The Clinical Characteristics And TCM Syndrome Distribution Of 81 Cases Of Asymptomatic Hyperuricemia Patients With Diabetic Nephropathy

Objective:Since the pathogenesis of DKD is not yet clear,treatment measures such as glycemic control,blood pressure reduction,lipid-lowering and proteinuria do not well curb its progress.At present,DKD is still the hot and difficult point for endocrinologists and nephrologists.The prevalence of hyperuricemia is also increasing,DKD with HUA is common.This project aims to statistically analyze the general data of 81 cases of DKD patients with asymptomatic HUA,In order to observe the clinical characteristics of DKD patients with asymptomatic HUA and the characteristics of TCM syndromes.Then Based on these characteristics,explore the treatment strategy of DKD with asymptomatic HUA about how to delay the progress of DKDMethod:This topic is a cross-sectional study,first,according to the research objectives and requirements of this project to develop relevant questionnaires,collecte the Clinical data of(186 cases)DKD patients,fill in the relevant contents in the attached form,build excel database,input data and check information.Sencond,according to uric acid value and western medicine diagnostic criteria,the included cases were divided into DKD with asymptomatic HUA group and DKD group only.The general data of the two groups were compared with some laboratory indicators.Third,To observe the clinical characteristics of DKD patients with asymptomatic HUA,and analyze the distribution characteristics of TCM syndromes in patients with DKD and asymptomatic HUAResults:A total of 186 cases of DKD were included in this study.There were 102 males and 84 females.The total prevalence of HUA was 43.5%.The prevalence of HUA in patients with microalbuminuria was 28.2%.The prevalence of HUA was 65.7%in the high proteinuria group.Among 81 DKD patients with asymptomatic HUA,43 males and 38 females,the average age was 62.94 years,the average course of disease was 12.80 years,the average BMI 27.39,average fasting blood glucose 7.48mmol/L,the mean systolic blood pressure was 136.02mmHg,and the mean diastolic blood pressure was 79.32mmHg;average HDL 1.13mmol/L,The average LDL tendency for 2.35 mmol,L,the average TG tendency for 2.94mmol/L,average ACR value 296.90mg/g,average SCr 101.68mmol/L,the average BUN tendency for 8.39 mmol/L,average eGFR 60.42,no significant difference in age,gender,course of disease,fasting blood glucose,blood pressure,HDL and LDL between the two groups(P>0.05).Compared with patients with simple DKD,the BMI,TQ ACR,SCr and BUN of patients with DKD accompanied by asymptomatic HUA were all higher than those with simple DKD.The difference was statistically significant(P<0.05).DKD patients with asymptomatic hyperuricemia and low eGFR were compared with patients with simple DKD,and the difference was statistically significant(P<0.05).There was a positive correlation between serum uric acid and ACR(r=0.842,P<0.05).There was a negative correlation between uric acid and eGFR(r=-0.134,P<0.05),positive correlation existed with BUN(r=0.014,P<0.05).In patients with DKD and HUA,the main syndrome is spleen-kidney qi deficiency.The main syndromes are liver depression syndrome.Overall deficiency syndrome spleen-kidney qi deficiency syndrome(52.5%)>qi and Yin deficiency syndrome(35%)>spleen-kidney Yang deficiency syndrome(12.5%);In the microalbuminuria group,spleen-kidney qi deficiency(46.7%)and qi-yin deficiency(43.3%);In the large proteinuria group,spleen-kidney qi deficiency syndrome(56%),>qi-yin deficiency syndrome(30%),and spleen-kidney Yang deficiency syndrome(14%).Overall standard empirical conditions:liver depression syndrome(60%)>phlegm-dampness syndrome(35%)>dampness-heat syndrome(32.5%)>blood stasis syndrome(30%);In the microproteinuria group,liver depression syndrome(60%);phlegm-dampness syndrome(35%),dampness and heat syndrome(33%),and blood stasis syndrome(30%).Patients with liver depression syndrome(70%),phlegm-dampness syndrome(38%),>blood-stasis syndrome(36%)and dampness and heat syndrome(28%)in the group with large amount of proteinuria.Conclusions:1.The prevalence of DKD with HUA was high 2.There is a positive correlation between serum uric acid and ACR.There was a negative correlation between serum uric acid and eGFR 3.In this study,patients with DKD and asymptomatic HUA are characterized by high uric acid,high triglyceride,proteinuria and obesity.The resultant force accelerates DKD progress 4.The TCM syndromes of patients with DKD and asymptomatic HUA are characterized by the mixture of deficiency and solid,Spleen-kidney qi deficiency syndrome is the main syndrome of this deficiency.The main excess syndrome is liver depression syndrome.