| Objectives:By exploring the distribution of TCM syndromes of Chronic Glomerulonephritis(CGN),the correlation between anxiety disorder and kidney-related laboratory test indicators,and excavating the results of Super Encephal of Luctuograph Technology in patients with CGN with anxiety disorder.To explore the characteristics of changes in the level of neurotransmitter activation in the brain,and provide corresponding basis for TCM differentiation of CGN,and provide objective and scientific support for clinical discovery,diagnosis,and treatment of such patients.Methods:Using cross-sectional research methods,from November 1,2020 to January 31,2021,121 patients with CGN in the outpatient of the Department of Nephrology,Guang’anmen Hospital were collected.General conditions,information on the four clinics of traditional Chinese medicine,and laboratory examinations,GAD-7,HAMA,SAS and other data are collected and organized,to statistic and analyze the distribution of Chinese medical syndromes;Preliminarily get the prevalence of CGN with anxiety state,and the patients were divided into 3 groups:CGN with anxiety state group,simple CGN group,and simple anxiety state group.The results of Serum Creatinine,Blood Urea Nitrogen,24-hour Urine Protein Quantification and Urine Occult Blood of the first two groups were statistically compared,and the anxiety state Whether this laboratory inspection item has an impact;Three groups of patients were examined by SET,and the distribution characteristics of neurotransmitters in the brains of CGN patients with anxiety disorder were analyzed by analyzing the examination results.Results:A total of 121 CGN patients were collected in this cross-sectional study,the youngest patient was 5 years old and the oldest was 89 years old.The average age of onset was 46.09 ± 16.66 years old,and the ratio of male to female was 1:1.52,women were more ill than men.Overall,the number of patients aged 31-40 are the largest,with 29 cases(24.0%),followed by 26 cases(21.6%)aged 41-50,20 cases(16.6%)aged 61-79,and aged 51-60 years old,17 cases(14.1%),16 cases(13.2%)aged 21-30 years,6 cases(4.9%)aged 71-80 years,4 cases(3.2%)≤20 years old,3 cases(2.4%)≥80 years old are the least.Among them,32 patients had a family history of kidney disease,accounting for 26.45%of the total number,CGN and Chronic Renal Failure were more common.Among 121 patients,the average course of disease was 52.92 months.The shortest course of disease is 3 months,and the longest course of disease is 283 months.The general outline of"CGN" TCM syndrome differentiation is "intrinsic deficiency and superimposition".Among the 121 CGN patients included in the study,49 cases(40.49%)of the spleen and kidney Qi deficiency of this deficiency syndrome were at most,25 cases(20.66%)were Qi and Yin deficiency syndromes,and 23 cases were liver and kidney Yin deficiency(19.01%),17 cases(14.05%)of spleen and kidney Yang deficiency,7 cases of lung and kidney Qi deficiency(5.79%)were the least;Damp-heat syndrome was the most common in Biao Shi,with 57 cases(41.30%),followed by 35 cases(25.36%)with blood stasis syndrome,29 cases(21.01%)with water dampness syndrome,and 17 cases with damp-turbid syndrome the least(12.32%).CGN disease location mainly involves kidney,spleen,liver and lung.The main clinical symptoms are:fatigue,weakness,waist and knee weakness,edema,and pale complexion,etc.,as well as mouth dry and bitterness,abdominal distension,anorexia,pain in both sides,dizziness,tinnitus,etc.;Among the standard evidence,the most common symptoms include yellow red urine,nausea and vomiting,heavy head and body sleepiness,and sore throat.The top ten clinical manifestations of CGN in descending order were fatigue and weakness in 96 cases(79.34%),waist and knee pain in 94 cases(77.69%),edema in 82 cases(62.77%),and dry mouth in 79 cases(65.29%),71 cases of abdominal distension(58.68%),68 cases(56.20%)of facial complexion,51 cases of poor appetite(42.15%),43 cases(35.54%)of distending and pain in both hypotensions,42 cases of frequent nocturia(34.71%),41 cases of bitter mouth(33.88%).The distribution of CGN syndrome types has nothing to do with gender,but has significant correlation with age:the average age of spleen-kidney-yang deficiency syndrome in this deficiency syndrome is the highest(63.76±17.85),followed by Qi-yin deficiency syndrome(59.92±10.30),liver and kidney Yin deficiency type(42.91±11.56),the average age of lung and kidney Qi deficiency syndrome is the lowest(21.14 ± 12.88).The highest average age of the four types of syndromes is wet-turbidity syndrome(65.11 ± 11.70),followed by blood stasis syndrome(59.85±12.99),damp-heat syndrome(46.75±15.64),and water-wet syndrome(41.38 ±15.81)is the smallest.There are 36 patients with CGN with anxiety disorder,and the incidence rate is as high as 29.75%.There was no significant difference in Scr,BUN,24h-UTP between patients with CGN with anxiety and patients with CGN alone(P>0.05),but the difference between the two groups of ERY was statistically significant(P<0.05).By analyzing the results of SET,it was found that the 5-HT and EXC activation level in the brain of patients with CGN and anxiety disorder were significantly higher than that of patients with CGN alone(P<0.01),the activities of INH were enhanced(P<0.05),and the activities of DA were weakened(P<0.05).There were no significant differences in ACH and NE activities(P>0.05);the ACH and EXC values in the brain of patients with pure anxiety state were significantly higher(P<0.05),and the actual measured values of the remaining four transmitters were not statistically significant(P>0.05).Conclusion:1.The age of onset of CGN is 46.09±16.66 years old,mainly in the young and middle-aged;the ratio of males to females is 1：1.52,and females are more affected than males;the average course of CGN is longer;2.CGN’s TCM syndrome differentiation is based on deficiency and excess,which is related to age.In this deficiency syndrome,the spleen and kidney Qi deficiency syndrome is the most common,the lung and kidney Qi deficiency syndrome is the least,the age is the lowest,and the spleen and kidney yang deficiency is the highest;the damp-heat syndrome is the most common among the standard syndromes,and the blood stasis and damp turbidity syndromes mainly appear in Later stage of the disease;3.The main clinical symptoms of chronic nephritis are:fatigue,weakness,waist and knees,swelling,lack of color,abdominal distension,anorexia,dizziness and tinnitus,etc.,as well as yellow and red urine,nausea and vomiting,head and body sleepiness,swelling and sore throat Equal actual symptoms;4.The incidence rate of CGN with anxiety is 29.75%.Anxiety has an impact on ERY，but it has no obvious correlation with Scr，BUN,and 24h-UTP;5.The activation levels of 5-HT，EXC，INH in the brain of patients with CGN with anxiety disorder increased and DA activation levels decreased compared with patients with pure CGN;the activation levels of ACH and EXC increased compared with patients with pure anxiety disorder. |
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