The Study Of Traditional Chinese Medicine Constitution Type And Related Risk Factors In Hyperuricemia With Early Kidney Damage

Objective:To analyze the Chinese medicine constitution type and the high-risk constitution features in hyperuricemia with early renal damage patients.To provide evidence for TCM syndrome differentiation and healthy constitution care in hyperuricemia with early renal damage patients.To explore related risk factors in order to provide objective evidence for early prevention of the disease.Methods:In this study,273 patients with hyperuricemia in Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2017 to February 2018 were enrolled.According to the urinary albumin creatinine ratio(UACR)level,273 patients were randomly divided into two groups,with 78 in hyperuricemia with early renal damage group and 195 in hyperuricemia without early renal damage group.Case data were collected including patient's name,sex,age,height,weight,BMI,history of smoking and drinking,past medical history,comorbidities,blood pressure,fasting blood glucose,glycosylated hemoglobin,triglycerides,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,uric acid and urinary albumin creatinine ratio(UACR).The type of TCM constitution in hyperuricemia with early renal damage patients was analyzed by filling in the Chinese medicine constitution self-measurement table and calculated by deputy Chief Physician or above with four diagnostics of traditional Chinese medicine.Related factors were analyzed by Logistic regression analysis to investigate the risk factors associated with the disease.Results:1.The two groups have the same baseline and are comparable.The indexes of age,weight,BMI,history of smoking,fasting blood glucose,glycosylated hemoglobin,triglyceride,low density lipoprotein cholesterol,history of hypertension and diabetes mellitus had statistical significance(P <0.05)Heart disease history,total cholesterol,high density lipoprotein cholesterol,systolic blood pressure,diastolic blood pressure,fatty liver,kidney stones and other indicators have no significant difference(P>0.05).2.The TCM constitutional distribution in 78 cases of hyperuricemia with early renal damage patients was single constitution type,account for 71.79%,with mixing constitution type 28.21%.The proportion of single constitutions from high to low was as follows: phlegm and dampness(17.95%),yang deficiency(16.66%),qi deficiency(12.82%),and damp heat(11.54%),accounting for the total number of studies included.58.97%;The proportions of the mixing constitutions in high to low proportions were as follows: qi deficiency with phlegm and dampness(8.97%),yang deficiency with phlegm and dampness(7.69%),Qi deficiency with dampness and heat(6.41%);The overall biased constitutional frequency according to the frequency of occurrence was as follows:phlegm dampness,qi deficiency,yang deficiency,dampness and heat quality.There was a difference in the composition ratio of males and females,but the difference was not statistically significant.The type of TCM constitution in the hyperuricemia without early kidney damage was ranked in descending order of the proportion: hot and dampness(21.02%),qi deficiency with damp heat(15.38%),phlegm and dampness(14.87%),qi deficiency with phlegm and dampness(11.28%).Converting the biased constitution into single constitution,the constitution type was ranked in order of appearance frequency: damp heat constitution > dampness constitution > Qi deficiency constitution > Yang deficiency constitution.3.By logistic regression analysis the various risk factors of phlegm-dampness,qi deficiency,yang deficiency and damp-heat in the main constitutions of hyperuricemia with early renal damage.The results showed that there was a positive correlation between phlegm-dampness and smoking history and the history of diabetes mellitus;There was a positive correlation between qi deficiency and body weight and dyslipidemia;The yang deficiency was positively correlated with age and diabetes mellitus and negatively correlated with hypertension history;The relationship between damp-heat quality and smoking and abnormal blood glucose was positive.Conclusion:1.The age,weight,BMI,smoking,history of hypertension,history of diabetes,fasting blood glucose,glycosylated hemoglobin,triglycerides,low density lipoprotein cholesterol indicators are closely related to the hyperuricemia with early renal damage.2.Hyperuricemia combined with early kidney damage patient's TCM constitution type is based on a single constitution,with phlegm-dampness constitution,accounting for 17.95% of the total,followed by yang deficiency,Qi deficiency,damp-heat quality.In the mixing constitution,qi deficiency and phlegm-dampness are the most,followed by yang deficiency with phlegm-dampness,qi deficiency with dampness and heat.There are differences between male and female in physical constitution,but the differences are not statistically significant.3.Hyperuricaemia without early renal damage patient,s TCM constitution type was mainly hot and humid,followed by dampness,qi deficiency,yang deficiency.Compared with the group with early kidney damage,the difference in constitution type was mainly characterized by dampness and heat.4.Smoking and diabetes history are risk factors for phlegm constitution.Weight and dyslipidemia are risk factors for qi deficiency.Age and history of hypertension and diabetes are risk factors for yang deficiency.Smoking history and blood glucose abnormalities are risk factors for dampness and heat constitution.