The TCM Syndromes Distribution And Clinical Analysis In Patients Undergoing MHD Combined With SHPT

Purposes: We want to provide the basis of the treatment and nursing of traditional Chinese medicine(TCM)of patients who get the disease of maintenance hemodialysis(MHD)combined with secondary hyperparathyroidism(SHPT)by collecting four diagnostic data and some related laboratory indexes of TCM in these patients,exploring the distribution characteristics of TCM and the relationship between the TCM syndromes and related laboratory indexes.Methods:The basic information of maintenance hemodialysis combined with SHPT and the four diagnostic questionnaires of TCM were made.A cross-sectional survey was conducted on 139 patients who met the inclusion criteria.The patients' ages,dialysis ages and primary diseases were carefully asked.Basic information and TCM four diagnostic information,with "yes" or "no" in the form of the four diagnostic information collected in the questionnaire.Assign "yes" to 1,"no" to 0,and enter patients' assignment information in Excel2007 to create a database of four TCM diagnostic information.Frequency analysis of four diagnostic information of TCM was made,and the four diagnostic information of lower frequency was deleted to simplify the database.Then the simplified database was analyzed by factor analysis,the common factors were clustered after the common factors were obtained,and the appropriate Euclidean distance was selected according to the correlation between the common factors to get the appropriate TCM syndromes.According to the results of normal distribution and homogeneity of variance test,the correlations of TCM syndromes with age,dialysis age and laboratory indexes were studied by parametric test or nonparametric test.The results were statistically significant with P <0.05,Draw the TCM syndrome and the relationship between the TCM syndromes and related laboratory indexes.Results:1.The three primary causes of patients in this study were diabetic nephropathy,chronic glomerular nephritis and hypertensive renal injury.The highest age of onset is 40-60 years old of the middle-aged.The most comon dialysis age is 1 to 5 years.2.Frequency analysis showed that frequency of the symptoms fatigue,dry mouth and throat,itchy skin,less gas lazy words,upset,shortness of breath,forgetfulness is more than 50%.Fifty-eight symptoms and signs remained after the deletion of four diagnostic data of TCM with frequency less than 15%.19 common factors were obtained after factor analysis,and then the common factors were systematically clustered.When the Euclidean distance was taken as 7,the common factors can be divided into 14 categories,and then based on clinical experience,these 14 categories were merged,resulting in five types of TCM syndromes,the proportion of which were: 35.0% of blood stasis,11.4% of yang deficiency of spleen and kidney,19.5% of Phlegm dampness spleen,5.7% of liver qi stagnation,28.5% of Qi and Yin Deficiency.3.There was no significant difference between the five syndromes in age and dialysis age.There was no significant difference in serum calcium between the five syndromes.Parathyroid hormone(PTH)in blood stasis syndrome was significantly higher than that in other four types.Phosphorus in Phlegm dampness spleen was obviously higher than the other four types.The value of hemoglobin of yang deficiency of spleen and kidney was significantly lower than that of the other four types.The albumin value of deficiency of qi and yin and yang deficiency of spleen and kidney were significantly lower than those of the other three types.Conclusion:There are many manifestations of Qi Deficiency in patients undergoing MHD combined with SHPT.The reasons are related to the long course of the disease,the consumption of body fluid and qi,and dehydration by dialysis,as well as daily restriction of drinking water.The TCM syndromes can be divided into five syndromes:blood stasis,yang deficiency of spleen and kidney,Phlegm dampness spleen,liver qi stagnation,Qi and Yin Deficiency.Five syndromes between the distribution of laboratory indicators have some differences.Ideas for the disease TCM dialectical treatment and care was provided to enable more patients to benefit from the treatment of TCM to some extend.