Study On The Evolution Of Tcm Syndromes In Type 2 Diabetic Nephropathy Based On CKD Staging

Purpose:This study is based on different renal function levels of type 2 diabetic nephropathy patients with traditional Chinese medicine differentiation,understanding of different CKD stage TCM syndrome type,to explore the evolution of TCM syndromes of different CKD staging,to provide objective scientific basis for the diagnosis of diabetic nephropathy.Content:In this study,a questionnaire survey on traditional Chinese medicine for diabetic nephropathy was conducted through a literature survey.A cross-sectional study was conducted to collect type 2 diabetes nephropathy hospitalized patients that they met the inclusion ande exclusion criteria for nephrology and endocrinology in 7 hospitals in Beijing and other cities from October 2017 to January 2018.Collecting nephropathy TCM questionnaire,basic information and clinical physicochemical indicators.SPSS 23 statistical software was used for data analysis.Measured data were expressed as mean±standard deviation,and count data was expressed as frequency and percentage.Measurement data using a single sample t test,count data using chi-square test,P <0.05 was statistically significant.Spearman’s correlation coefficient was used to correlate TCM symptoms and physical and chemical indicators.In accordance with “the syndrome differentiation of syndrome ”,the analysis of the syndrome elements is carried out.According to “syndrome differentiation of TCM guidelines for diabetic nephropathy”,TCM syndrome differentiation was carried out.Results:1.Based on the previous laboratory basics,literature research and expert consultation method,a “Diabetes Nephropathy TCM Questionnaire ” containing 52 TCM symptoms was established.2.Among the 317 patients with type 2 diabetic nephropathy,95 were CKD1,60 were CKD2,59 were CKD3,36 were CKD4,and 67 were CKD5.The average age of patients was 58.3±11.35 years old,male patients accounted for 76.3%,and the average history of diabetes was 180.68±85.40 months.The percentage of hemoglobin,atherosclerosis,and fatty liver decreased with the frequency of CKD progression.3.Symptom Analysis of Traditional Chinese Medicine: In this study,TCM symptoms of type 2 diabetic nephropathy progress from CKD to less,from simple to complex,waist and knees are awake,aversion to cold,cold lips,pale lips,and low frequency of appetite and nausea progress with CKD.Spearman correlation was used to analyze serum albumin and edema(r=-0.440,P<0.01),creatinine and complexion chlorosis(r=0.405,P<0.01),and there was a statistically significant correlation.4.Analysis of TCM syndromes: In this study,type 2 diabetic nephropathy with different stages of CKD disease was mainly liver,kidney and spleen.With the development of CKD,liver,kidney and spleen were aggravated;disease-induced deficiency of yin and yang deficiency in the whole course of the disease.There is evidence that qi deficiency and blood deficiency gradually increase with the progress of CKD,and yang deficiency is particularly prominent in CKD3.The benchmarking evidence runs through the wet card,and the qi stagnation card begins to appear from the CKD2 phase.The stasis syndrome is reflected in the CKD5 phase.5.TCM syndrome analysis: In this study,patients with type 2 diabetic nephropathy had CKD1 and CKD2 with deficiency of both yin and yin and deficiency of liver and kidney yin deficiency.CKD3 stage was mainly spleen and kidney yang deficiency,and CKD4 stage was with liver and kidney yin deficiency and qi.Yin deficiency,spleen and kidney yang deficiency as the main syndrome,CKD5 period spleen and kidney yang deficiency,qi and blood deficiency.The cardinal signs of liver yang hyperactivity persisted throughout the year and had the highest percentage of frequency in CKD3 period.The syndrome was mainly in the venomous human brain and was the highest percentage in the CKD4 period.Conclusions:1.In the present study,type 2 diabetic nephropathy was mainly composed of liver,kidney and spleen,and aggravated with the development of CKD disease.The deficiency of qi and blood deficiency of this disease gradually worsened with the progress of the disease.Yang deficiency was particularly prominent in CKD3.Benchmarking evidence runs through wet cards.2.In this study,type 2 diabetic nephropathy patients with CKD1 and CKD2 were mainly characterized by deficiency of both qi and yin,deficiency of liver and kidney,CKD3 was mainly due to spleen and kidney yang deficiency,and CKD4 was mainly due to deficiency of liver and kidney,deficiency of qi and yin,and spleen.Kidney yang deficiency is the main syndrome type,CKD5 stage is mainly spleen and kidney yang deficiency and qi and blood deficiency.The deficiency of both qi and yin,the deficiency of liver-kidney yin deficiency showed a downward trend along with the development of CKD,and the symptoms of qi and blood deficiency and spleen-kidney yang deficiency gradually became prominent after CKD3.The syndrome of hepatic yang hyperactivity was also observed throughout the period and was particularly prominent during the CKD3 period.It is particularly evident that CKD4 is the main variant of the poison the human brain.