The Research On The Relationship Between The Cardiac Damage And Clinical Indicators,and TCM Syndromes In Patients With Primary Chronic Kidney Disease At Stage 3

Objective To explore the relationship between the cardiac damage and TCM syndromes in patients with primary CKD3,and cardiac damage related factors.To explore TCM syndrome types and clinical indicators in law of development and internal mechanism in the occurrence of cardiac damage from CKD3 to CKD4 through combining with the early stage primary CKD4 study results,optimization of traditional Chinese medicine syndrome differentiation and diagnosis system.Methods A total of 108 patients' clinical data was collected,including the type of syndrome,clinical indicators,Echocardiographic indices and so on,to analysis of the relationship between the cardiac damage and TCM syndromes,and cardiac damage related factors.Results(1)There were 48.1%having the cardiac structure changes and 19.4%having myocardial thickening and 82.4%having left ventricular diastolic dysfunction,but without dysfunction of Systolic function.hypertension(?=4.851,OR=27.816,P<0.05),hypertension history time(?=1.020,OR=2.774,P<0.05),anemia(?=-2.825,OR=0.059,P<0.05)and phosphorus ion(?=3.392,OR=29.739,P<0.05)were significant for myocardial hypertrophy regression model.Age(?=0.188,OR=1.207,P<0.01)and free thyroxine(?=0.390,OR=1.477,P<0.05)were risk factors for valvular regurgitation.(2)Both Yin and Yang deficiency syndrome in heart damage was much greater than spleen and kidney Yang deficiency syndrome and qi and Yin deficiency syndrome,and the impairment of cardiac function deficiency of Both Yin and Yang deficiency syndrome was more serious than other syndromes.LAD of spleen and kidney Yang deficiency syndrome was less than spleen and kidney deficiency syndrome,qi and Yin deficiency syndrome(p<0.05).From low to high incidence of ventricular remodeling in order for the,spleen and kidney deficiency syndrome,spleen and kidney Yang deficiency syndrome,qi and Yin deficiency syndrome,liver and kidney Yin deficiency syndrome and both Yin and Yang deficiency syndrome(P<0.05).Between different syndrome types diastolic dysfunction,valvular calcification and valvular regurgitation difference was not significant.(3)LVMI of Empirical group was greater than non empirical group(P<0.05).IVSd(P<0.05)and IVSs(P<0.05)of wet and heat syndrome were less than Wet muddy syndrome,blood stasis(P<0.05),LVPW(P<0.05),LVPWs(P<0.05)and LAD(P<0.05)were less than blood stasis.IVSd of moisture syndrome was less than blood stasis(P<0.05).LVIDs of Wet muddy syndrome was less than blood stasis(P<0.05).LVMI of blood stasis was greater than wet and heat syndrome,Wet muddy syndrome and moisture syndrome.The incidence of ventricular remodeling of blood stasis was higher than wet and heat syndrome.Between different syndrome types diastolic dysfunction,valvular calcification and valvular regurgitation difference was not significant.(4)The impairment of cardiac function deficiency of CKD4 spleen and kidney Yang deficiency was more serious.The incidence of left ventricular diastolic dysfunction of CKD3 qi and Yin deficiency syndrome was higher than CKD4 qi and Yin deficiency syndrome.EDV and ESV of CKD4 Yin and Yang deficiency syndrome were greater than CKD3 Yin and Yang deficiency syndrome(P<0.05),LVPWd(P<0.05),LVIDd(P<0.05)and LVMI(P<0.05)were greater than CKD3 Yin and Yang deficiency syndrome.(5)FS(P<0.05)and EF(P<0.05)of CKD3 were greater than CKD4 wet and heat syndrome.LVMI of CKD4 Wet muddy syndrome was greater than CKD3 Wet muddy syndrome(P<0.01)?Conclusion Patients of CKD3 with decreased diastolic function and cardiac structure change has been relatively common,some patients exist myocardial hypertrophy.Anemia,hypertension,hypertension history time and phosphorus ion were risk factors for myocardial hypertrophy.Heart damage from high to low was both Yin and Yang deficiency syndrome,spleen and kidney Yang deficiency syndrome and qi and Yin deficiency syndrome and spleen and kidney deficiency syndrome or liver and kidney Yin deficiency syndrome.Evil empirical can further aggravate heart damage.The myocardial hypertrophy,ventricular and atrial enlargement degree of blood stasis were more serious than other syndromes.The incidence of ventricular remodeling of CKD3 was lower than CKD4.The ventricular and atrial enlargement degree of CKD4 Yin and Yang deficiency syndrome was greater than CKD3 Yin and Yang deficiency syndrome.