of yang deficiency of sleen and kidney in44cases (14.7%), the syndrome of qi deficiency of lung and kidney in12cases (4.0%),without the syndrome of yin and yang deficiency;In standard empirical, the heat and humid with blood stasis syndrome in209ceases (69.7%) is the most common, second to wet muddy card with blood stasis syndrome in66ceases (22.0%)> water wet card with blood stasis syndrome in25ceases (8.3%).3. The correlation analysis results:(1)The serum creatinine (for short Scr) level and the number the maximum length diameter of renal cysts present positive correlation. It reveals that there is the more cyst numbers or the larger cyst size, the higher in Scr lever. The serum urea nigtrogen (for short BUN) level and the number of renal cysts also have closely related. However, the serum uric acid (for short UA) and the number, the maximum] ength diameter of renal cysts has no correlation.(2) There is significantly correlation between the Scr level and the presence of hypertension,renal calculus. The renal cyst patients with hypertension or renal calculus have higher Scr level. The renal cyst patients with hypertension have more cyst numbers and larger cyst size.(3) In the deficiency syndrome, the Scr, BUN level and the syndrome of yang deficiency of sleen and kidney,the syndrome of qi deficiency of sleen and kidney, the syndrome of deficiency of qi and yin may be exist the correlation. In the standard empirical, the correlation between the standard empirical and the Scr, BUN、UA level may be not strong.(4) In the group of normal renal function, the primary deficiency syndrome is the syndrome of deficiency of qi and yin, the main standard empirical is the moist heat with blood stasis. In in the group of abnormal renal function, the syndrome of yang deficiency of sleen and kidney is the most common in deficiency syndrome, next to is the syndrome of deficiency of qi and yin, the syndrome of yin deficiency of liver and kidney,the syndrome of qi deficiency of sleen and kidney, the syndrome of qi deficiency of lung and kidney; the main standard empirical is also the moist heat and blood stasis.(5)In the group of normal blood pressure level, the most common type in the deficiency syndrome is the syndrome of deficiency of qi and yin, following by the syndrome of qi deficiency of sleen and kidney, the syndrome of yin deficiency of liver and kidney, the syndrome of yang deficiency of sleen and kidney, the syndrome of qi deficiency of lung and kidney. However, i n the group with hypertension, the most common in the blood pressure level1is the syndrome of deficiency of qi and yin, following by the syndrome of qi deficiency of sleen and kidney, the syndrome of yang deficiency of sleen and kidney, the syndrome of yin deficiency of liver and kidney, the syndrome of qi deficiency of lung and kidney is rare; the most common in the blood pressure level2is the syndrome of yang deficiency of sleen and kidney and the syndrome of yin deficiency of liver and kidney, following by the syndrome of qi deficiency of sleen and kidney, the syndrome of deficiency of qi and yin, the syndrome of qi deficiency of lung and kidney;the most common in the blood pressure level3is the syndrome of yang deficiency of sleen and kidney and the syndrome of yin deficiency of l iver and kidney. In standard empi ri cal, all cases contain blood stasis syndrome, no matter the blood pressure is normal or not, the humid and heat with blood stasis syndrome is the most common, second are wet muddy card with blood stasis syndrome and water wet card with blood stasis syndrome.(6) The correlation analysis between the urinalysis and the syndrome of traditional Chinese medicine:The result reveals that wherether the result is normal or not in urinalysis, the most common type in the deficiency syndrome is the syndrome of deficiency of qi and yin and the syndrome of qi deficiency of sleen and kidney; the most common form in standard empirical is the humid and heat with blood stasis syndrome. Nevertheless, in the degress of pyuria, hematuria and proteinuria, the deficiency syndrome shows no regularity,we speculated that it may be concerned with the less sample. In standard empirical, the most common type is the humid and heat with blood stasis syndrome.ConclusionThe simple renal cyst is the most common in the cystic renal disease, and is one of the risk factors which leading to end-stage renal disease. The high-risk age is20-80years old, and the incidence of simple renal cyst in male is higher than female.The study result shows that there exists certain correlation between the number, the maximum length diameter of the renal cyst and the Scr level, BUN level, hypertension, urinalysis. On the the syndrome of traditional Chinese medicine, the data shows that all the ceases appear the empty mark empirical, among them the most common type is the syndrome of deficiency of qi and yin, moist heat and blood stasis. The blood pressure level, Scr level,BUN level and urinalysis results have a certain effect on the the distribution of syndrome.