Analysis Of Related Factors Of Diabetic Kidney Disease Stage Ⅲ-Ⅴ And The Distribution Of TCM Syndromes

Objective: To study the correlation between diabetic kidney disease(DKD)patients and laboratory indicators,and to study the relationship between the distribution of TCM syndrome types,syndrome types and clinical laboratory indicators,aiming to treat DKD with integrated TCM and Western medicine Provide theoretical basis,improve prognosis,delay the progress of DKD,and improve the quality of life of patients.Methods: A total of 209 patients with stage Ⅲ to stage Ⅴ DKD who were treated in the first affiliated hospital of Tianjin University of Traditional Chinese Medicine from February2019 to January 2020 were collected.According to the inclusion and exclusion criteria,a total of 209 patients were included.Record the patient’s basic information and relevant laboratory indicators,and use the four-diagnosis of traditional Chinese medicine to classify DKD patients.The data was built into a database,and SPSS 25.0 software was used for statistical analysis of the data.Result:1.Among the 209 patients with stage Ⅲ to stage Ⅴ DKD in this study,the proportion of diabetes with a course of 11-20 years was the largest(57.9%),followed by 8-10 years(20.1%).There were 25 patients in stage Ⅲ(11.96%),164 patients in stage IⅤ(78.47%),and 20 patients in stage Ⅴ(9.57%).2.The age,gender,course of diabetes,BMI,SBP,DBP,pulse pressure difference,FBG,Hb Alc,LDL-C,HDL-C,TG,TC in the different stages of DKD among the 209 patients with stage Ⅲ to stage Ⅴ DKD The difference is not statistically significant;Scr,BUN,UA,GFR,Cys-C,Ca,P,PTH,Hb,ALB,FIB,m ALB,24h-PRO have statistically significant differences between different stages,with the increase of DKD Progress,patients’ GFR,Ca,Hb,ALB gradually decreased,Scr,BUN,UA,Cys-C,P,PTH,m ALB,24h-PRO,FIB gradually increased.3.Correlation analysis between m ALB and clinical indicators shows that P,HDL-C are extremely weakly positively correlated with them;Scr,BUN,Cys-C,PTH,LDL-C,and TC are weakly positively correlated;FIB is moderately positive Correlation;24h-PRO showed a strong positive correlation.Gender showed a very weak negative correlation,age,GFR,andHb showed a weak negative correlation,serum Ca showed a moderate negative correlation,and ALB showed a strong negative correlation.4.In patients with stage Ⅲ-Ⅴ DKD,patients with primary deficiency are most common in patients with deficiency of both qi and yin,followed by yang deficiency of the spleen and kidney;the differences of the primary deficiency syndromes in different DKD periods are statistically significant.Yin deficiency is the main syndrome,followed by liver and kidney yin deficiency;stage IⅤ is mainly due to spleen and kidney yang deficiency,followed by qi and yin deficiency;stage Ⅴ is mainly due to yin and yang deficiency,followed by spleen and kidney yang deficiency..With the development of DKD,the types of Yin and Yang deficiency are increasing,and the types of Qi and Yin deficiency and liver and kidney deficiency are gradually decreasing.5.In patients with stage Ⅲ-Ⅴ DKD,patients with blood stasis syndrome have the most standard evidence,followed by phlegm turbidity syndrome,and drowning syndrome the least;the difference between each standard evidence in different DKD periods is statistically significant,both in stage Ⅲ and IⅤ The syndrome of blood stasis is the main one,followed by the syndrome of phlegm turbidity;patients with stage Ⅴ have the syndrome of drowning toxin,followed by the phlegm turbidity.With the progress of DKD,the types of the syndrome of drowning are increasing,and the types of blood stasis and phlegm-turbidity are gradually decreasing.6.The Scr,BUN,UA,GFR,Cys-C,Ca,P,PTH,Hb,ALB,FIB,m ALB,24h-PRO of the patients in this deficiency syndrome are related to the distribution of the syndrome type,among which Scr,BUN,PTH are The levels of Qi and Yin deficiency and liver and kidney yin deficiency are significantly lower than the other three types,while the levels of GFR and Ca are significantly higher;P is the lowest in Qi and Yin deficiency;UA is in Yin and Yang deficiency.The level in the syndrome is significantly higher than that of Qi and Yin deficiency,liver and kidney yin deficiency,and spleen and kidney Yang deficiency;the levels of Cys-C,24h-PRO,and m ALB in Qi and Yin deficiency syndrome are significantly lower than that of Qi and blood deficiency The levels of Hb and ALB in Qi and Yin deficiency syndrome are significantly higher than the other three syndrome types;the level of FIB in liver and kidney yin deficiency syndrome is significantly lower than that of Qi and blood deficiency.Syndrome,spleen and kidney yang deficiency syndrome and yin and yang deficiency syndrome.7.The age,Scr,BUN,UA,GFR,Cys-C,Ca,P,PTH,m ALB,24h-PRO,Hb,ALB,FIB,LDL-C,HDL-C,TG,TC of the patients in the standard evidence The level of such indicators is related to the distribution of syndrome types.Among them,the levels of GFR,Hb,and Ca in the syndrome of drowning were significantly lower than those of blood stasis,damp-heat and phlegm-turbid syndrome,while the levels of Scr,BUN,Cys-C,and PTH were significantly higher than the other three syndromes;24h-The levels of PRO,m ALB,and FIB in blood stasis syndrome are significantly lower than those of damp-heat syndrome,phlegm turbidity syndrome,and drowning syndrome,while the level of ALB is significantly higher than the other three syndrome types;the level of P in drug drowning syndrome is significantly higher than that in blood Stasis.The level of UA in phlegm turbidity syndrome is significantly higher than that of damp-heat syndrome;the level of LDL-C and TC in blood stasis syndrome is significantly lower than that of damp-heat syndrome and phlegm turbidity syndrome;the level of TG in blood stasis syndrome is significantly lower than that of damp-heat syndrome.8.Scr is a risk factor for Qi and Yin deficiency and Qi and blood deficiency to progress to Yin and Yang deficiency;ALB and TG are risk factors for liver and kidney yin deficiency to progress to Yin and Yang deficiency;Scr,UA,Hb,ALB,TG and TC are the risk factors for the progression of spleen and kidney yang deficiency to yin and yang deficiency.Conclusion:1.DKD patients’ Scr,BUN,UA,GFR,Cys-C,Ca,P,PTH,m ALB,24h-PRO,Hb,ALB,FIB and other indicators have significant differences between different stages of DKD.2.The level of m ALB in DKD patients is related to its coagulation function,degree of anemia,hypoproteinemia,toxin levels in the body,lipid metabolism,calcium and phosphorus metabolism and parathyroid function.3.In patients with stage Ⅲ～Ⅴ DKD,the primary deficiency syndrome is mainly due to deficiency of both qi and yin,stage Ⅲ is mainly due to deficiency of both qi and yin,stage IⅤ is mainly due to deficiency of spleen and kidney,and stage Ⅴ patients are mainly due to deficiency of yin and yang.Mainly;the standard evidence is mainly blood stasis syndrome,of which the blood stasis syndrome is the mainstay in stage Ⅲ and IⅤ,and the drug drowningsyndrome is the mainstay in stage Ⅴ patients.4.In this deficiency syndrome,the toxin accumulation,kidney damage,and calcium and phosphorus metabolism disorders in patients with Qi and Yin deficiency and liver and kidney yin deficiency are more serious than other syndromes;in the standard evidence,the toxin accumulation in patients with drowning The degree of kidney damage and anemia is more serious than other syndromes.The urine protein and FIB of patients with blood stasis syndrome are lower than those of other syndromes.5.Scr is a risk factor for Qi and Yin deficiency and Qi and blood deficiency to progress to Yin and Yang deficiency;ALB and TG are risk factors for liver and kidney yin deficiency to progress to Yin and Yang deficiency;Scr,UA,Hb,ALB,TG and TC are the risk factors for the progression of spleen and kidney yang deficiency to yin and yang deficiency.