Retrospective Study On The Related Factors Of Recurrent Onset Of Peritoneal Dialysis Associated Peritonitis And The Regularity Of Traditional Chinese Medicine Syndromes Type

Research purposes: To analyze the relevant factors and etiological distribution characteristics of recurrent PDAP patients in our center,and to establish a multi-factor joint prediction model for recurrent PDAP,to explore the distribution of traditional Chinese medicin syndromes,and to expand the prevention and treatment ideas of TCM and Western medicine.Research methods: From July 1,2012 to June 30,2022,patients who underwent peritoneal dialysis regularly in the peritoneal dialysis center of our hospital and were hospitalized for PDAP were retrospectively analyzed.A total of 327 people met the inclusion criteria.Patients with PDAP frequency 1 time/year were defined as the single-occurrence group,and patients with PDAP frequency > 1 time/year were defined as the frequent-occurrence group.Collect and count the general information,etiological examination,laboratory indicators and four diagnosis contents of traditional Chinese medicine of patients.First analyze the medical history and clinical data,conduct correlation analysis,find statistically significant indicators,and then use Logistic regression analysis to find out the risk factors affecting the recurrence of PDAP,and build a prediction model with the obtained parameters.Finally,according to the TCM syndrome types of patients with PDAP,compare and analyze the differences and distribution characteristics of the TCM syndrome types of patients in the single group and the frequent group,the distribution rules of the TCM syndrome types of the frequent group and the compatibility of the syndrome types,as well as the correlation with the general data of patients.Research results: 1.Statistical results show that from July 1,2012 to June 30,2022,a total of 327 PDAP patients met the inclusion criteria,with 189 in the single incidence group and 138 in the frequent incidence group.2.There were statistically significant differences in age and BMI index between the single incident group and the frequent incident group(P>0.05).3.The first symptoms of PDAP in both the single and frequent groups were mainly abdominal pain and turbid peritoneal fluid,and there was no statistically significant difference between the groups(P>0.05);The main symptoms were abdominal pain,followed by turbid peritoneal fluid.There was no statistically significant difference between the two groups in terms of the main symptoms(P>0.05).4.The main inducing factors for both the single and frequent group were non sterile procedures,followed by gastrointestinal dysfunction and upper respiratory tract infections.The proportion of non sterile procedures in the frequent group of PDAP patients was significantly higher than that in the single group.There was no statistically significant difference(P>0.05)in the comparison between the two groups of inducing factors.5.The pathogenic bacteria in the single and frequent PDAP patients were mainly coagulase negative Staphylococcus,followed by Staphylococcus aureus;G-is mainly Escherichia coli,followed by Klebsiella pneumoniae.There was no statistically significant difference between the two groups in terms of colony structure.6.There was a statistically significant difference(P<0.05)between the single episode group and the frequent episode group hs CRP group.There was no statistically significant difference(P>0.05)between the two groups in terms of white blood cells in peritoneal dialysis fluid,multinuclear ratio of white blood cells in peritoneal dialysis fluid,ultrafiltration volume,blood white blood cells,and blood neutrophils.7.There was a statistically significant difference(P<0.05)between the ALB group and the frequent ALB group.There was no statistically significant difference between the two groups in RBC,HGB,TG,TC,and fasting blood glucose indicators(P>0.05).8.There was no statistically significant difference in Kt/v,BUN,CO2 CP,K,and transport function between the single incidence group and the frequent incidence group(P>0.05).9.There was no statistically significant difference in calcium and phosphorus metabolism and coagulation function indicators between the single group and the frequent group(P>0.05).10.Logistic regression analysis showed that the risk factors for frequent PDAP include age,BMI index,and hs CRP;The inhibitory factor is ALB.The predictive model for frequent PDAP has certain diagnostic value.11.In the traditional Chinese medicine syndrome types of the two groups of PDAP patients,the deficiency syndrome is mainly spleen kidney qi deficiency and spleen kidney yang deficiency,while the standard syndrome is mainly dampness turbidity syndrome and dampness heat syndrome.There is no statistically significant difference in the comparative analysis of traditional Chinese medicine syndrome types between the two groups.12.The frequent group of patients with spleen and kidney qi deficiency syndrome and qi yin deficiency syndrome are often mixed with damp heat syndrome and damp turbid syndrome,liver and kidney yin deficiency syndrome is often mixed with blood stasis syndrome and liver wind syndrome,spleen and kidney yang deficiency syndrome is often mixed with water gas syndrome and damp heat syndrome,and yin yang deficiency syndrome is often mixed with water gas syndrome and damp turbid syndrome.The proportion of frequent Qi and Yin deficiency syndrome in female patients is significantly higher than that in male patients,with a female/male ratio of1.79.Conclusion: 1.Age,ALB,BMI index,hs CRP are correlated with frequent PDAP(P<0.05);2.Logistic regression analysis showed that the risk factors of frequent PDAP were age,BMI index and hs CRP;The inhibiting factor is ALB.Multi-factor prediction model Logit(P)= 0.017 age(years)-0.182 ALB(g/L)+ 0.149 BMI index(Kg/m2)+ 0.005 hs CRP +1.080.It has certain diagnostic value.3.The inducing factor of PDAP in our center is mainly non-sterile operation.The second is gastrointestinal dysfunction and upper respiratory tract infection.The proportion of non-sterile operation of PDAP patients in frequent group is significantly higher than that in single group.There was no statistical significance in the comparison of predisposing factors between the two groups.4.The results of the study showed that the pathogenic bacteria of PDAP patients in the single and frequent groups were mainly coagulase-negative staphylococcus,Escherichia coli,Staphylococcus aureus,and Klebsiella pneumoniae.There was no statistically significant difference in the colony structure between the two groups.5.The results showed that the deficiency syndrome of the two groups of PDAP patients was mainly spleen and kidney qi deficiency syndrome and spleen and kidney yang deficiency syndrome,while the standard syndrome was mainly dampness and turbidity syndrome and damp-heat syndrome,with no statistical significance.The patients in the frequently-occurring group were mostly divided into damp-heat syndrome and damp-heat syndrome,blood-stasis syndrome and liver-wind syndrome,water-qi syndrome and damp-heat syndrome,and damp-heat syndrome.In the frequent group,the proportion of deficiency of both qi and yin in female patients was higher than that in male patients,1.79 for female/male patients.