Study On The Correlation Between The Distribution Of TCM Constitution And Syndrome Types And Nutritional Status In Patients With Maintenance Peritoneal Dialysis

Objective:This study assessed the nutritional status of patients with maintenance peritoneal dialysis(PD)by collecting the basic information of TCM constitution,TCM syndromes and related clinical data,and explored the TCM constitution,TCM syndrome distribution rules and nutritional status of maintenance peritoneal dialysis patients,To reveal the internal relationship between TCM physique,TCM syndromes,clinical indicators,and nutritional status,and provide certain clinical evidence for the prevention and treatment of dialysis-related malnutrition from the perspective of TCM.Methods:From March 2020 to February 2021,patients with chronic renal failure and uremic patients who had undergone peritoneal dialysis treatment in the outpatient and inpatient nephrology department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected according to the inclusion and exclusion criteria.Collect the patient’s TCM physique and syndrome information through the questionnaire method,collect anthropometric data on site,complete the evaluation of the patient’s nutritional status,and collect the patient’s electronic medical record,collect their laboratory examinations and other related data,and determine the final Include cases.Enter the above data into an Excel table,apply SPSS 24.0 software for data statistical analysis,and finally draw statistical and professional conclusions.Result:1 The characteristics of the physical distribution of PD patients in traditional Chinese medicine:(1)A total of 238 physical data of maintenance peritoneal dialysis patients were collected in this study.A total of 577 individuals were measured,including 87 people with a single physique,151 people with a complex physique,and 2 types of physiques in the complex.52 people(34.4%),mainly 44 people(29.1%)with three types of combined constitutions,and up to 3 people(2.0%)with 7 types of combined constitutions.(2)The top three people with physique appearance frequency were 137(23.7%)with phlegm-dampness,99(17.1%)with blood stasis,and 90(15.6%)with yang-deficiency.(3)The top three subjects were yang deficiency in 59 cases(24.1%),blood stasis in 53 cases(21.6%),and phlegm-dampness in 49 cases(20%).(4)There is a correlation between the two constitutions of the complex constitution.There is a positive correlation between the constitution of yang deficiency and the constitution of yin deficiency(P=0.011,R=0.157),and the constitution of yang deficiency and qi deficiency is positively correlated(P=0.002,R=0.194),Yin deficiency quality and Qi deficiency quality are positively correlated(P=0.003,R=0.183),Yin deficiency quality is positively correlated with phlegm-damp quality(P=0.000,R=0.332),Yin deficiency quality is positively correlated with damp-heat quality(P=0.003,R=0.191),Qi-deficiency quality is positively correlated with phlegm-damp quality(P=0.000,R=0.248),Qi-deficiency quality is positively correlated with damp-heat quality(P=0.001,R=0.206),Qi-deficiency quality is positively correlated with There is a positive correlation between idiosyncrasies(P=0.012,R=0.159),phlegm-dampness quality is positively correlated with damp-heat quality(P=0.000,R=0.379),phlegm-dampness quality is positively correlated with blood stasis quality(P=0.000,R=0.236),phlegm-damp quality and Qi-stagnation type are positively correlated(P=0.011,R=0.154),damp-heat quality and Qi-stagnation type are positively correlated(P=0.001,R=0.210),idiosyncratic quality and Qi-stagnation The quality is positively correlated(P=0.001,R=0.217).2 The characteristics of the distribution of TCM syndromes in PD patients;91 patients(38.2%)with the syndrome of deficiency of spleen and kidney qi,37 patients with syndrome of liver and kidney yin deficiency(15.5%),71 patients with syndrome of spleen and kidney yang deficiency(29.8%),qi yin There were 18 persons(7.6%)with two-deficiency syndrome,and21 persons(8.8%)with both yin and yang syndrome.In the standard empirical evidence,80people(33.6%)had wet-turbidity syndrome,36 people had damp-heat syndrome(15.1%),89 people had blood stasis syndrome(37.4%),13 people had fiery-heat syndrome(5.5%),and 2people had wind-movement syndrome(0.8%),18 people(7.6%)without concurrent certificates.3 Distribution of nutritional status of PD patients:71 people(29.8%)were well-nourished,147people(70.2%)were malnourished,of which 142 were mild to moderate malnutrition and 5were severely malnourished.4 The physical fitness of PD patients is correlated with general conditions:(1)There is no correlation between age,gender,dialysis age,type of peritoneal transport and physical fitness(P>0.05).5 Correlation between syndrome types of PD patients and general conditions:(1)There is no correlation between gender,age,peritoneal transport type and syndrome types(P>0.05).(2)There is a correlation between dialysis age and syndrome types(P<0.05).6 The correlation between the nutritional status of PD patients and general conditions:(1)Gender,age,and type of peritoneal transport are not related to nutritional status(P>0.05).(2)There is a correlation between nutritional status and dialysis age(P<0.05).7 Correlation between TCM constitution and TCM syndrome types of PD patients:(1)Spleen-kidney deficiency syndrome is correlated with calm quality,phlegm-damp quality,and damp-heat quality(P<0.05);spleen-kidney Yang-deficiency syndrome is related to phlegm-damp quality,Yang There is a correlation between deficiency quality(P<0.05);there is a correlation between liver and kidney yin deficiency syndrome and damp-heat quality and yin deficiency quality(P<0.05).(2)The damp turbidity syndrome is correlated with the calm quality and Yang deficiency quality(P<0.05);the blood stasis syndrome is correlated with the blood stasis quality,phlegm-damp quality,and damp-heat quality(P<0.05).8 Correlation between TCM physique and nutritional status of PD patients:(1)The distribution type of TCM physique has nothing to do with nutritional status(P>0.05).(2)There is a correlation between the state of single constitution and complex constitution and nutritional status(P<0.05),and the nutritional status of patients with complex constitution is worse.9 Correlation between TCM syndrome types and nutritional status of PD patients:(1)Spleen and kidney qi deficiency,spleen and kidney yang deficiency,qi and yin deficiency,yin and yang deficiency syndrome are related to nutritional status(P<0.05).(2)There was a correlation between damp turbidity syndrome,damp-heat syndrome,blood stasis syndrome,and no concurrent syndromes and nutritional status(P<0.05).10 Correlation between physical fitness of PD patients and laboratory tests:(1)ALB,BMI,and Ca levels are correlated with physical fitness distribution.(2)Results of pairwise comparison between groups:(1)The level of damp-heat quality ALb is higher than that of phlegm-dampness;(2)the BMI level of phlegm-dampness is higher than that of yang-deficiency;(3)the Ca level of phlegm-dampness is lower than that of yang-deficiency,calmness and blood stasis quality.11 Correlation between PD patients’ syndrome types and laboratory indicators:(1)The levels of BUN and SCR are correlated with the distribution of the deficiency syndrome,and the BUN level of the deficiency of both qi and yin is syndrome of deficiency of both yin and yang.(2)The level of LDL-C is correlated with the distribution of standard empirical evidence.The LDL-C level of damp-heat syndrome is higher than that of damp-turbid syndrome.12 The correlation between the nutritional status of PD patients and laboratory examinations:(1)BMI,ALB,TG,UA,triceps skinfold thickness,upper arm circumference,upper arm muscle circumference levels are correlated with nutritional status.(2)Two-by-two comparisons between groups: 1.Severe malnutrition BMI level is lower than good nutrition,mild to moderate malnutrition;2.Mild to moderate malnutrition,severe malnutrition,triceps skinfold thickness level is lower than good nutrition;3.Mild to moderate malnutrition,severe malnutrition,upper arm circumference level is lower than good nutrition;4.Mild to moderate malnutrition,severe malnutrition ALB level is lower than good nutrition;5.Severe malnutrition TG level is lower than good nutrition;6.The upper arm muscle circumference level of severe malnutrition is lower than that of good nutrition and mild to moderate malnutrition;7.The UA level of severe malnutrition is lower than that of good nutrition and mild to moderate malnutrition.Conclusion:1 The distribution of TCM constitution of PD patients is mainly based on yang deficiency,phlegm-dampness,and blood stasis,and the main physique type is compound constitution;the distribution of TCM syndromes is mainly based on spleen-kidney yang deficiency and spleen-kidney qi deficiency.The main evidence is damp turbidity syndrome and blood stasis syndrome.2 There is a certain correlation between the TCM syndrome type of PD patients and the nutritional status.There is no obvious correlation between the TCM constitution distribution and the nutritional evaluation results obtained by the MQSGA score.However,with the increase of the complex constitution,the incidence of malnutrition also increases.3 The nutritional status results obtained after MQSGA score show that the incidence of malnutrition in PD patients is higher.4 With the prolonged dialysis time of PD patients,the TCM syndromes of patients gradually changed from syndrome of deficiency of spleen and kidney qi and deficiency of spleen and kidney to yin and yang deficiency syndrome,and the incidence of malnutrition increased.5 BMI,ALB,TG,UA,triceps skinfold thickness,upper arm circumference,upper arm muscle circumference levels are inherently related to the nutritional status assessment results obtained by MQSGA.6 ALB,BMI,Ca have a certain correlation with TCM constitution,and BUN,LDL-C have a certain correlation with TCM syndrome type.