Analysis Of TCM Syndrome In Peritoneal Dialysis Patients And Correlation Analysis Between TCM Syndromes And Influencing Factors Of Prognosis

Objective: Through cross-sectional clinical study,the distribution and evolution of TCM syndrome in 120 CAPD patients with different age of dialysis were studied,and the correlation of different TCM Syndrome Types and various risk factors affecting the prognosis of patients with CAPD was analyzed.Methods: a total of 120 CAPD patients were investigated by questionnaires,and the relevant clinical data and samples were collected.According to the diagnostic criteria of TCM syndromes,the clinical symptoms of patients during dialysis were scored,and the highest score was taken as the syndrome type of the patients.In patients with dialysis age as the basis of stages,analysis of the distribution of CAPD in patients with different dialysis stage,TCM syndrome evolution,determine the main syndrome in patients with different dialysis time,and according to the clinical data and examination data collected,analysis of different syndromes in patients with dialysis adequacy,nutritional status,inflammation and cardiovascular diseases the risk of the existence of differences.Results:(1)CAPD patients with dialysis age less than 24 months,the main deficiency is deficiency of spleen and kidney(15%),>24 months in hemodialysis patients with Yang deficiency of spleen and kidney mostly(48.33%),and the patients of the deficiency type conversion performance is from deficiency of spleen and kidney yang deficiency of spleen and kidney and gradually evolved into the some patients eventually develop syndrome,deficiency of yin and Yang two.Dialysis age less than 24 months of CAPD patients with dampness syndrome is the most common superficiality;while the blood stasis and Turbid Toxin found in the dialysis stage;the standard empirical type with dialysis time from turbid dampness and gradually evolved into the dampness and dampness heat syndrome.(2)the KT/V value of CAPD spleen kidney qi deficiency syndrome patients was significantly higher than that of spleen kidney yang deficiency and Yin Yang deficiency syndrome(two deficiency syndrome),and the difference was significant(P<0.05).(3)the nutritional status of CAPD patients with spleen and kidney qi deficiency is the best,and the nutritional indicators(ALB,Hb,TRF and transferrin saturation)are the highest.The Qi Yin two deficiency syndrome is the second,and the Yin Yang two deficiency syndrome is the worst,with a significant difference(P<0.05).(4)the level of CRP and IL-6 in CAPD spleen and kidney qi deficiency patients is the lowest,the micro inflammatory state is significantly lighter than that of other syndromes,and the micro inflammatory state is the most serious in patients with Yin Yang and two deficiency syndrome(P<0.05).(5)the levels of Hcy,UA and LDL in CAPD patients with different asthenia syndrome were significantly different,and those with spleen and kidney qi deficiency were the lowest and the risk of cardiovascular disease was the smallest(P<0.05).(6)CAPD dampness syndrome of KT/V,ALB,Hb,TRF and CRP,transferrin saturation,IL-6,Hcy,UA,LDL and other indexes were better than other syndromes in patients(P < 0.05);(7)CAPD CRP and IL-6 levels in patients with damp heat syndrome was significantly higher than that of damp and moisture patients(P < 0.05);Hcy and LDL levels of moisture syndrome and blood stasis syndrome was significantly higher than other syndromes(P < 0.05).(8)differences in peritoneal transport type different syndromes of patients with CAPD significantly(P < 0.05),and the spleen kidney qi deficiency and dampness syndrome in peritoneal for high average transport,the toxin and water removal effect were better,while patients with Yin and yang deficiency syndrome in two and Zhuodu of peritoneal clearance effect of toxin is poor.Conclusion:(1)the most common deficiency of dialysis age less than 24 months of CAPD patients is spleen and kidney qi deficiency,turbid dampness is the most common.The deficiency of spleen kidney yang deficiency and Yin and yang two deficiency syndrome is the main deficiency syndrome of CAPD patients at >24month's age of dialysis,and most of the positive cases are damp heat syndrome,blood stasis syndrome and turbidity and toxin syndrome.In terms of syndrome transformation,the deficiency syndrome follows the evolution law from spleen and kidney qi deficiency to spleen kidney yang deficiency to Yin and yang two deficiency,while the standard syndrome is mostly transformed from damp turbidity syndrome to water vapor syndrome and dampness heat syndrome.(2)the correlation analysis of each deficiency syndrome and its prognostic factors showed that the indexes of KT/V,ALB,Hb,TRF and transferrin saturation,CRP,IL-6,Hcy,UA and LDL were all better than those of spleen kidney yang deficiency syndrome and Yin Yang two deficiency syndrome.(3)the correlation analysis of the factors affecting the empirical type and prognosis,as dialysis adequacy and nutritional status of dampness syndrome of micro inflammation status,the best the most light,had the lowest risk of cardiovascular disease;syndrome of damp heat syndrome of CAPD patients with the highest level of inflammatory factors;moisture syndrome and blood stasis syndrome is a high-risk syndrome CAPD patients with cardiovascular disease.(4)Spearman analysis showed that there was a significant correlation between the type of peritoneal transport and the deficiency syndrome and the syndrome type in CAPD patients.