Clinical Analysis And Study Of TCM Syndromes Of Maintenance Hemodialysis Combined With Restless Leg Syndrome

ObjectivesThis study is to know the related factors and the distribution of traditional Chinese medicine(TCM)syndromes in maintenance hemodialysis(MHD)patients with restless leg syndrome.Probe the risk factors of hemodialysis-associated restless leg syndrome,the correlation rules between hemodialysis-associated restless leg syndrome and TCM syndromes.This study aims to provide new TCM treatment ideas for hemodialysis-associated restless leg syndrome.MethodsAnalyze the collected clinical data of MHD patients retrospectively.Analyze the risk factors of MHD patients being complicated restless leg syndrome by using logistic regression analysis.Discriminate the TCM syndromes by referring the standards of TCM syndromes of chronic kidney disease and the collected symptom including tongue and pulse.Contrast the clinical indicators from different TCM syndromes.Analyze the regulation of TCM syndrome and the correlation between TCM syndromes and clinical indicators.Results1.General information: 304 cases were collected totally,43 have restless leg syndrome.The differentiation in associated with diabetes(DM)between the RLS-positive group and RLS-negative group is of statistical significance.The differentiation in other dates is of no statistical significance,including sex,age,mode of dialysis,age of dialysis,time of dialysis and BMI.2.Laboratory indexes:The clinical indicators——Kt/V,hemoglobin,creatinine,urea,albumin,beta 2 microglobulin,serum inorganic phosphorus,blood calcium,parathyroid hormone,serum ferritin,transferrin saturation,C reactive protein,folic acid concentration,vitamin B12 concentration,were contrasted between the RLS-positive group and RLS-negative group.The prevalence rate of RLS in patients with TS < 20% was higher,and the difference was statistically significant,and the other indexes were not different.3.Risk factors:to make multiple factors Logistic regression for find risk factors,take combining RLS as a dependent variable,SF,TS,Hb,ALB,Kt/V,2-MG,PTH,beta diabetes,dialysis methods as independent variables.The result showed that transferrin saturation < 20% were independent risk factors of dialysis patients with RLS.4.Distributions of TCM syndromes: The distributions of deficiency syndrome: most patients have Qi deficiency of spleen and kidney syndrome which make up for 47.7%(n=145),followed by deficiency of both Qi and Yin syndrome of 20.7%(n=63),Yin deficiency of liver and kidney syndrome of 16.8%(n=51),Yang deficiency of spleen and kidney syndrome of 9.9%(n=30),least patients have deficiency of both Yin and Yang syndrome of only 4.9%(n=15).The sthenia syndrome could be divided into 5 types,the most commonly seen is blood-stasis syndrome(n=116,38.1%),followed by damp-turbidity syndrome(n=86,28.3%),damp-heat syndrome(n=68,22.4%),water-vapor syndrome(n=28,9.2%),and the least seen wind-stirring syndrome(n=6,2.0%).5.Correlation study of RLS in MHD patients and its TCM syndromes: In deficiency syndrome and sthenia syndrome patients,there was significant difference in prevalence rate of RLS.In deficiency syndrome,the most common syndrome occurred in hemodialysis-associated restless leg syndrome patients is deficiency of both Qi and Yin syndrome,followed by Yin deficiency of liver and kidney syndrome.In sthenia syndrome,the most common syndrome occurred in hemodialysis-associated restless leg syndrome patients is blood-stasis syndrome.6.Correlation study of TCM syndromes and its clinical indexes: In different deficiency syndrome groups,the differentiation in transferrin saturation,age and age of dialysis of different groups has its statistical significance,and patients with deficiency of both Qi and Yin syndrome or Yin deficiency of liver and kidney syndrome have a lower TS level.The age of Yang deficiency of spleen and kidney syndrome and deficiency of both Yin and Yang syndrome patients is older.The dialysis age of patients with deficiency of Qi and deficiency of both Yin and Yang syndrome patients is longer.There was a significant difference in dialysis mode,dialysis age and Kt/V between different standard groups.The patients in hemodialysis with damp-turbidity syndrome and water-vapor syndrome was more than that of other syndromes.The age of patients with wind-stirring syndrome was longer than that of other syndromes,and the urea clearance index of damp-turbidity patients was lowest.ConclusionLow transferrin saturation is a risk factor for maintenance hemodialysis combined with restless legs syndrome.Maintaining normal level of transferrin saturation may be beneficial for preventing and treating secondary restless legs syndrome.In the deficiency syndrome of chronic renal failure,the syndrome of restless leg syndrome is most common in deficiency of Qi and Yin and deficiency of liver and kidney yin.The highest incidence of restless leg syndrome is blood stasis syndrome.The correlation between syndromes and clinical indicators shows that the proportion of transferrin saturation < 20% is more in patients with deficiency of both qi and Yin and deficiency of Yin Syndrome of liver and kidney.It can be beneficial to improve the level of transferrin and improve restless legs by treating qi,nourishing Yin,nourishing liver and kidney.The use of Chinese medicine for activating blood and removing stasis may help to reduce the occurrence of restless leg syndrome in dialysis patients.