| Objective Observation of maintenance hemodialysis in our hospital263patients with TCM syndrome type and analysis of related factors, distribution characteristics of TCM syndromes in patients with hemodialysis, for the further study of traditional Chinese medicine in the prevention and treatment of hemodialysis patients with chronic diseases, improve the quality of life and lay a theoretical basis.Methods Through unified TCM differentiation standard and the questionnaire of TCM diagnosis on maintenance hemodialysis in263patients, at the same time to collect clinical physicochemical data of patients, including gender, age, disease, dialysis time, dialysis adequacy of hemodialysis (Kt/V), as well as the main biochemical indexes, using the statistical analysis of relevant factors.Results①The characteristics of Chinese medicine symptoms:MHD263patients, symptom score minimum2, maximum54points, averaged (20.1±4.3); the symptoms of frequency is highest is soreness of waist and knee146times (55.5%), frequency fatigue, aversion to cold, anorexia, shortness of breath were135times (51.3%),128(48.7%),124(47.1%),118(44.9%), the rest are5symptoms in more than20%for dry mouth and throat, dizziness, nausea, edema and pain, the distribution of the deficiency symptoms in patients with frequency higher than standard positive symptoms, and disease like many in the mild, severe rare.②The relationship between TCM Syndrome Distribution and sex:In263patients,142male (54%),121women (46%), Chinese medicine syndrome in male patients with liver kidney yin deficiency syndrome,47cases (17.9%), female patients with spleen kidney yang deficiency syndrome,33cases (12.5%),χ2test statistical analysis suggests that the distribution relationship card MHD patients in medicine and gender had no significant difference (P>0.05).③Relationships between the distribution of TCM syndrome and age:263patients aged19-88years old, mean age (57.30±16.1) years old. The deficiency in the minimum age is deficiency of spleen and kidney, deficiency of both yin and Yang is the largest scale excess syndrome; the youngest is no syndrome, age is the largest of the blood stasis syndrome. By using variance analysis showed that the deficiency syndrome of deficiency of spleen and kidney<liver kidney yin deficiency syndrome,deficiency of spleen and kidney<syndrome of deficiency of Qi and Yin,deficiency of spleen and kidney<syndrome of deficiency of both yin and yang,spleen kidney yang deficiency syndrome<syndrome of deficiency of both yin and yang,the above card type has significant difference (P <0.05);In the absence of syndrome in superficiality and evidence of age<damp heat syndrome,no syndrome<blood stasis syndrome,the wet muddy syndrome<blood stasis syndrome,the above card type has significant difference (P<0.05).④The relationship between TCM Syndrome Distribution and dialysis time:263cases of patients with HD was3-288months, the mean HD (43.4±37.6) months, the deficiency syndrome of deficiency of spleen and kidney and yang deficiency of spleen and kidney dialysis time is short, liver kidney yin deficiency syndrome, Qi Yin deficiency syndrome and deficiency of yin and Yang Ju, two longer time on dialysis; standard excess syndrome without syndrome, dampness syndrome dialysis time is short, blood stasis longer time on dialysis. By using variance analysis showed that the deficiency of liver kidney yin deficiency syndrome,syndrome of deficiency of both yin and Yang> deficiency of spleen and kidney;liver kidney yin deficiency syndrome,syndrome of deficiency of both yin and Yang> spleen kidney yang deficiency syndrome,the above card type has significant difference (P<0.05);No marked excess syndrome of syndrome,the wet muddy syndrome<blood stasis syndrome,no syndrome<fengdong syndrome,damp heat syndrome;Evidence of water vapor<blood stasis syndrome,the above card type has significant difference (P<0.05).⑤Relationships between the distribution of TCM syndromes and diseases:Chinese medicine syndrome and disease relationship, chronic glomerulonephritis with deficiency of spleen and kidney and spleen kidney yang deficiency syndrome, a total of40cases (51.3%), diabetic nephropathy with deficiency of liver and kidney yin and deficiency of Yin Ju, a total of29cases (49.2%), hypertensive nephropathy with deficiency of liver and kidney yin, a total of31cases (56.4%), polycystic kidney with Yang deficiency of spleen and kidney deficiency, a total of22cases (59.5%), other disease syndromes showed no obvious characteristics; TCM syndrome and disease relationship, chronic glomerulonephritis with blood stasis and dampness syndrome, a total of46cases (68.7%), diabetic nephropathy with blood stasis the main syndrome, a total of17cases (39.5%), hypertensive nephropathy with wind syndrome and blood stasis syndrome, a total of29cases (59.2%), polycystic kidney with blood stasis and dampness syndrome, a total of20cases (58.8%), other disease syndromes of blood stasis is the main performance, a total of15cases (accounting for51.7%).⑥The relationship between TCM Syndrome Distribution and main laboratory indexes:In263patients, the relationship between TCM syndrome and the biochemical indices of liver kidney yin deficiency, red blood cell (RBC), hemoglobin (Hb) was significantly higher than that of the other four syndromes; plasma albumin spleen kidney yang deficiency syndrome (Alb) was significantly lower than that of liver kidney yin deficiency syndrome and deficiency of Yin with, the Ca*P was significantly higher than that of liver kidney yin deficiency syndrome Qi and yin deficiency, yin and yang deficiency syndrome and natural; high density lipoprotein deficiency of spleen and kidney (HDL) was significantly higher than that of liver kidney yin deficiency and Yin and yang deficiency syndrome of Qi and yin deficiency syndrome; both the cardiac ejection fraction (EF) was significantly lower than that of liver kidney yin deficiency, spleen kidney yang deficiency of spleen and kidney qi deficiency syndrome of both yin and yang deficiency syndrome; parathyroid hormone (PTH) was significantly higher than that of the spleen and kidney qi and yin deficiency of liver and kidney syndrome, and its KT/V value was lower than that of the spleen and kidney qi deficiency, Yang deficiency of spleen and kidney and liver kidney yin deficiency syndrome, the differences were statistically significant (P<0.05). The relationship between TCM syndrome and main biochemical index, there was no significant difference in RBC, Hb (P>0.05); blood stasis syndrome of HDL was significantly lower than the wet muddy syndrome and damp heat syndrome, the EF was significantly lower than that of the wet muddy syndrome, damp heat syndrome and evidence of water vapor; dampness syndrome, Kt/V was less than Alb evidence of water vapor, blood stasis syndrome and wind syndrome; calcium phosphorus product wind syndrome (Ca*P) was significantly higher than that of the other four syndromes, the parathyroid hormone (PTH) was significantly higher than that of water, damp syndrome and blood stasis syndrome, these differences were statistically significant (P<0.05).⑦The relationship between the distribution of syndrome of traditional Chinese medicine syndromes and syndromes:In263patients, Chinese medicine syndrome in liver kidney yin and yang deficiency of spleen and kidney, a total of144cases (54.8%), including79cases of liver kidney yin deficiency syndrome (30%); TCM syndrome with blood stasis and dampness syndrome, a total of134cases (51%), including82cases of blood stasis syndrome (accounted for31.2%); TCM syndrome in patients with MHD syndrome with the syndrome with and card folder, a total of222cases (84.4%). Yang deficiency of spleen and kidney in65cases (24.7%), including12cases without syndrome, syndrome53cases, liver kidney yin deficiency syndrome in79cases (30%), including18cases without syndrome, syndrome61cases,x2test statistical analysis indicated that traditional Chinese medicine in patients with MHD syndrome in the liver kidney Yin deficiency and yang deficiency of spleen and kidney license and permit no distribution had no significant difference (P>0.05).Conclusion Most of the maintenance of TCM Syndromes of hemodialysis patients is the card with the accompanied syndromes, few could appear alone this deficiency, but appear alone and syndrome is rare; TCM syndrome type in this credit is the most liver kidney yin and yang deficiency of spleen and kidney, and syndrome is the most blood stasis and dampness syndrome; The TCM symptom shows the deficiency symptom occurrence frequency is higher than standard positive symptoms, the severity of symptoms with light symptoms, severe rare; The basic pathogenesis of TCM Syndromes of deficiency in origin and excess in superficiality, but in man-made mechanical change in the environment is complex and changeful, actual situation mixture has the particularity, traditional Chinese medicine should be based on "the false as the key link, it is marked" as the principle, four diagnostic methods, pay attention to the different characteristics of patients with disease pathogenesis transformation and the clinical physical and chemical factors, and has a certain correlation. |
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