Study On The Correlation Between Tongue Coating Exfoliated Cells And TCM Syndromes And CKD Stages In Patients With Chronic Renal Failure

Purpose:To observe the tongue appearance of end-stage hemodialysis patients with chronic renal failure and to detect the morphological index maturation index(MI)and mature value(MV)of tongue exfoliated cells,try to study tongue distribution and tongue characteristics of end-stage dialysis patients with chronic renal failure and to study the relationship between tongue coating and tongue exfoliation cells according to their characteristics.Material and method:Case collection time is September 2017,A total of 55 cases of renal hemodialysis patients in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were collected,including 30 males and 25 females;Collected 30 cases of non-dialysis patients in Department of Nephrology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,including 15 male and female patients;another 20 healthy normal people in Liaoning University of Traditional Chinese Medicine were collected as control group,including 10 males and 10 females?Each time in the exfoliative cells collected before the tongue,in accordance with the traditional Chinese medicine method,under natural light to observe the tongue tongue coating,tongue tongue coating classification refer to Zhu Wenfeng,who edited the "diagnosis of traditional Chinese medicine" ?The smear method was used to collect the tongue exfoliated cells,each taking twice,taking the average?Using Papanicolaou staining,the number of various cells(surface cells,middle layer cells,bottom layer cells)and the total number of 10 fields were counted and observed under a light microscope(10 × 10)under light microscope.Index MI and Mature Value MV?Using SPSS17.0 statistical software to analyze the data and observe whether there is statistical difference.Results:1.There was no significant difference in MI and MV between the exfoliative cells of the tongue in patients of different gender,age and dialysis time.2.There was a significant difference between MI and MV in all syndromes(P <0.05).Thetrend of mature value was as follows: normal group>Damp heat group >damp heat stasis group > wet turbid group > dampness cloudy blood stasis group>deficiency of spleen and kidney>deficiency of both spleen and kidney and blood stasis group.3.Tongue exfoliated cells mature value trends: pink tongue> red tongue> dull tongue.The MI and MV values of red tongue were significantly different from those of pale red tongue(P<0.01).The MI and MV values of dull tongue were significantly different from those of pale red tongue(P <0.05)There was a significant difference between MV and dull tongue(P<0.05).4.Tongue exfoliated cells mature value trends: Thin white moss> Thin yellow moss> Yellow greasy moss> White greasy moss.There was a significant difference in MI between MV and white moss(P <0.01),the values of MI and MV of yellow greasy moss were significantly different from those of thin white moss(P <0.01),the values of MI and MV of white greasy moss were significantly different from those of thin yellow moss(P <0.01),the MI and MV of yellow greasy moss were significantly different from those of thin yellow moss(P<0.01),there was no significant difference between white greasy moss and yellow greasy moss(P> 0.05),but there was no significant difference between thin white moss and thin yellow moss(P> 0.05).5.The MI and MV of patients with different CKD stages were significantly different(P<0.01).The mature value of the exfoliative cells in the four groups tended to be CKD2>CKD3> CKD4> CKD5.6.Significant statistical difference was found between MI and superficial cells with serum creatinine value <707umol / L and serum creatinine value ?707umol / L(P <0.05),but there was no significant difference between them(P> 0.05).7.There were significant differences in the number of superficial cells between the urea value <20umol / L and the urea value between 20-30 umol / L(P <0.05),and the rest were not statistically significant(P> 0.05).8.In 55 dialysis and 30 non-dialysis patients,there was no significant difference in the distribution of tongue and tongue between patients of different ages(P> 0.05).9.In 55 cases of dialysis and 30 non-dialysis patients,tongue distribution and tongue coatingin different genders had no statistical difference(P> 0.05).10.There was no significant difference in the distribution of tongue and tongue between dialysis patients and different dialysis patients(P> 0.05).Conclusion:There were significant differences in the MI and MV of each syndrome type of chronic renal failure compared with the normal group,the MV value of spleen and kidney deficiency and blood stasis group was the lowest,and that of damp heat group was the lightest.There were significant differences in MI and MV between patients with different CKD stages.CKD2 had the smallest change,and CKD5 had the lowest MV value.So mature index and maturation value of exfoliative cells of the tongue can be used as one of the reference bases for syndrome differentiation and CKD staging of chronic renal failure,and provide a method for the objective study of tongue diagnosis.