Study On Risk Factors And TCM Syndrome Distribution Of CKD Stage 2-4 Combined With Hyperuricemi

Purpose:To provide a new reference idea for early prevention and TCM-related treatment of CKD patients with HUA through the analysis of related risk factors and the distribution of TCM syndromes in CKD 2-4 patients with HUA.Materials and Methods:Patients who were diagnosed with chronic kidney disease(CKD)stage 2-4 in the Department of Nephrology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from October 2020 to October 2021 were collected.A total of350 patients were collected,and their medical records were sorted later.During the data process,screening was carried out according to the criteria of intake and excretion,and finally a total of302 patients were included in this study,and the collected results were divided into hyperuric acid group(HUA group)and non-hyperuric acid group((non-HUA group),collect the general information and laboratory indicators of the patients,and use the four-diagnosis and reference method to differentiate the syndromes of the patients,and then organize the data into tables and use SPSS statistical software for further analysis.Results:1 A total of 302 patients were included in this study,of which 139(46.0%)were HUA patients and 163(54.0%)non-HUA patients.The prevalence of HUA was 46%.The prevalence of HUA in different stages of CKD patients was also different,and there was a statistical difference(χ2=14.62,P=0.001).As chronic kidney disease progresses,the prevalence of HUA is gradually increasing.2 There were statistically significant differences in drinking history,smoking history,hypertension history,diabetes history,serum phosphorus,triglyceride,low density lipoprotein and blood urea nitrogen between the HUA group and the non-HUA group(P<0.05).).Age,gender,serum calcium,serum magnesium,total cholesterol,high-density lipoprotein,24-hour urine protein quantification,serum albumin,serum creatinine,cystatin C,C-reactive protein,glutamyl transpeptidase between the two groups,alanine aminotransferase,aspartate aminotransferase,glucose and hemoglobin were not significantly different(P>0.05).3 Factors with P<0.05 were included in multivariate logistic regression analysis,and it showed that smoking history,hypertension history,serum phosphorus,low density lipoprotein and blood urea nitrogen were all related to the occurrence of HUA in patients with CKD2-4 stages.High blood urea nitrogen(OR=1.104,95%Cl: 1.037-1.175,P<0.05),high and low density lipoprotein(OR=1.579,95%Cl: 1.196-2.085,P<0.05),high blood phosphorus(OR= 4.037,95%Cl: 1.861-8.758,P<0.001),history of smoking(OR=2.557,95%Cl: 1.410-4.638,P<0.05),history of hypertension(OR=1.789,95%Cl: 1.048)-3.056,P<0.001)was a related risk factor for CKD 2-4 with HUA.4 302 cases of CKD patients,in which the syndrome of spleen and kidney qi deficiency is the most,accounting for 36.8%;the least is the syndrome of yin and yang deficiency,accounting for 4.6%.Among the concurrent syndromes,dampness and turbidity syndrome was the most,accounting for 33.4%;wind-movement syndrome was the least,accounting for 1.0%.Among the combined syndromes,the spleen-kidney qi deficiency syndrome combined with dampness-turbidity syndrome and blood stasis syndrome,and the spleen-kidney-yang deficiency syndrome combined with dampness-turbidity syndrome and blood stasis syndrome accounted for relatively more.5 Comparison of this syndrome and its concurrent syndrome between the HUA group and the non-HUA group: This syndrome type: the HUA group had the most patients with spleen-kidney yang deficiency,accounting for 33.8%;the least was liver-kidney yin deficiency,accounting for 3.6% The non-HUA group had the most patients with spleen-kidney qi deficiency syndrome,accounting for 42.3%;the least was yin-yang deficiency syndrome,accounting for 4.9%,and there was a statistical difference between the two groups(P=0.001,P<0.05).Concurrent syndrome type: HUA group had the largest proportion of patients with concomitant blood stasis syndrome,accounting for 35.3%;The non-HUA group had the largest proportion of patients with damp-turbidity syndrome,accounting for 33.7%;the least was rheumatic syndrome,accounting for 1.2%,and there was a statistical difference between the two groups(P=0.001,P<0.05).6 Among the 139 CKD patients with HUA,gender distribution: in this syndrome: male patients have the most spleen-kidney yang deficiency syndrome;the least is yin-yang deficiency syndrome;female patients have the most spleen-kidney qi deficiency syndrome;the least is liver-kidney yin syndrome false evidence.And there was a statistical difference between the two groups of patients(P=0.045,P<0.05).Among the concurrent syndromes: blood stasis syndrome and damp turbidity syndrome are the most common in male patients;wind-moving syndrome is the least.Among the concurrent syndromes,female patients had the most blood stasis syndrome;the least were heat-toxin syndrome and wind-moving syndrome.There was no statistical difference between the two groups of patients(P=0.620,P>0.05).7 Among the 139 patients with CKD and HUA,the age distribution: in this syndrome: young people are mainly with spleen and kidney qi deficiency syndrome;middle-aged people are mainly with qi and yin deficiency syndrome;young and old people are mainly with spleen and kidney yang deficiency syndrome.host.Concurrent Syndrome: Young people mainly have no Concurrent Syndrome;middle-aged and young old people are mainly Damp-turbid Syndrome;Older people are mainly Blood Stasis Syndrome.8 The correlation analysis between TCM syndrome types and SUA showed that: spleen-kidney yang deficiency syndrome,damp-heat syndrome were positively correlated with serum uric acid value(P=0.031;P<0.001);spleen-kidney qi deficiency syndrome was negatively correlated with serum uric acid value(P=0.031;P<0.001).P=0.044);there was no significant correlation between other syndromes and SUA(P>0.05).Conclusion:1 The prevalence of HUA in patients with CKD stages 2-4 is 46%,and the prevalence of HUA is increasing with the progression of chronic kidney disease.2 High blood urea nitrogen,high and low density lipoprotein,high phosphorus,smoking history,and history of hypertension are all related risk factors for HUA in CKD 2-4,and these factors should be prevented,diagnosed and treated in advance.3 302 cases of CKD 2-4 patients were mainly characterized by spleen and kidney qi deficiency syndrome,and the concurrent syndrome was mainly damp turbidity syndrome.4 In 139 cases of CKD combined with HUA,the main affected syndromes in this syndrome are spleen-kidney qi deficiency syndrome,spleen-kidney yang deficiency syndrome,and qi-yin deficiency syndrome;the main affected syndromes in this syndrome are damp-turbid syndrome,blood stasis syndrome and damp-heat syndrome certificate.5 There is a positive correlation between spleen-kidney yang deficiency syndrome,damp-heat syndrome and serum uric acid value;spleen-kidney qi deficiency syndrome is negatively correlated with serum uric acid value.