Study Of The Correlation Among TCM Syndrome Pattern, Tongue Picture And Exfoliated Tongue Coating Cells Of CKD Patients In Phases 3 And 4

Objective: To discuss the distribution of TCM syndrome patterns,disease phases and tongue pictures in the maturation index(MI)and maturation value(MV)of exfoliated tongue coating cells of the patients having chronic kidney disease(CKD)in phase 3a,3b and 4,so as to accelerate the objectification of tongue diagnosis.Methods: The research was a casecontrol experiment.80 CKD patients in phases 3a,3b and 4 were divided into several groups,with 20 patients in the control group.TCM syndrome differentiation and tongue picture analysis were conducted,and specimens of exfoliated tongue coating cells were prepared by Papanicolaous dying method.MI and MV of the cells were observed with the help of microscope,and the experiment study of the TCM syndrome patterns,phases and tongue pictures of each experimental group was respectively analyzed and compared in the group,and then compared with those of the control group.Results: Correlation between CKD phases and exfoliated tongue coating cells: There was no statistic difference(P>0.05)in MI and MV of the exfoliated upper layer and middle layer tongue coating cells among the CKD 3a,3b,4and control groups.Correlation between CKD TCM syndrome pattern and exfoliated tongue coating cells: a.For MI of the exfoliated upper layer tongue coating cells,those of the spleen-kidney yang deficiency group and qi-yin deficiency group were higher than those of the control group,liver-kidney yin deficiency group and spleen-kidney qi deficiency group,and the result had statistic difference(P<0.01);that of the damp-heat syndrome group was higher than that of the damp-turbidity syndrome group,the data of which was still higher than the control group,no syndrome group,blood stasis syndrome group and water-qi syndrome group.The result had statistic difference(P<0.01).b.For MI of the exfoliated middle layer tongue coating cells,that of the spleen-kidney yang deficiency group was lower than those of the liver-kidney yin deficiency group and control group,and that of the spleen-kidney qi-yin deficiency group was lower than that of the liver-kidney yin deficiency group.The result had statistic difference(P<0.01);those of the damp-heat syndrome group and damp-turbidity syndrome group were lower than those of the control group,no syndrome group and blood stasis syndrome group.The result had statistic difference(P<0.01).c.For MV of the exfoliated tongue coating cells,those of the spleen-kidney yang deficiency group and qi-yin deficiency group were higher than those of the control group,liver-kidney yin deficiency group and spleen-kidney qi deficiency group.The result had statistic difference(P<0.01);that of the damp-heat syndrome group was higher than that of the damp-turbidity syndrome group,which was still higher than those of the control group,no syndrome group,blood stasis syndrome group and water-qi syndrome group.The result had statistic difference(P<0.01).Correlation between CKD tongue pictures and exfoliated tongue coating cells: a.For MI of the exfoliated upper layer tongue coating cells,there was no statistic difference between the control group,pale red tongue group,pale tongue group and red tongue group(P>0.05);that of the yellow coating group was higher than those of the control group and white coating group.The result had statistic difference(P<0.01);that of the thick coating group was higher than that of the control group,the thin coating group being the lowest.The result had statistic difference(P<0.01).b.For MI of the exfoliated middle layer tongue coating,there was no statistic difference between the control group,pale red tongue group,pale tongue group and red tongue group(P>0.05);that of the yellow coating group was lower than those of the control group and white coating group.The result had statistic difference(P<0.01);that of the thick coating group was lower than that of the thin coating group.The result had statistic difference(P<0.05).c.For MV of the exfoliated tongue coating cells,there was no difference between the control group,pale red tongue group,pale tongue group and red tongue group(P>0.05);that of the yellow coating group was higher than those of the control group and white coating group.The result had statistic difference(P<0.01);that of the thick coating group was higher than that of the control group,which is still higher than that of the thin coating group.The result had statistic difference(P<0.01).Conclusion: 1?The MI and MV of the upper layer cells of patients with CKD spleen-kidney yang deficiency,spleen-kidney qi-yin deficiency,damp-heat syndrome,damp-turbidity syndrome,yellow coating and thick coating are significantly higher than those of other syndromes.Correspondingly,the MI of middle layer cells is significantly lower than those of other syndromes.2?There is no obvious correlation among CKD phases,tongue nature and exfoliated tongue coating cells.