The Investigation On TCM Constitution Of Patients With Chronic Kidney Disease Stage 4 With CKD-MBD

Objective: To understand the distribution of TCM constitution in Chronic kidney disease with Mineral and Bone Disorder(CKD-MBD).To explore the correlation between various constitution types and eGFR,Bun,CYS-C,serum calcium,serum phosphorus and iPTH;analyze the risk factors of each constitution.Methods: This study is a cross-sectional survey.According to the inclusion criteria and exclusion criteria,120 patients with CKD stage 4with CKD-MBD were enrolled.Gather information as these: basic data(name,gender,age,body mass index),past history(smoking,drinking,allergies,hypertension,diabetes,hyperlipidemia,hyperuricemia),lifestyle(diet,sleep,exercise)and related laboratory indicators(creatinine,urea nitrogen,cystatin C,serum calcium,serum phosphorus,parathyroid hormone),then fill in the TCM constitution measurement table.Using the SPSS22.0 statistical analyze the distribution of constitution,and analyze the relationship between various constitution and laboratory indicators,and analyze the risk features of the TCM constitution by logistic regression analysis.Results:1.The age of the 120 patients with CKD-MBD was mainly concentrated in 40-79 years old;male patients were slightly more than female patients.2.Among the 120 patients with CKD-MBD,the physique of yang deficiency(26.7%)and qi deficiency(22.5%)were the most,followed by blood stasis(15.8%)and phlegm(14.2%).There was no allergiesin this investigation.Young patients(18 ~ 39 years)have more qi deficiency and peace.Middle-aged patients(40~59 years)have more qi deficiency and dampness.Older patients(60 years and older)have yang deficiency.There was a significant difference in the distribution of constitution between different age groups(P<0.05).Among male patients,yang deficiency is the most common,and female patients with qi deficiency are the most common.There was no difference in the distribution of constitution between different genders(P>0.05).3.There were significant differences in serum calcium and serum phosphorus between different TCM constitution types(P<0.05).The serum Ca level of patients with yang deficiency and qi deficiency was significantly lower than that of patients with phlegm-dampness,yin deficiency and peace(P=0.014,0.009,0.032).The serum P of patients with CKD-MBD was significantly higher than that of yang deficiency.Patients with yin deficiency(P=0.003,0.014).There was no significant difference in eGFR,cystatin C(CYS-C)and parathyroid hormone(iPTH)between different TCM constitution types(P>0.05).4.Qi deficiency is positively correlated with spicy diet,and phlegm-dampness is positively correlated with greasy diet and drinking history.Conclusion:1.The distribution of TCM constitution in patients with CKD stage 4combined with CKD-MBD is mainly yang deficiency and qi deficiency,followed by blood sputum and phlegm.2.Patients with yang deficiency and qi deficiency may be more prone to hypocalcemia,and patients with blood stasis may be more prone to hyperphosphatemia.3.Spicy diet may be a risk factor for qi deficiency.Drinking greasy food and drinking may be a risk factor for phlegm.