Survey Research On The Feature Of TCM Syndrome In CKD

ObjectiveWith high morbidity, high disability, high medical costs, combined cardiovascular events in high-risk, CKD has become one of the major public health problems of humanity in the21st century. TCM prevention and treatment of CKD is lagging behind and the research of TCM syndrome in each stage of CKD is lack. Preliminary Survey of CKD patient’s symptoms and syndrome differentiation typing for standardizing of CKD syndrome type is the purposes of this research.MethodsIn strict accordance with the inclusion criteria to select the diagnosed adult patients of chronic kidney disease among the hospitalization and outpatient of the Department of Nephrology of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from January of2006to December of2011, this research uses the method of cross-sectional, prospective, retrospective research and gathers Information of the patients’ gender, age, etiology of CKD, CKD stage, independent symptoms, signs, TCM syndromes, laboratory examination data to carry out the statistical analysis.Results1. Chronic kidney disease etiologySurvey results of393cases the cause of CKD are as follows.112cases of chronic glomerulonephritis (28.5%),72cases of nephrotic syndrome (18.32cases of IgA nephropathy (8.1%),11cases of occult glomerulonephritis (2.40cases of hypertensive nephropathy(10.2%),40cases of diabetic nephropathy (10.2%),33cases of lupus nephritis (8.4%),23cases of obstructive nephropathy(5.8%),14cases of polycystic kidney disease(3.6%),13cases of gouty nephropathy(3.3%),3cases of other cases(0.8%).227cases of primary chronic kidney disease(57.7%),166cases of secondary chronic kidney disease (42.3%). Chronic glomerulonephritis is a major cause of chronic kidney disease, followed by nephrotic syndrome, IgA nephropathy. Hypertensive nephropathy, diabetic nephropathy is a major cause of secondary chronic kidney disease, followed by lupus nephritis.2. TCM syndrome distribution in each stage of chronic kidney disease In CKDl~2Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome (55.1%), Yin deficiency syndrome (18.8%). five internal organs deficiency syndrome is common to Kidney deficiency syndrome (66.7%), spleen deficiency syndrome (17.4%). Compound deficiency syndrome is common to Qi deficiency in Kidney and spleen syndrome (14.5%), Yin deficiency in liver and Kidney syndrome (7.2%). Excess syndrome is common to damp heat syndrome (65.2%), dampness syndrome (10.1%). In CKD3Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome (57.4%), Yin deficiency syndrome (23.4%). Five internal organs deficiency syndrome is common to Kidney deficiency syndrome (61.7%), spleen deficiency syndrome (57.4%). Compound deficiency syndrome is common to Qi deficiency in Kidney and spleen syndrome (53.2%), Qi-Yin deficiency syndrome (19.1%). Excess syndrome is common to dampness syndrome (48.9%), blood stasis syndrome (27.7%). In CKD4Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome (80.5%). Five internal organs deficiency syndrome is common to Kidney deficiency syndrome (77%), spleen deficiency syndrome (71.3%). Compound deficiency syndrome is common to Qi deficiency in Kidney and spleen syndrome (67.8%), Qi deficiency in lung and kidney syndrome (13.8%). Excess syndrome is common to dampness syndrome (56.3%), blood stasis syndrome (48.3%), damp heat syndrome (32.2%), wet muddy svndrome (25.3%). In CKD5Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome (71.6%), blood deficiency syndrome (37.4%), Yi deficiency syndrome (32.1%). Five internal organs deficiency syndrome is common to Kidney deficiency syndrome (69%), spleen deficiency syndrome (67.4%), lung deficiency syndrome (29.5%). Compound deficiency syndrome is common to Qi deficiency in Kidney and spleen syndrome (63.2%), Qi-Yin deficiency syndrome (31.1%), Qi deficiency in lung and kidney syndrome (24.2%). Excess syndrome is common to blood stasis syndrome (52.1%), dampness syndrome (47.4%), wet muddy syndrome(35.8%). The results of cluster analysis and traditional dialectical analysis are basically the same.Conclusion1. Chronic kidney disease etiology Primary chronic glomerular disease is the main cause of chronic kidney disease, and the most common is chronic glomerulonephritis. The cause of secondary chronic kidney disease is common to hypertensive nephropathy, diabetic nephropathy, lupus nephritis.(Base on the Survey of393cases)2. Syndrome characteristics of chronic kidney disease Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome and blood deficiency syndrome. Five internal organs deficiency syndrome is common to kidney deficiency syndrome, spleen deficiency syndrome and lung deficiency syndrome. Compound deficiency syndrome is common to Qi deficiency in Kidney and spleen syndrome, Qi deficiency in lung and kidney syndrome, Qi-Yin (blood) deficiency syndrome. Excess syndrome is common to dampness syndrome, blood stasis syndrome, wet muddy syndrome, Damp heat syndrome. In clinical practice, deficiency and excess combined syndrome is mainly.3. Each stage of chronic kidney disease syndrome distribution characteristicsCKD1~2Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome, Yin deficiency syndrome. Five internal organs deficiency syndrome is common to kidney deficiency syndrome, spleen deficiency syndrome. Compound deficiency syndrome is common to Qi deficiency in kidney and spleen syndrome, Yin deficiency in liver and kidney syndrome. Excess syndrome is common to damp heat syndrome, dampness syndrome.CKD3Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome, Yin deficiency syndrome. Five internal organs deficiency syndrome is common to kidney deficiency syndrome, spleen deficiency syndrome. Compound deficiency syndrome is common to Qi deficiency in Kidney and spleen syndrome, Qi-Yin deficiency syndrome. Excess syndrome is common to dampness syndrome, blood stasis syndrome.CKD4Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome. Five internal organs deficiency syndrome is common to kidney deficiency syndrome, spleen deficiency syndrome. Compound deficiency syndrome is common to Qi deficiency in kidney and spleen syndrome, Qi deficiency in lung and kidney syndrome. Excess syndrome is common to dampness syndrome, blood stasis syndrome, damp heat syndrome, wet muddy syndrome.CKD5Qi-blood-Yin-Yang deficiency syndrome is common to Qi deficiency syndrome, blood deficiency syndrome, Yi deficiency syndrome. Five internal organs deficiency syndrome is common to Kidney deficiency syndrome, spleen deficiency syndrome, lung deficiency syndrome, Compound deficiency syndrome is common to Qi deficiency in kidney and spleen syndrome, Qi-Yin deficiency syndrome, Qi deficiency in lung and kidney syndrome. Excess syndrome is common to blood stasis syndrome, dampness syndrome.TCM syndrome of CKD belongs to the deficiency and excess combined syndrome. In the early stages of chronic kidney disease, Qi deficiency in kidney syndrome is the most common, lesion is kidney and excess syndrome is common to damp heat syndrome. In the middle stage of chronic kidney disease, Qi deficiency in Kidney and spleen syndrome is the most common, lesion is Kidney. Spleen and excess syndrome is common to dampness syndrome, blood stasis syndrome and damp heat syndrome. In the later stages of chronic kidney disease, deficiency syndrome is common to Qi deficiency in Kidney and spleen syndrome, Qi-Yin (blood) deficiency syndrome, Qi deficiency in lung and kidney syndrome. Lesion is kidney, spleen, lung. Excess syndrome is common to blood stasis syndrome, dampness syndrome, wet muddy syndrome.