| ObjectiveBy analyzing the distribution of clinical data of patients with type 2 diabetic nephropathy,the clinical value of serum cystatin C in type 2 diabetic nephropathy and the distribution of TCM syndromes in patients with type 2 diabetic nephropathy were discussed.MethodsA total of 223 patients with type 2 diabetic nephropathy who were treated in the Nephrology Department of the First Teaching Hospital of Tianjin University of TCM from January 2018 to June 2019 were selected.Combined patients'24-hour urine protein quantification and e GFR,divided into 3 groups of clinical stages:early DKD[24-hour urine protein quantification?0.3g,and/or e GFR>60m L/(min·1.73m2)],DKD dominant phase[24-hour urine protein quantification>0.3g,and e GFR 60-15m L/(min·1.73m2)],DKD terminal stage[e GFR<15m L/(min·1.73m2)].Collect clinical data such as gender?age?height?weight?smoking and drinking status?current diagnosis?past medical history?various biochemical indicators and cardiac ultrasound detection indicators.Employed SPSS21.0statistical software for statistical analysis,and compare various indicators between groups To explore the value of serum cystatin C in the monitoring of type 2 diabetic nephropathy,and to analyze the distribution of disease syndromes.Results1.A total of 223 patients were included in this study,including 136 male patients(61%)and 87 female patients(39%).The gender distribution of men and women differed in clinical stage(?~2=21.219,P<0.01),and the distribution of patients in end-stage patients Significantly more than women;mean age of patients(63.19±11.06)years old,60-80 years old patients distributed up to 132(60%);mean BMI(26.43±3.60)kg/m~2,overweight and obese patients accounted for 74.9%of the total%;204 patients(91.5%)with hypertension,145 patients(65%)with cardiovascular disease,and there are differences in the incidence of cardiovascular disease in different stages(P<0.01),the incidence of cardiovascular disease in end-stage patients is 87.8%,significantly higher than early and mid-term patients.2.The serum CysC level of patients gradually increased with the progress of DKD clinical stage(P<0.01),and had a good correlation with e GFR(r=-0.745,P<0.01),and P?BUN?SCr?UA?CK?LDH?HBDH?Hcy are positively correlated,and negatively correlated with HGB?Ca?NAG?GAL.3.Serum CysC levels in patients with cardiovascular disease were higher than those without cardiovascular disease(P<0.01).As serum CysC increased,LAD?LVD?RAD?RVD?IVST increased,and LVEF decreased.4.The distribution of the deficiency syndrome of 223 patients:62 cases(27.8%)of yin deficiency and dry heat syndrome,54 cases(24.2%)of deficiency of both qi and yin and spleen and kidney qi deficiency(24.2%),53 cases(23.8%)of deficiency of yin and yang;There is a statistically significant difference in the distribution of deficiency syndromes in the clinical stages of DKD(?~2=12.845,P<0.05).In the early stage,10 cases(37.0%)of yin deficiency and dry-heat syndrome accounted for the largest proportion,and 36 cases(31.6%)accounted for the largest proportion,28 cases(34.1%)of end-stage yin and yang deficiency syndrome accounted for the largest proportion;the distribution of standard evidence:78 cases of blood stasis syndrome(35.0%),60 cases of damp-heat syndrome(26.9%),54 cases of phlegm-turbid syndrome Cases(24.2%),31 cases(13.9%)with water-wet syndrome.5.Correlation analysis between TCM syndrome types and laboratory indicators found that the Hcy level of Qi and Yin deficiency syndrome is lower than other syndrome types,the GGT level of Yin deficiency and dry heat syndrome is higher than that of Qi and Yin deficiency and spleen and kidney Qi deficiency,and the HGB level of Yin and Yang deficiency syndrome.Compared with other syndrome types,the levels of BUN,SCr,and CysC are higher than those of other syndrome types.The level of Ca is lower than that of Qi and Yin deficiency and Yin deficiency and dry heat syndrome,and P is higher than that of Qi and Yin deficiency syndrome(P<0.05);TCM standard Comparison of laboratory indicators between syndromes:GLB level in blood stasis syndrome is higher than that of other syndromes,and blood phosphorus level is significantly higher than that of damp-heat syndrome.Conclusion1.Type 2 diabetic nephropathy is mainly caused by the elderly and obese people,and it is easy to be complicated with hypertension and cardiovascular disease,and the incidence of cardiovascular disease is increasing with the progress of clinical stage.2.Serum CysC is highly sensitive to renal function damage in type 2 diabetic nephropathy,and can quickly and accurately reflect glomerular filtration function.It is an accurate?reliable?and easy-to-clinically sensitive indicator of renal function,which can be used for the clinical diagnosis of DKD?staging and assessing the condition to provide a reliable basis.3.Type 2 diabetic nephropathy is based on the fact that this deficiency is the basic pathogenesis of traditional Chinese medicine.This deficiency syndrome type basically follows the development rule of yin deficiency and dry heat-qi and yin deficiency-spleen and kidney qi deficiency-yin and yang deficiency,as well as phlegm,stasis,and dampness,Turbidity and other standards are actually affected,especially the blood stasis damage to the kidney collateral is the main cause of the disease. |
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