Distribution Of Hot And Humid Parts In Patients With Chronic Kidney Disease Complicated With Hyperuricemia

Background:Chronic kidney disease harmful to human life and health is geting more and more attention.The final prognosis of chronic kidney disease(CKD)is influenced by many factors,and the rational knowledge of damage factors and effective control is the key to the protection of renal function.Hyperuricemia is becoming more and more clear in the renal injury mechanism,and gradually becomes one of the key concerns of clinicians,which can largely affect the occurrence,development and prognosis of chronic kidney diseases.Traditional Chinese medicine has contributed significantly to delaying the progress of renal function,and a large number of clinical cases have confirmed that TCM has a positive effect on delaying the entry of end-stage renal disease(ESRD).Research purposes:This topic for CKD and CKD+HUA analyse the clinical data of two groups of patients,to explore the effect of HUA on type of syndrome of TCM and to know the damp-heat distribution characteristics in CKD+HUA.Besides,we need to explore the correlation between damp-heat syndrome and laboratory index in order to provide basic of clinical differentiation.Research methods:Formulating unified observation list,It is needed to collect CKD 200 cases and CKD+ HUA 200 cases from January 2014-January 2018 combination traditional Chinese and western medicine hospital of Beijing and the Beijing university of Chinese medicine DongZhiMen hospital outpatiens and inpatients who accord with standard.Descriptive statistical analysis was used to analyze the distribution of syndromes,the distribution of damp-heat parts,and the distribution of the symptoms which is related to damp-heat syndrome.The difference between two groups of patients with syndrome shoud use ?2 examination,and the correlation between the Scr,UA,BUN,ALB,TP,GFR,et al which is link to the disease of kidney and damp-heat syndrome in CKD+HUA group was analyzed using logic binary regression.The purpose is to explore the effect of hyperuricemia on chronic renal disease syndrome and the correlation between laboratory indicators of renal disease and damp-heat syndrome and summarize the clinical experience of professor Li jian min in the treatment of CKD with HUA.Results:In this study,200 CKD patients were included,and 34 patients who did not meet the criteria were excluded.166 cases were statistically analyzed,104 males and 62 females,with an average age of 62.1 years.200 CKD+HUA patients were enrolled and exclude 13 patients who did not meet the criteria,including 187 cases,119 males and 68 females,with an average age of 58.65 years.1 The deficient root of 166 CKD patients,deficiency of Qi(38%)as well as deficiency of Qi and Yang(34.3%)are the first,and deficiency of Qi and Yin(24.1%)are the second.In the real pathogenesis,blood stasis(67.4%),dump-heat(63.3%),are the first,followed by fever poision(57.8%),and Qi stagnation(22.9%),etc.The deficient root of 187 CKD+HUA patients,deficiency of Qi and Yin(39%)and deficiency of Qi(28.3%)is the first,followed by Qi deficiency involved Yang(25.7%),deficiency of Yin and Yang(7%).In the real pathogenesis,blood stasis(64.2%)and damp-heat syndrome(78.5%)are the first,followed by heat poision(58.3%),Qi stagnation(23.5%),and water wet(23.3%),etc.In addition,the differences analysis between the two groups of CKD and CKD+HUA showed that the deficiency of Qi Yin and the damp-heat syndrome P<0.05,and the other test results showed that P>0.05.2 147 cases in 187 CKD+HUA are damp-heat syndrome,among which 96 is male,and 51 is female.large intestine damp-heat syndrome(59.3%),spleen-stomach damp-heat syndrome(29.6%),liver and gallbladder damp-heat syndrome(48.3%),bladder damp-heat syndrome(4.1%).The damp-heat syndrome are most common in spleen and the stomach,large intestine,liver and gallbladder.3 The stage of CKD by GFR in patients CKD+HUA,for each phase of damp-heat syndrome distribution were analyzed,and the result shows:CKD1-2 damp-heat area is commonly in liver and gallbladder(49%?32%);CKD3-5 are commonly in spleen and the stomach(13.9%?13.7%?38.5%),and the large intestine(32.7%?53.2%?52.1%).4 In CKD+HUA,The damp-heat symptoms related to spleen and the stomach is abdominal distension(25.7%),relevant to liver and gallbladder is bitter mouth and dry throat(45.6%),and the large intestine symptoms is sticky and stagnant stool(55.1%).5 Statistic analysis of the correlation between Scr,UA,24hUPr,ALB and damp-heat syndrome in CKD +HUA found that only UA is related to damp-heat syndrome and the relative risk was>1.Conclusion:1 HUA has an influence on the distribution of CKD type of TCM syndromes,mainly affecting the deficiency root(Qi Yin deficiency syndrome)and the real pathogenesis(damp-heat syndrome).Qi Yin deficiency syndrome and damp-heat syndrome are significantly higher in CKD+HUA than that in CKD.2 In CKD+HUA patients,the distribution of damp-heat syndrome are mainly in large intestine wet heat,spleen and stomach wet heat,and liver and gallbladder wet heat.3 In CKD+HUA patients,liver and gallbladder were more common in CKD 1-2 stage,along with large intestine,spleen and stomach are more common in the CKD3-5 stage.4 In CKD+HUA patients,damp-heat related symptoms commonly include sticky and stagnant stool,anorexia and abdominal distention,dry mouth and bitter..5 There is a correlation between HUA and the damp-heat syndrome.HUA can be used as a clinical judgment to determine whether there is damp-heat syndrome in the CKD patients.