The TCM Syndrome Differentiation And Clinical Analysis Of Intestinal-renal Syndrome ? In MHD Patients

Purposes:By analyzing the characteristics of traditional Chinese medicine(TCM)syndromes of intestinal-renal syndrome ? in maintenance hemodialysis(MHD) patients, to guide the syndrome differentiation and typing, and in order to provide theoretical basis for the treatment of traditional Chinese medicine in MHD patients complicated with intestinal-renal syndrome ?.And discuss the contact between intestinal-renal syndrome ? in MHD patients related laboratory index and TCM syndrome type distribution. To further screen for the evaluation of the rational indicators of TCM syndrome differentiation.Methods:According to the questionnaire, a cross-sectional survey was used to collect the case data. For the cases that meet the inclusion criteria, one by one investigation, and detailed, realistic and objective record of the questionnaire. Collate and check the survey data, confirm the error after encoding. Transform the binomial distribution variable in the questionnaire to numerical data, and establish MHD complicated with intestinal-renal syndrome ? TCM database by using Excel 2007 table. Applying SPSS 22.0 for data descriptive analysis, factor analysis, cluster analysis and rank sum test.Results:The clinical data of 136 patients with MHD complicated with intestinal-renal syndrome ? were collected and analyzed:Fatigue, thirst for drinking water, dry skin,aversion to cold, shortness of breath, sound timid, constipation, spiritlessness, trapped body weight, irritability, skin itching, palpitations, Bowel flatus, sallow complexion,eructating foul odor and vomiting acid, epigastric and abdominal fullness and distention as the main syndromes of traditional Chinese Medicine. Factor analysis was performed on 55 high frequency syndromes, and 21 common factors were obtained. According to the standard of diagnosis and curative effect of TCM syndrome, and combined with clinical experience, the following conclusions are drawn: spleen qi deficiency syndrome;kidney(Yang) deficiency syndrome; liver blood deficiency syndrome factor; yin deficiency syndrome;heart blood deficiency syndrome;body fluid deficiency syndrome;blood stasis syndrome;qi stagnation syndrome;phlegm dampness(Phlegm turbidity) syndrome,and so on. They can be used as a common factor, and further cluster analysis to determine the attribution of the syndrome. The 21 potential factors were used as the index of the variables, and the hierarchical clustering of the R type. When the Euclidean distance is 12,the 21 common factors are divided into 12 categories. According to the results of factor analysis and cluster analysis, and reference to the TCM syndrome diagnosis and curative effect standard and professional knowledge, they can be classified into six syndromes:Spleen qi deficiency syndrome, Kidney yang deficiency syndrome, syndrome of yin deficiency and depletion of fluid, Heart and Liver blood deficiency syndrome, Phlegm dampness syndrome and Liver and stomach qi stagnation and blood stasis. And preliminary analysis of the correlation between the clinical indicators of each syndrome.Conclusion:MHD complicated with intestinal-kidney syndrome ? mainly consists of6 types of syndrome: Spleen qi deficiency syndrome, Kidney yang deficiency syndrome,syndrome of yin deficiency and depletion of fluid, Heart and Liver blood deficiency syndrome, Phlegm dampness syndrome and Liver and stomach qi stagnation and blood stasis. Its pathogenesis is divided into the deficiency syndrome and sthenia syndrome. In terms of deficiency syndrome, because of the pathological characteristics of MHD patients,Qi, blood, yin and Yang have varying degrees of loss. deficiency of vital energy is mainly due to the deficiency of spleen-QI, deficiency of yang is mainly due to the insufficiency of kidney-YANG, deficiency of yin causes Fluid depletion and yin asthenia generating intrinsic heat, blood deficiency is mainly due to the heart and liver. While the pathogenic factor hyperactivity syndrome is mainly caused by Phlegm, qi stagnation and blood stasis.Simple pathogenic factors are rare, much for the cause of deficiency and excess syndrome is due to the accumulation of pathological products in deficiency syndrome.The clinicalindicators are related with deficiency syndrome and sthenia syndrome respectively.The clinical indicators related deficiency syndrom consist of Hemoglobin and albumin, while the clinical indicators related sthenia syndrome contain SCr, BUN, K, TCO2. At present,the correlation between the syndrome differentiation and clinical indexes have been explored. It is significant to promote the standardization of TCM syndrome differentiation.