| Objective:This project mainly studies the influence of maintenance hemodialysis(MHD)patients’ dialysis age on the distribution of TCM syndrome types,and observes the relationship between MHD patients’ dialysis age,TCM syndrome types and various laboratory indicators,so as to provide reference for TCM clinical treatment of MHD patients through syndrome differentiation.Methods:This study adopted a cross-sectional study method,and selected patients on maintenance hemodialysis at the Blood Purification Center of the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from February 25 to February 28,2021.After admission criteria,136 MHD patients were recruited,and questionnaires were designed to collect TCM syndromes of the patients,and record the patient’s gender,age,dialysis age,height and blood routine,renal function,liver function,blood lipids,electrolytes,calcium and phosphorus,and parathyroid.Test results of adenine,ferritin,etc.According to the diagnostic criteria of TCM syndromes in Chronic Renal Failure in the "Diagnosis,Syndrome Differentiation Analysis and Efficacy Evaluation of Chronic Renal Failure(Trial Plan)",the maintenance hemodialysis patients will be evaluated by professional TCM physicians.At the same time,MHD patients were divided into A(≤36 months)and B(>36 months)two groups according to the dialysis age according to the previous experimental research basis.Incorporate the above collected information into an Excel table to establish a patient clinical data database.Use frequency analysis to discover the distribution of TCM syndrome types in maintenance hemodialysis patients.The method of frequency analysis and chi-square test explores the differences in the distribution of TCM syndrome types in MHD patients with different dialysis ages.Use Kruskal-Wallis H or one-way analysis of variance to compare the differences in laboratory indicators between different TCM syndrome types.Use spss software Mann-Whitney U test or independent sample T test to compare the differences in laboratory indicators of different dialysis ages;use frequency analysis and chi-square test to compare the differences in the rate of achievement of laboratory indicators of different dialysis ages.Results:1.This study collected 136 MHD patients,76 males and 60 females.The average age was 62.86±12.15 years,the average dialysis age was 41.56±28.91 months,the dialysis age was less than 36 months for 67 people,and the dialysis age was more than 36 months for 69 people.There were 55 cases of primary diabetic nephropathy,32 cases of chronic nephritis,16 cases of hypertensive kidney injury,13 cases of polycystic kidney disease,6 cases of hyperuricidic nephropathy,4 cases of lupus kidney,and 10 cases of unknown cause.There were 88 cases using AVF for vascular access,accounting for 64.7%;48 cases using TCC,accounting for 35.5%.2.Common TCM symptoms include 106 cases of oliguria(77.0%),72 cases of waist and knee weakness(52.9%),70 cases of fatigue and fatigue(51.4%),66 cases of dry mouth and thirst(48.5%),and 65 cases of cold limbs.(47.7%),58 cases(42.6%)of eating poorly and appetite.In traditional Chinese medicine,the most patients with deficiency of liver and kidney were 47 cases(34.6%);the least was deficiency of both yin and yang,16 cases(11.8%).The most significant evidence was damp turbidity syndrome,which was 58 cases(42.6%);the least was heat-toxin syndrome,which was 5 cases(3.7%).3.There is a difference in the distribution of TCM syndrome type deficiency syndromes between groups A and B(P < 0.05).There is a difference in the proportion of spleen and kidney qi deficiency and yin and yang deficiency between the two groups(P<0.005).Group A has spleen and kidney qi deficiency syndrome.The proportion is higher than that of group B,and the proportion of yin and yang deficiency in group B is higher than that of group A.There was no significant difference in the distribution of TCM syndrome types between A and B groups(P>0.05).4.Comparison of laboratory indicators among syndromes of TCM syndromes,the levels of hemoglobin and hematocrit in spleen and kidney yang deficiency are lower than those of spleen and kidney qi deficiency and qi and yin deficiency(P<0.05).There was no significant difference in other indicators among the various syndrome types(P>0.05).There was no significant difference in the comparison results of laboratory indicators among the empirical cases of TCM syndromes(P>0.05).5.Comparison of laboratory indexes between groups A and B.The anion gap,calcium-phosphorus product,and parathyroid hormone levels in group B were higher than those in group A(P<0.05),and there was no significant difference in other laboratory indexes(P>0.05)..6.The patient’s overall hemoglobin compliance rate was 47.1%,ferritin compliance rate61.8%,blood calcium compliance rate 41.9%,phosphorus compliance rate 35.5%,parathyroid hormone 30.1%,potassium compliance rate 92.6%,and albumin compliance rate45.6%.There was no significant difference in the compliance rate of laboratory indicators between A and B groups(P>0.05).Conclusion:1.The distribution of TCM syndromes in maintenance hemodialysis patients.Deficiency is mainly composed of liver and kidney yin deficiency,followed by spleen and kidney qi deficiency,spleen and kidney yang deficiency,qi and yin deficiency,and yin and yang deficiency.And the deficiency of both Yin and Yang increased with the dialysis age,and the deficiency of the spleen and kidney Qi decreased with the dialysis age.The empirical evidence is mainly based on phlegm turbidity syndrome,and each syndrome type does not change with the dialysis age.2.Hemodialysis treatment can improve the empirical evidence of patients with chronic renal failure,but the effect on deficiency syndrome is not obvious.Therefore,TCM syndrome differentiation and treatment for MHD patients can intervene from the aspect of deficiency syndrome to improve the patient’s symptoms and the compliance rate of various laboratory treatments. |
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