| 吴一帆,刘旭生,黄春林,鲁新红,汪涛.156例维持性腹膜透析患者中医证型分析[J].,2010,30(2):146-149 |
| 156例维持性腹膜透析患者中医证型分析 |
| Analysis of Chinese Medicine Syndrome Types in 156 Patients Undergoing Maintenance Peritoneal Dialysis |
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| DOI： |
| 中文关键词: 维持性腹膜透析 中医辨证 容量负荷 炎症 |
| 英文关键词:peritoneal dialysis Chinese medicine syndrome differentiation volume load inflammation |
| 基金项目:中华人民共和国教育部长江学者奖励计划;教育部教育振兴行动计划专项基金资助(No.985工程) |
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| 中文摘要: |
| 目的分析维持性腹膜透析患者的中医证型特点,为临床辨证施治提供参考。方法参考中华中医药学会肾病分会2006年《慢性肾衰的诊断、辨证分析及疗效评定》标准对156例维持性腹膜透析患者进行中医辨证分型,并收集血清白蛋白(ALB)、C反应蛋白(CRP)、血红蛋白(HB);总尿素清除指数KT/V(总)和残肾尿素清除指数KT/V(残肾);血流介导的血管内皮舒张功能(FMD)及容量超负荷(OH)等检查结果进行分析。结果各证型在维持性腹膜透析患者中均占有一定比例,且随透析时间延长,本证方面气虚向阳虚再向阴阳俱虚证转化,标证方面湿浊向血瘀证转化。结合各项检查指标,本证主要体现在脾肾阳虚及阴阳俱虚证型血ALB水平明显低于脾肾气虚及气阴两虚证(P<0.05),阴阳俱虚证型KT/V(总)最低,与肝肾阴虚、气阴两虚证比较,差异有统计学意义(P<0.05),脾肾阳虚及阴阳俱虚证型的OH值明显高于其他证型(P<0.01);标证主要体现在无兼证型的年龄最低,湿热证与血瘀证年龄明显偏高(P<0.01),湿热证型的CRP水平明显高于其他证型(P<0.05),血瘀证型的FMD明显低于湿浊证及热毒证(P<0.01),湿浊证患者OH值明显高于其他证型(P<0.01)。结论维持性腹膜透析患者证型分布有一定规律可循,且与一些西医检查结果有一定相关性,能为临床辨证施治提供参考。 |
| 英文摘要: |
| Objective To analyze the Chinese medicine syndrome types of patients undergoing maintenance peritoneal dialysis to provide some clinical reference for the treatment based on syndromes. Methods According to the criterion made by the Nephropathy Branch of China Association of Chinese Medicine in 2006, the syndrome type of 156 patients were differentiated, and the related laboratory parameters, including serum albumin (ALB), C-reactive protein (CRP), hemoglobin (HB), total urea clearance rate (KT/Vt), residual kidney urea clearance (KT/Vr), blood flow mediated vascular endothelial dilatation (FMD) and volume overload (OH) were measured. Results Syndrome type presented in patients was different. Along with the progress of dialysis, it changed in the root syndromes from qi-deficiency to yang-deficiency and further to both yin-yang deficiency, while in the superficial syndromes it turned from turbid-damp to blood-stasis. ALB in patients with Pi-shen yang-deficiency type and both yin-yang deficiency type was significantly lower than that in patients with Pi-Shen qi-deficiency type and both qi-yin deficiency type (P<0.05); KT/Vt in both yin-yang deficiency type was the lowest, significantly lower than that in Gan-Shen yin-deficiency type and both qi-yin deficiency (P<0.05); OH in Pi-Shen yang-deficiency type and both yin-yang deficiency type was significantly higher than that in other types (P<0.01). Comparison of patients′ age showed that group of patients without superficial syndrome was the youngest and the group of patients with damp-heat syndrome type was the oldest (P<0.01). CRP in damp-heat type was significantly higher than that in other types (P<0.05); FMD was lower in blood-stasis type than in turbid-damp type and toxic heat type (P<0.01); and OH was significantly higher in turbid-damp type than in other types (P<0.01). Conclusion Some rules of syndrome type distribution could be seen in patients undergoing peritoneal dialysis, which is related with some laboratory parameters to a certain extent, so may provide a few references for clinical treatment based on syndrome type. |
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