Cross-sectional Study Of TCM Syndrome Analysis Of CAPD Patients

Purpose:With long-term ambulatory maintenance peritoneal dialysis(continuous ambulatory peritoneal dialysis,CAPD)patients as the research object,using traditional Chinese medicine theory and method analysis of peritoneal dialysis in patients with TCM syndrome type distribution and characteristics of syndrome types,can expect on the basis of exploration on the basis of traditional Chinese medicine dialysis treatment intervention strategy,designed to improve the long-term survival rate and survival quality of CAPD patients.Material and method: 1.The research object and the inclusion criteria: on July 1,2017 to December 31,306 cases of shenyang military region general hospital regular follow-up demonstration center of peritoneal dialysis patients in TCM syndrome differentiation and the card type analysis.Inclusion criteria :(1)during the follow-up of the center,the duration of maintenance peritoneal dialysis was greater than 3 months;(2)no peritonitis occurred within 1 month;(3)no CRRT or hemodialysis was done in 3 months.2.The type of syndrome diagnostic criteria: peritoneal dialysis in patients with TCM syndrome type of traditional Chinese medicine in chronic renal failure according to syndrome differentiation(refer to the publication of China association of Chinese medicine in 2006 of "the diagnosis of chronic renal failure,and curative effect evaluation").3.Analysis of TCM syndrome differentiation in patients with follow-up of collected at the same time follow-up of peritoneal dialysis patient's general condition,the primary disease,dialysis age,nutritional status,capacity,state type of calcium and phosphorus metabolism,peritoneal,dialysis adequacy,frequency of symptoms in patients with etc.4.Statistical analysis was performed using SPSS 22.0 software for various indicators of different TCM syndromes to find differences and correlations.Results: 1.The certificate distribution of 306 cases of peritoneal dialysis patients: spleen and kidney deficiency syndrome,92 cases(30.1%),liver and kidney Yin deficiency syndrome: 46 cases(15.1%),spleen and kidney Yang deficiency syndrome,76 cases(24.8%),qi and Yin deficiency syndrome: 50 cases(16.3%),Yin deficiency syndrome: 42 cases(13.7%).And card distribution: no and certificate: 12 cases(3.9%)in the wet muddy syndrome: 113 cases(36.9%),hot and humid card: 42 cases(13.7%),toxic heat syndrome: 22 cases(7.2%),blood stasis syndrome: 113 cases(36.9%),pneumatic,4 cases(1.4%).2.All patients with peritoneal dialysis in this study were mainly based on spleen deficiency syndrome(30.1%)and spleen-kidney Yang deficiency syndrome(24.8%),mainly with wet turbidity certificate(36.9%)and blood stasis syndrome(36.9%).The TCM syndromes of the patients were mainly spleen and kidney qi deficiency and wet turbidity syndrome(12.1%)and spleen and kidney Yang deficiency and blood stasis syndrome(13.1%).3.Different in patients with renal failure caused by the primary disease,nephritis,192 cases(62.7%)and diabetic nephropathy: 80 cases(26.1%),hypertensive renal damage: 21 cases(6.9%),other: 13 cases(4.3%),with nephritis caused by the largest proportion of patients with renal failure.4.With the gradual increase of the age of dialysis patients,or the gradual increase of the dialysis age of the patients,the evolution law of TCM syndromes of the patients is: spleen kidney qi deficiency syndrome,spleen kidney Yang deficiency syndrome,Yin and Yang deficiency syndrome.All the indicators of nutritional status of the patients were roughly in line with the evolution law of the syndrome.5.In the aspect of dialysis,the mean value of Kt/V of liver and kidney Yin deficiency syndrome(1.90 ± 0.52)was the highest,and 32 patients(63.5%)with adequate dialysis were significantly higher than other syndromes.The capacity of the state,in patients with liver and kidney Yin deficiency syndrome best capacity status,the proportion is as high as 69.6%,patients with edema type described in patients with water quantity slightly higher than other syndrome types,but the sum of ultrafiltration volume and urine is significantly higher than other syndromes.6.Calcium phosphorus metabolism,in terms of low calcium: the main syndrome of spleen and kidney deficiency syndrome(2.18±0.24),Yin deficiency syndrome(2.18±0.27),and the wet muddy syndrome(2.18±0.25),damp heat syndrome(2.18±0.31)numerical minimum,each type the number of patients with low calcium,respectively is: the spleen and kidney deficiency syndrome,31 cases(33.7%).13 cases of Yin and Yang deficiency syndrome(31.0%);Wet turbidity certificate in 40 cases(35.4%);16 cases(38.1%)of humidity and heat.High phosphorus level: the highest level of serum phosphorus in qi Yin deficiency syndrome(1.79±0.53)and no double syndrome(1.84±0.46).The number of patients with hyperphosphatemia were: qi Yin and Yin deficiency syndrome: 21 cases(42.0%).6 cases(50.0%).In the aspect of parathyroid hormone,i PTH(271.25±210.48)was the best control,with 14 cases(33.3%)of patients with the i PTH greater than 300 pg/ml.However,the i PTH(493.27±453.23)was not well controlled.7.In the condition of patients' microinflammation(leukocyte,hypersensitive c-reactive protein,and blood sedimentation),the patients with spleen-kidney qi deficiency syndrome and unaccompanied syndromes control the best indicators.8.Among the symptoms of peritoneal dialysis patients,the frequency of fatigue and weak lumbago was the highest,292 times(95.4%)and 270 times(88.2%).There was also a large proportion of patients who had 158 cases(51.6%)and those who suffered from abdominal bloating(51.0%).Conclusion:1.The certificate of peritoneal dialysis patients is given priority to with spleen and kidney deficiency syndrome and spleen kidney Yang deficiency,and card is given priority to with dampness syndrome and blood stasis syndrome,TCM syndrome type in patients with mainly spleen and kidney deficiency and dampness syndrome and spleen kidney Yang deficiency and blood stasis syndrome.2.With the increase of the age of peritoneal dialysis patients and the gradual extension of dialysis age,the patient's syndrome was developed in the direction of "deficiency syndrome of spleen and kidney qi,spleen and kidney Yang deficiency syndrome,Yin and Yang deficiency syndrome".The evolution rule of the syndrome is: wet turbidity certificate and blood stasis syndrome.3.The dialysis sufficiency and capacity status of patients with liver and kidney Yin deficiency were significantly better than those of other syndromes.