| Objective:To study the clinical characteristics and TCM syndrome type distribution of patients with hyperuricemia in stage ?-? of chronic kidney disease,and to explore the correlation between hyperuricemia and other clinical indicators of patients with stage III-IV of chronic kidney disease and TCM syndrome characteristics,so as to find an effective starting point of TCM treatment.Methods:the patients with hyperuricemia in stage ?-? chronic kidney disease who were hospitalized in Department of Nephrology Endocrinology,Dongzhimen Hospital,Beijing University of Chinese Medicine from September 2018 to December 2019 were included through the inclusion criteria.The clinical data of patients were collected and analyzed by spss26.0 software:the difference between two groups of normal distribution data was compared by two independent sample t-test,and the single factor analysis of variance was used for multi group comparison;the nonparametric test was used for non normal distribution data or uneven variance;the count data was expressed by percentage,and chi square(x 2)test was used;Pearson correlation coefficient was used And Spearman rank correlation coefficient.According to the results of single factor and correlation analysis,the significant variables were analyzed by multiple regression analysis.Result:1.Age distribution:a total of 217 ckdiii-iv patients,129 males and 88 females,aged 85 at the maximum and 23 at the mnimum,with an average age of 60.73±14.526 years;131 patients with hyperuricemia,with an average age of 60.37 ± 15.474 years;86 patients without hyperuricemia,with an average age of 61.28±13.018 years.Among all the patients,53 were aged?50 years,accounting for 24.4%of the total number,79 were aged 51-65 years,accounting for 36.4%of the total number,49 were aged 66-75 years,accounting for 22.6%of the total number,36 were aged 76-85 years,accounting for 16.6%of the total number;of 131 patients with hyperuricemia,34 were aged?50 years,accounting for 26.0%,44 years The age range is 51-65 years old,accounting for 33.6%;28 people are 66-75 years old,accounting for 21.4%;25 people are 76-85 years old,accounting for 19.0%.2.The situation of hyperuricemia in different stages of CKD:among the chronic kidney disease patients included.59 were in stage ?a,77 were in stage ?b,and 81 were in stage IV;26 were accompanied by hyperuricemia in stage ?a,44.1%,including 16 males,27.1%,and 10 females,16.9%;51 patients with hyperuricemia in stage ?b,accounting for 66.2%,including 28 males,accounting for 36.4%,23 women,accounting for 29.9%;54 patients with hyperuricemia in stage IV,accounting for 66.7%,including 25 males,accounting for 30.9%,and 29 females,accounting for 35.8%.3.The situation of taking uric acid lowering drugs:Among the patients with hyperuricemia,40 people(30.5%)took uric acid lowering drugs,and 11 out of 16 people who had gout took uric acid lowering drugs(68.8%).In the use of uric acid-lowering drugs,regardless of whether it is gout patients,sodium bicarbonate is the most frequently used,followed by febuxostat,followed by allopurinol;each stage ?a,?b,? is accompanied by hyperuricemia The number of people was 26,51,54,and the proportion of people taking uric acid-lowering drugs in each period to the total number of hyperuricemia in each period was:26.9%,33.3%,29.6%.4.Distribution of TCM syndrome types:In different stages of CKD,the distribution of the syndrome is basically the same.The syndrome of deficiency of spleen and kidney qi takes the lead,the syndrome of deficiency of qi and yin ranks second,followed by the syndrome of deficiency of liver and kidney yin,followed by It is the spleen and kidney yang deficiency syndrome,followed by the yin and yang deficiency syndrome;the distribution of the standard syndromes in different stages of CKD is mostly concentrated in the three syndromes of blood stasis syndrome,damp turbidity syndrome,and damp heat syndrome,of which the blood stasis syndrome is more prominent;The proportion of spleen and kidney qi deficiency syndrome in the hyperuricemia group was higher than that in the non-hyperuricemia group(54.2%vs 38.4%),and the difference was statistically significant.In the non-hyperuricemia group(41.2%vs26.7%),the difference was statistically significant.The hyperuricemia group and the non-hyperuricemia group have similar patterns in the distribution of syndrome types.In this syndrome,the spleen and kidney qi deficiency syndrome account for the highest proportion,followed by the qi and yin deficiency syndrome,and the liver and kidney yin deficiency syndrome Syndrome,followed by spleen and kidney yang deficiency syndrome,and yin and yang deficiency syndrome are the least;in the standardization,the syndrome types of patients in the hyperuricemia group and non-hyperuricemia group are concentrated in the blood stasis syndrome,damp turbidity syndrome and damp heat syndrome.Among the three syndrome types,the blood stasis syndrome accounted for the highest proportion in the hyperuricemia group,followed by the damp-turbidity syndrome,followed by the damp-heat syndrome,and the wet-turbidity syndrome in the non-hyperuricemia group accounted for the highest proportion,followed by the damp-heat syndrome,followed by the For blood stasis.5.Analysis of related factors of CKD?-? combined HUA:The significant indicators obtained in the univariate analysis are:renal function indicators,HUA group BUN and Scr are significantly higher than non-HUA group,HUA group eGFR is significantly lower than non-HUA group;HUA group albumin is higher than non-HUA group;HUA group BMI is significantly higher than non-HUA group;in coagulation function index,HUA group FIB is lower than non-HUA group;HUA group urine PH value And 24h urine protein was significantly lower than non-HUA group;HUA group iPTH was significantly higher than non-HUA group,HUA group TSH was significantly lower than non-HUA group.The serum iron in HUA group was significantly higher than that in non-HUA group;the proportion of dipper blood pressure in HUA group was significantly lower than that in non-HUA group.The proportion of left ventricular hypertrophy,decreased left ventricular diastolic/systolic function,carotid or lower extremity arteriosclerosis or plaques,and renal diffuse lesions in the HUA group were significantly higher than those in the non-HUA group.Through correlation analysis,the above indicators,as well as spleen and kidney qi deficiency syndrome,gout,diabetes history,and cerebral infarction history are related to SUA.According to regression analysis,males,urine PH>6.2,diabetes,dipper-type blood pressure are protective factors for patients with CKD? to ? stage with HU A,BUN,carotid artery/lower extremity arteriosclerosis with plaque,obesity,cerebral infarction,kidney stones,Spleen and kidney qi deficiency syndrome and blood stasis syndrome are the risk factors of CKD??? with HUA.Conclusions:1.The prevalence of HUA in patients with CKD?-? stage between 50 and 85 years old increases with age.2.The drug treatment rate of uric acid in patients with CKD and HUA is low.Among them,sodium bicarbonate is used most frequently,followed by febuxostat,followed by allopurinol3.HUA and other comorbidities of CKD ?-? patients are interrelated and affect each other.4.The main influencing syndromes of CKD ?-? patients with hyperuricemia are syndrome of Pishenqixu and syndrome of Yuxue. |
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