| Objective:Through exploring the distribution of TCM syndrome types and related influencing factors of sleep quality of patients with stage CKD3-5(non-dialysis)in the second Department of nephrology of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,and analyzing its internal mechanism from the perspective of TCM,which provides new ideas for the combined Chinese and Western medicine treatment of patients with CKD stage 3-5(non-dialysis)with insomnia in the future.Methods:1.The cases in this study were obtained from patients with CKD stage 3-5(non-dialysis)who attended the inpatient department of the Second Department of Nephrology of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from December 1,2021 to December 1,2022.A total of 125 patients were enrolled according to the inclusion and exclusion criteria and the general clinical data and relevant clinical biochemical indicators of the patients were collected after admission.2.Based on patients’ clinical symptoms and TCM four diagnosis information,TCM syndrome types data statistics were completed.3.125 patients with CKD stage 3-5(non-dialysis)were assessed and grouped for sleep quality according to the Pittsburgh Sleep Quality Index scale(PSQI).Patients were divided into normal sleep group(PSQI ≤ 7 points)and insomnia group(PSQI > 7 points)according to the scale scores.4.The data collected including general clinical data,relevant clinical biochemical indicators,total PSQI score,and TCM syndrome types,and were entered and collated using an Excel sheet.Data was processed using SPSS26.0 statistical software.Then the distribution of TCM syndrome types of sleep quality and the correlation between TCM syndrome types and different data in 125 patients with stage CKD3-5(non-dialysis)was analyzed.Finally,to explore the factors influencing sleep quality in patients with CKD stages 3-5(non-dialysis).Results:1.A total of 125 patients with stage CKD3-5(non-dialysis)were enrolled,of whom 51 males(40.8%)and 74 females(59.2%).The patients were aged between 25 and75 years.There were 84 patients(67.2%)in insomnia group and 41 patients(32.8%)in normal sleep group.The prevalence rate of insomnia in patients with stage CKD3-5(non-dialysis)in this study was 67.2%.2.Distribution of TCM syndrome types in patients with stage CKD3-5(non-dialysis):Among the primary deficiency syndrome,the largest number of patients with pattern of qi deficiency of spleen and kidney were 38 cases(30.4%),and the smallest number of patients with pattern of deficiency of yin and yang were 16 cases(12.8%).Among the secondary excess symptoms,the largest number of patients with dampness-turbidity pattern were 53cases(42.4%),and the smallest number of patients with drowning toxin pattern were 6 cases(4.8%).3.Distribution of TCM syndrome types of sleep quality in patients with CKD stage 3-5(non-dialysis):There was statistical difference between the normal sleep group and the insomnia group in terms of the distribution of primary deficiency syndromes(P<0.05).In the insomnia group,the most number of primary deficiency syndromes were distributed among30 cases(35.7%)of pattern of yang deficiency of spleen and kidney,while the least number of pattern of deficiency of qi and yin and pattern of deficiency of yin and yang were 10 cases(11.9%).In the normal sleep group,there were a maximum of 17 cases(41.5%)of pattern of qi deficiency of spleen and kidney,and a minimum of 4 cases(9.8%)of pattern of yin deficiency of liver and kidney.There was statistical difference between the normal sleep group and the insomnia group in terms of the distribution of secondary excess syndromes(P<0.05).In the insomnia group,the most number of secondary excess syndromes were distributed among 31 cases(36.9%)of dampness-heat pattern,while the least number of drowning toxin pattern were 5 cases(6.0%).In the normal sleep group,there were a maximum of 24 cases(58.5%)of dampness-turbidity pattern and a minimum of 1 case(2.4%)of drowning toxin pattern.4.The relationship between the TCM syndrome types and the total PSQI score in the insomnia group:There was statistical difference in total PSQI score among the primary deficiency syndromes(P<0.01).The total PSQI score of pattern of deficiency of yin and yang was the highest.There was statistical difference in total PSQI score among the secondary excess syndromes(P<0.05),and the total PSQI score of drowning toxin pattern was the highest.5.Relationship between TCM syndrome types and relevant clinical data of patients in the insomnia group:There was statistical difference in body mass index among different primary deficiency syndromes(P<0.01).There was statistical difference in hemoglobin among the primary deficiency syndromes(P<0.05).There was statistical difference in low density lipoprotein and CKD stage among the secondary excess syndromes(P<0.01).6.Factors influencing sleep quality in patients with CKD stages 3-5(non-dialysis):There was statistical difference(P<0.05)in terms of gender,marital partner or not,emotional tendency,duration of CKD,and CKD stage.There was statistical difference in age,hemoglobin,serum calcium,serum phosphorus,parathyroid hormone,serum creatinine,uric acid and glomerular filtration rate(P<0.01).And there was no statistical difference between the two groups in terms of body mass index,education level,occupational status,fasting blood glucose,glycosylated hemoglobin,triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol and blood urea nitrogen(P>0.05).Conclusion:1.Distribution of TCM syndrome types of patients in stage CKD3-5(non-dialysis)insomnia group:Pattern of yang deficiency of spleen and kidney was the main TCM syndrome types in the primary deficiency syndromes,followed by pattern of qi deficiency of spleen and kidney,pattern of yin deficiency of liver and kidney,pattern of deficiency of qi and yin and pattern of deficiency of yin and yang.Among the secondary excess syndromes,the main TCM syndrome types were dampness-heat pattern,followed by dampness-turbidity pattern,blood stasis pattern and drowning toxin pattern.2.In stage CKD3-5(non-dialysis)insomnia group,in the primary deficiency syndromes,the highest total PSQI scores were found in the pattern of deficiency of yin and yang.In the secondary excess syndromes,the highest total PSQI points were obtained for drowning toxin pattern.3.There were differences in body mass index,hemoglobin level,low density lipoprotein level and CKD stage among TCM syndrome types in stage CKD3-5(non-dialysis)insomnia group.4.Gender,age,marital partner or not,emotional tendency,duration of CKD,CKD stage,hemoglobin,serum calcium,serum phosphorus,parathyroid hormone,serum creatinine,uric acid,and glomerular filtration rate may be factors that affect the sleep quality of CKD patients in stages 3-5(non dialysis). |
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