| Objective:Based on the clinical observation of traditional Chinese medicine (TCM) syndrome in patients with peritoneal dialysis (PD) and syndrome differentiation, to explore and TCM syndrome characteristics of patients with PD, and to analyze its influence factors, providing the basis for improving their life quality and protecting residual renal function for PD patients with Chinese medicine treatment.Methods:"TCM syndrome questionnaire of PD patients" was established, and all objects enrolled in the study were investigated with the questionnaire by assigned personnel to record the patients’ symptoms, signs and tongue and pulse, to carry on TCM differentiation and analyze the distribution of TCM syndromes. Blood samples of patients according with the observation standard were collected under the same conditions (including blood routine examination, serum albumin, C reactive protein and parathyroid hormone), once per two months.Results:①In the total observations of127times for65patients, it was Qi efficiency of both the spleen and kidney that the most commonly seen deficiency syndrome in origin, accounting for33.1%, followed by Yang deficiency of spleen and kidney, deficiency of both Yin and Yang and deficiency of both Qi and Yin, while Yin deficiency syndrome of both liver and kidney was rare; blood stasis and damp turbidity were the main superficiality excess syndromes, accounting for29.8%and25.4%respectively, followed by damp-heat and wind srirring, while heat-toxin syndrome was relatively uncommon; accompanying syndromes of deficiency in origin and excess in superficiality displayed that, damp turbidity was easily to combine with Qi efficiency of both the spleen and kidney and Yang deficiency of spleen and kidney, and damp-heat was easily to combine with deficiency of both Qi and Yin and Yin deficiency of both liver and kidney. Blood stasis was common in all syndromes, which was highest in deficiency of both Qi and Yin and lowest in Qi efficiency of both the spleen and kidney, and wind srirring was highest in deficiency of both Qi and Yin and deficiency of Qi and Yin, and heat-toxin syndrome was uncommon in various syndromes. ②The relationship analysis of TCM syndrome and dialysis age in peritoneal dialysis patients showed that, the PD patients whose Dialysis age are less than12months or between12months to24months mainly belong to the spleen and kidney qi deficiency syndrome and spleen and kidney yang deficiency syndrome; the PD patients whose Dialysis age are more than24months belong to the deficiency of Yin and Yang, Yang deficiency of spleen and kidney and deficiency of Qi and Yin (P <0.05).In Biaoshi syndrome, the PD patients whose Dialysis age are less than12months always be with damp-turbidity and damp-heat sydromes. the PD patients whose Dialysis age are between12months to24months mainly belong to damp-turbidity and Blood stasis sydromes,while the patients with the Dialysis age of more than24months belong to Blood stasis and wind srirring (P <0.05)③Deficiency syndromes in origin patients with heart failure mainly were Yang deficiency of spleen and kidney and deficiency of Yin and Yang, largely combined with damp turbidity and wind srirring, followed by blood stasis and damp-heat; patients with peritonitis were most deficiency of Yin and Yang and deficiency of Qi and Yin, most combined with damp-heat, blood stasis and wind srirring, rarely combined with damp turbidity; anemia existed in various types of syndromes, having larger proportion; hyperparathyroidism was common in Yang deficiency of spleen and kidney and deficiency of Qi and Yin.④Compared with PTH of patients with non these syndromes, that of patients with Qi deficiency of spleen and kidney, Yang deficiency of spleen and kidney and deficiency of Yin and Yang had statistical significance (P <0.05); Hb of patients with deficiency of Yin and Yang and wind srirring was smaller than that of the patients with non these syndromes (P0.05); Alb of patients with Qi deficiency of spleen and kidney, non deficiency of Yin and Yang, no combined syndromes, non blood stasis syndrome and non wind srirring was higher than that of patients with non above syndromes (P <0.05); CRP of patients with deficiency of Yin and Yang and non Yin deficiency of liver and kidney was higher than that of patients with non deficiency of Yin and Yang and Yin deficiency of liver and kidney (P <0.05). TG comparison of PD patients with different syndromes displayed that, there were statistical differences between Qi deficiency of spleen and kidney and non Qi deficiency of spleen and kidney, deficiency of Qi and Yin and non deficiency of Qi and Yin, damp-heat and non damp-heat (P <0.05). Conclusions:①TCM differentiation of PD patients is deficiency in origin and excess in superficiality, which often appear as the combination, and Qi deficiency of spleen and kidney and Yang deficiency of spleen and kidney are dominated in the deficiency in origin, while damp turbidity and blood stasis are dominated in excess in superficiality.②With the increase of dialysis age, the deficiency syndrome in origin changes from Qi deficiency of spleen and kidney and Yin deficiency of liver and kidney to Yang deficiency of spleen and kidney and deficiency of Qi and Yin, and eventually to the trend of deficiency of both Yin and Yang. In the aspect of excess syndrome in superficiality, dialysis age of patients with blood stasis and wind srirring is significantly greater than the other syndromes.③There are close relationship between complications in PD patients, such as heart failure, peritonitis, micro inflammatory state and poor nutrition and the distribution of TCM syndromes, which affects the variation of TCM syndromes.④TCM Syndrome distribution of PD patients is related to some western medicine laboratory examination results, providing the reference basis for TCM differential treatment. |
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