Analyses Of Syndrome Elements And Traditional Chinese Medicine Syndrome On Hemodialysis Patients

Maintenance Hemodialysis (MHD) has become the primary replacement method in the end-stage renal disease patients.With the continuous development of hemodialysis, the survival of patients is growing longer. However, limited mobility and a variety of dialysis complications occur, the patients’quality of life are seriously affected. That how to improve the quality of life of MHD patients effectively becomes urgent concern.Now the chinese medical science therapeutics of maintenance hemodialysis patient is fewer and lack the systemic syndrome research.The topic that study the chinese medical science to analy syndrome elements and characterization of traditional Chinese medicine syndrome, promote the survival rate and the quality of life of the patient has been widely concerned, and the determination of treatment based in symptoms is the most important. So to study the maintenance hemodialysis patient symptom rule has the great theory and clinic value.We studied the syndrome elements and characterization of traditional Chinese medicine syndrome through the236patients of maintenance hemodialysis disease to support the chinese medical science determine the treatment based on differentiation of symptoms and syndrome elements.Primary part Documents research1The current research situation on maintenance hemodialysisReseach the chinese medical science documents on the maintenance hemodialysis Chinese medicine syndrome and summarize them.We find that the chinese medical science therapeutics of maintenance hemodialysis patient is fewer and lack the systemic syndrome research. Determination of treatment based in pathogenesis obtained throu-gh differentiation of symptoms and signs is the fundamental chinese medical science cure method, evidence is the foundation determination of treatment based in pathogenesis obtained throu-gh differentiation of symptoms and signs. So to study the maintenance hemodialysis patient syndrome elements and characterization of traditional Chinese medicine syndrome has the great theory and clinic value.2Maintenance hemodialysis chinese medical science symptom rule systema analysisStudy the maintenance hemodialysis chinese medical science documents through the evidence medical science method from chinese medical science symptom, differentiation of symptoms and signs and basic prescription. Find the most common asthenia of healthy energy of maintenance hemodialysis is deficiency of kidney-qi spleen,others is deficiency of both vital energy and yin, hepatic and renal yin deficiency, asthenia of both yin and yang;deficiency of both yin and yang, spleen deficiency of kidney-qi, insufficiency of qi of the spleen and kidney, state of evil domination, the frequent state of evil domination is pathogenic damp> liquid cease、haemostasis、wet heat.Second part clinical research papers1.1Case of a particular disease sourceAll236cases were from blood purification centers of China Academy of Chinese Medicine Wangjing Hospital (99cases) and Guanganmen Hospital (137cases).1.2Case of a particular disease election1.2.1End-stage renal disease diagnostic criteria: American Kidney Disease Foundation2001NKF-K/DOQI in end-stage renal disease diagnostic criteria, classification GFR<15ml/min/1.73m2, often accompanied by uremia symptoms and signs, or needed renal replacement (dialysis or renal transplantation).1.2.2Cases inclusion(1)hemodialysis>3months.(2) compliance in good order.(3) consent of the investigation.(4) age range from18-80years.1.3Symptom research methodApply symptom count differentiation of symptoms and signs method(ZHU Wen-feng), formulate clinical observation chart, cumulate symptom score, identify evidence diagnose. 1.4Statistics method Apply SPSS17.0, test-X2for numeration data, significance discrepancy while P﹤0.05.2Consequence and Analysis2.1General data meansSex distribution information:107male patients account45.34%,129female patients account54.66%.the proportion is1:1.25, no significant deviation.Age distribution information:the smallest age of onset is the age of20, the biggest age of onset is the age of80, concentrate age of onset is40-80, mean age is57.83±13.55.Protopathy distribution information:the major reason lead to renal failure protopathy is chronic glomerulonephritis,the others are diabetic nephropathy and high blood pressure nephrosis.Dialyze frequency distribution information: dialyze3times/week, account88.6%; dialyze2times/week,5.9%; dialyze4times/week,5.5%.Dialyze age distribution information:shortest:3months, longest22years, average3.73±3.53years.2.2Syndrome research2.2.1Symptom distributionInvestigation236patients of maintenance hemodialysis, The results showed clinical symptoms in the wider distribution and the lack of symptoms with a high degree of central tendency. Only dry skin in163cases (69.07%), pale complexion,144cases (61.02%), purple lips,136cases (57.63%), forgetfulness,120cases (53.39%), malaise and fatigue,120cases (50.85%), accounting for more thanhalf. Tongue of frequencies higher is the tongue side of teeth marks in106cases (44.92%) and81cases (34.32%), fat red tongue, sublingual vein tortuosity in56cases (23.73%), tongue tired of the76cases (32.20%), yellow tongue coating, and64cases (27.12%). Pulse frequency more pulse was95(40.25%), pulse string of92cases (38.98%), slippery pulse of79cases (33.47%).2.2.2differentiation of symptoms and signs elemental definition 199patients syndrome of hemopenia accumulated points achieve threshold value,182patients yang asthenia accumulated points achieve threshold value,177patients yin asthenia accumulated points achieve threshold value,169patients syndrome of deficiency of qi accumulated points achieve threshold value;171patients syndrome of wet accumulated points achieve threshold value,126patients syndrome of syndrome of stagnation of qi accumulated points achieve threshold value,83patients syndrome of stagnation of blood accumulated points achieve threshold value;186patients syndrome of kidney accumulated points achieve threshold value;163patients syndrome of liver accumulated points achieve threshold value,115patients syndrome of spleen accumulated points achieve threshold value.Asthenia of healthy energy syndrome distribution feature in different sexes:there is no significant deviation. Asthenia of healthy energy syndrome distribution feature in different ages:there is significant deviation.Asthenia of healthy energy syndrome distribution feature in different dialyze frequencies:deficiency syndrome of both xue and qi in patients with4times/week; deficiency syndrome of both kindney and lung in patients with4times/week.There are significant deviation in different ages patients with deficiency syndrome of both qizhi and xueyu.State of evil domination distribution feature in patients:there is significant deviation. turbid damp;pathogenic damp is the first,then the syndrome of stagnation of qi、Sputum cease、syndrome of blood stasis,stagnation of blood.3Discussion3.1Fundamental syndrome featureThe clinical situation of maintenance hemodialysis patients mainly is asthenia of healthy energy, combining state of evil domination; the patients with high dialyse frequency easily appear syndrome with xue asthenia, state of evil domination in patients with2times/week is low;the frequency of syndrome of stagnation of qi is less than pathogenic damp.Patients with maintenance hemodialysis mainly appear deficiency of xue asthenia, and patients with maintenance hemodialysis mainly appear deficiency syndrome of both yin and yang,also appear syndrome with qi asthenia. 3.2Merit and defectThis research apply symptom count differentiation of symptoms and signs method (Wen-feng Zhu), formulate clinical observation chart, cumulate symptom score for clear diagnose. Merit: differentiation of symptoms and signs cover extensively, less subjective interference, diagnostic accurately.Investigate only236patients because of limited time and energy.Not mentioned the comparision between the patients with syndrome translation rule and before maintenance hemodialysis, still need further research.