| OBJECTIVE: To measure the body composition of CKD stage 5 maintenance hemodialysis patients by multi-frequency bioelectrical impedance method(MF-BIA method)and use human body composition analyzer to link with the TCM syndrome types and explore different TCM syndrome types.The body composition of CKD stage 5 maintenance hemodialysis patients,supplemented by the basis of microscopic syndrome differentiation.At the same time,it provides an objective reference for accurately setting and evaluating dry weight according to the TCM syndrome status of CKD stage 5 patients.METHODS: This subject was included in the outpatient clinic that was enrolled in the hemodialysis system of Beijing University of Traditional Chinese Medicine and Dongzhimen Hospital from January 1,2018 to March 1,2019,and the dialysis time was more than 3 months.According to the cross-sectional study,90 cases of inpatients were included in the TCM syndrome differentiation and grouping of the included cases according to the cross-sectional study.Collect basic data such as age,gender,height,weight,and dialysis age of each group,use InBodyS10 to measure body composition,and record the whole body phase angle(°),total water specific gravity(%),and extracellular moisture ratio(%).Body cell volume(kg),body mass index(kg/m2),body fat percentage(%),inorganic salt(kg),bone mineral content(kg),basal metabolic rate(kcal)all data entered into the database,and Take SPSS24.0 software for statistical analysis and processing.RESULTS: First,the quantitative grouping of TCM syndromes: divided into 5 groups of deficiency syndrome,of which spleen and kidney yang deficiency group(34/90,37.78%),liver and kidney yin deficiency syndrome(6/90,6.67%)According to the number of each group,the order was: spleen and kidney yang deficiency group> yin and yang deficiency group> spleen and kidney qi deficiency group> Qiyin deficiency group> liver and kidney yin deficiency group;divided into 5 groups,including blood stasis group The most(31/90,34.44%),the lowest in the water-gas group(12/90,13.33%),according to the number of each group: blood group>damp heat group>wet turbidity group>wind group>water gas group Second,the relationship between TCM syndromes and gender and age in each group: in terms of gender,there are 44 males(48.89%)and 46 females(51.11%);in terms of age,the average age of 90 cases is(62.26±12.998)The age range,the youngest is 30 years old,the largest is 87 years old.The age distribution of 90 patients was compared,including 11 patients(12.22%)<50 years old,57 patients(63.33%)aged 50-70 years,and 22 patients(24.44%)>70 years old.Comparing the gender and age differences between the groups in this group,the patients were found to have the highest spleen and kidney yang deficiency group,male or female,including 20 females(22.2%)and 14 males(15.6%).The average age of the selected patients was the spleen and kidney qi deficiency group,the smallest was the qi and yin deficiency group;the difference between the gender and age of the patients in each group was compared.It was found that the patients were the most bloody group,male or female.There were 14 females(15.6%)and 17 males(18.9%).The average age of the selected patients was the hot and humid group,and the youngest was the blood stasis group.Through stratification study of age,it was found that the spleen and kidney deficiency were mainly in the spleen and kidney yang deficiency group in all ages;the standard evidence was mainly in the blood sputum group at the age of <50 years old and 50-70 years old.>70 years old mainly in the blood stasis group and the damp heat group.According to statistical analysis,there was no significant difference in gender and age between the groups and the standard group(P>0.05).Third,the relationship between TCM syndromes and dialysis age in each group: The average dialysis age of the 90 patients included was(57.50±42.932)months,of which the shortest dialysis treatment was 4 months,and the longest was 195 months.Among them,33 cases(36.67%)had dialysis age <36 months,22 cases(24.44%)in 36-60 months,and 24 cases(26.67%)in 61-120 months,>120 months 11 cases(12.22%).The average dialysis age of this deficiency syndrome is the shortest,that is,the dialysis pre-dialysis group is mostly spleen and kidney qi deficiency group,and the longest average dialysis age is yin and yang deficiency group.The order of average dialysis time of each group was: yin and yang deficiency group> liver and kidney yin deficiency group> spleen and kidney yang deficiency group> Qiyin deficiency group> spleen and kidney qi deficiency group.The average dialysis age in the standard evidence is that the dialysis group is mostly in the damp heat group,while the longest dialysis age is the wind group.The order of average dialysis time of each group was: pneumatic group > blood group > water gas group > wet turbid group > damp heat group.Multivariate logistic regression analysis of TCM syndromes in each group found that: compared with the spleen and kidney qi deficiency group,the dialysis age of the spleen and kidney yang deficiency group and the yin and yang deficiency group were significantly different,and the dialysis age was significantly longer;the yin and yang deficiency groups Compared with the Qi and Yin deficiency groups,the dialysis age was also significantly different;the dialysis age of the patients with wet turbidity group,water vapor group,blood stasis group,Fengqi group and damp heat group was also significantly prolonged.4.Correlation between body composition and syndrome: Using multivariate logistic regression analysis,it was found that:(1)the deficiency of the syndrome: a.Compared with the spleen and kidney qi deficiency group: the body composition index of the spleen and kidney yang deficiency group was not significant Sexual difference;the extracellular water ratio and body mass index of patients with liver and kidney yin deficiency group were significantly lower;the body cell volume of patients with qi and yin deficiency group was significantly lower;the whole body phase angle and body cell volume of patients with yin and yang deficiency group and Inorganic salt was significantly lower;b.Compared with patients with spleen and kidney yang deficiency group: the ratio of extracellular water in patients with liver and kidney yin deficiency group was significantly lower;the content of inorganic salt in patients with qi and yin deficiency group was significantly higher;The whole body phase angle of the patients was significantly lower;c.Compared with the patients with liver and kidney yin deficiency group: the extracellular water ratio of patients with qi and yin deficiency group was significantly higher;the total water content of patients with yin and yang deficiency group was significantly lower.The extracellular water ratio was significantly higher;d.Compared with the Qi and Yin deficiency groups,the systemic phase angle,inorganic salt and basal metabolic rate were significantly lower in the Yin and Yang deficiency groups.(2)Standard evidence: a.Compared with the wet turbidity group: the extracellular water ratio of the patients in the damp heat group was significantly smaller,and the basal metabolic rate was significantly higher;the systemic phase angle of the patients in the water vapor group was significantly smaller,and the extracellular water ratio was The percentage of body fat and body fat was significantly higher;there was no significant difference in body composition index among patients in the blood stasis group;the extracellular water ratio,body mass index and body fat percentage of the patients in the wind group were significantly smaller;b.Compared with the damp heat group: The whole body phase angle of the patients in the water-gas group was significantly smaller,and the extracellular water ratio and body fat percentage were significantly larger;the body mass index,inorganic salt,and basal metabolic rate of the blood stasis group were significantly smaller;The water ratio,body mass index,and inorganic salts were significantly smaller;c.Compared with patients in the water-gas group: the whole body phase angle of the blood stasis group was significantly larger,and the percentage of body fat was significantly smaller;the whole body phase angle of the patients in the wind-driven group Significantly larger,the extracellular water ratio,body mass index,and body fat percentage were significantly smaller;d.Compared with the blood stasis group,the extracellular water ratio of the wind group was significantly smaller.V.The results of the complete human body composition analysis and the TCM syndrome type and the two-dimensional logistic regression analysis can be concluded that the patients with spleen and kidney qi deficiency group have larger body cells than the non-spleen and kidney qi deficiency group.The patients with yin deficiency group had higher inorganic salt and basal metabolic rate than those with non-qi yin deficiency group.The patients in the damp heat group had higher body mass index,inorganic salt and basal metabolic rate than the non-damp heat group,and the water and gas group patients were lower than the non-water group.In the gas group,the extracellular water ratio and the percentage of body fat were higher.Patients in the liver-kidney yin deficiency group had a smaller ratio of extracellular water than those in the non-liver-kidney yin deficiency group.The patients in the yin-yang deficiency group had lower systemic phase angle and inorganic salt than the non-yin-yang deficiency group.The patient's whole body phase angle was small.The basal metabolic rate of the patients in the blood stasis group was smaller than that in the non-blood group.The extracellular water ratio,body mass index,and body fat percentage of the patients in the wind group were smaller than those in the non-wind group.CONCLUSION:(1)The TCM syndromes of CKD stage 5 maintenance hemodialysis patients are mainly spleen and kidney yang deficiency syndrome(Ben Xu)and blood stasis syndrome(standard);(2)CKD stage 5 maintenance hemodialysis patients with dialysis age and TCM syndrome There is a correlation between them;(3)by using multi-frequency bioelectrical impedance method(MF-BIA),there is a correlation between the body composition measured by CKD stage 5 maintenance hemodialysis patients and the syndrome of traditional Chinese medicine,which can be used as a reference for TCM syndrome differentiation to some extent. |
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