Distribution Of TCM Syndromes Of Type 2 Diabetic Nephropathy (Xiaoke Nephropathy)

Objective : This study intended to observe the distribution pattern of TCM syndromes of type 2 diabetic nephropathy,and preliminarily explore the correlation between TCM syndromes distribution and clinical indicators.committed to providing a basis for improving the TCM diagnosis and treatment of diabetic nephropathy in this area.Methods:The medical records of 467 patients with type 2 diabetic nephropathy who were admitted to Yin Chuan Hospital of Traditional Chinese Medicine from January 2013 to November 2020 were retrospectively studied.The syndromes were determined according to the information of the four diagnoses and the TCM syndrome scale.General patient data,clinical data,laboratory indicators and other contents were extracted to establish a database.SPSS.26 was used for statistical analysis.Disordered Logistic multiple regression was used to analyze the relationship between TCM syndromes and clinical indicators.P < 0.05 indicated that the difference was statistically significant.Results:1.Among 467 patients with diabetic nephropathy,56.7% were males and 43.3% were females;91.7% of patients aged between 55 and 70 years old;The mean course of disease was 13.25±7.18 years.The early stage of nephropathy accounted for 61.8%,the middle stage accounted for 29.6% and the late stage accounted for 8.6%.Most patients had other complications(89.5%)and comorbidities(92.2%).2.The frequency of this syndrome: 134 cases(28.7%)of deficiency of liver and kidney Yin,117 cases(25.0%)of deficiency of spleen and kidney Yang,112 cases(24.0%)of deficiency of qi and Yin,104 cases(22.3%)of deficiency of Yin and Yang;The frequency of concurrent syndrome:207 cases of phlegm and dampness syndrome(44.3%),106 cases of blood stasis syndrome(22.7%),80 cases of damp-heat syndrome(17.2%),74 cases of no concurrent syndrome(15.8%).The distribution of this syndrome and concurrent syndrome is different with P < 0.05.3.Comparison between different stages of nephropathy and TCM syndrome distribution P < 0.05.The syndrome of deficiency of both Qi and Yin in early stage of DN accounted for 31.1%,the syndrome of deficiency of Yin in liver and kidney accounted for 33.2%,and the syndrome of deficiency of spleen and kidney Yang in middle stage accounted for35.5%.Late Yin and Yang deficiency syndrome accounted for 50%.4.Age,Course of diabetes,SBP,WHR,BMI,FBG,Hb A1 c,Scr,MALB and TC are clinical indicators related to TCM syndromes.5.The dependent variables of this syndrome and concurrent syndrome were taken as reference,respectively,the syndrome of deficiency of both Qi and Yin and the syndrome of absence of concurrent syndrome.Logistic multiple regression results of the last item of independent variable reference value showed that FBG>16.3mmol/L(OR=4.301,P=0.012),Hb A1c>10%(OR=2.735,P=0.038),TG≥2.25mmol/L(OR= 3.706,P=0.005)had higher risks of liver and kidney Yin deficiency syndrome.MALB>300mg/L(OR=3.004,P=0.29)had a higher risk of spleen-kidney Yang deficiency syndrome;years> 20(OR=16.673,P=0),course of years among11-20(OR=5.434,P=0.011),Scr >111mmol /L(OR=26.159,P=0)had higher risk of Yin and Yang deficiency syndrome.BMI > 27(OR=3.272,P=0.019)and course of years>20(OR=3.165,P=0.043)had higher risk of blood stasis syndrome TG≥2.25mmol/L(OR=1.898,P=0.048)had a higher risk of phlegm-dampness syndrome;course of years>20(OR=3.634,P=0.029)was associated with a higher risk of dampness-heat syndrome.Conclusion:The syndrome of yin deficiency of liver and kidney is the most frequent,and phlegm dampness syndrome is the most common concurrent syndrome;in the process of DN progression,the syndrome changes from Qi Yin deficiency,liver and kidney yin deficiency to spleen and kidney yang deficiency,and Yin and yang deficiency in the late stage;the syndrome is related to a variety of clinical indicators;logistic multiple regression suggests that the syndrome is an independent risk factor of yin deficiency of liver and kidney according to Qi and yin deficiency The risk factors were FBG,Hb A1 c and TG.The independent risk factor of spleen kidney yang deficiency syndrome is MALB.The independent risk factors of Yin-Yang deficiency syndrome were the course of diabetes and Scr,while the independent risk factors of blood stasis syndrome were BMI and course of disease.The independent risk factor of phlegm dampness syndrome was TG.The independent risk factor of damp heat syndrome was the course of disease.