摘要
目的:对慢性肾脏病(CKD)合并代谢综合征(MS)患者的中医证候进行回顾性研究,了解CKD合并MS的证候特征,为CKD的个体化诊治提供指导。方法:收集2007年～2009年住院或门诊的CKD患者,其中CKD合并MS组121例,CKD非合并MS组123例,设计中医证候临床观察表,对两组病人临床脉证进行调查研究。结果:(1)CKD合并MS组男性患病人数明显高于女性,年龄大于CKD非合并MS组。两组病程及慢性肾脏病的分期差异无统计学意义。(2)代谢综合征各组分比较:CKD合并MS组腰围(W)、BMI、高血压发生率、FPG、TG、LDL-C明显高于CKD非合并MS组(P<0.01)。HDL-C明显低于CKD非合并MS组(P<0.05)。(3)两组病人肾损害比较:Scr、BUN、24h尿蛋白定量、血尿及肾衰竭发生率两组相比差异无统计学意义(P<0.05)。CKD合并MS组UA明显高于CKD非合并MS组(P<0.001)。(4)两组病人中医证候的比较:虚证中合并MS组以脾肾气虚多见,非合并MS组以气阴两虚多见;实证中合并MS组以血瘀、痰湿、热盛多见,非合并MS组以湿热、血瘀为多见;合并MS组实证中两证以上相兼的现象较非合并MS组常见;合并MS组血瘀证和热盛证兼夹、血瘀和痰湿证兼夹、血瘀、痰湿和热盛证兼夹多见,非合并MS组以血瘀和湿热证兼夹、湿热和热盛证兼夹多见。两组总的证候均以虚实夹杂为主要特征。结论:CKD合并MS的中医证候特点以虚实夹杂,多证相兼为主要特征。虚证以脾肾气虚为主,实证以血瘀、痰湿、热盛为主。
Objective：Retrospective system study for TCM syndrome of chronic kidney disease（CKD） patients with complicated with metabolic syndrome（MS） and comparison with the TCM syndrome of CKD patients non-complicated with MS,which contribute to understand the characteristic of TCM syndrome in patients of CKD complicated with MS,provide guidance for the individual treatment of CKD.Methods：We collected 244 cases of hospital or clinic patients with CKD,including 121 patients with CKD complicated with MS（MS group）,and 123 patients with CKD of non-complicated MS（non-MS group）,then we research for the clinical symptoms,tongue diagnosis and pulse-taking diagnosis of the two groups according to TCM syndrome observation chart.Results：（1） The male patients were obviously higher than female in MS group,and patients in MS group were older than non-MS group,there were no statistical differences in terms of the course and the stage of CKD between two groups.（2） Comparison of component of metabolic syndrome in two groups：waist,BMI,FPG,TG,LDL-C and incidence of hypertension were higher in MS group than in non-MS group.HDL-C decreased in MS group than in non-MS group.（3）Renal injury in two groups：Serum creatinine,blood urea nitrogen,the prevalence of hematuria and renal insufficiency had no significant difference between two groups （P0.05）.As expected,with MS group had significantly higher uric acid （P0.01）.（4） Asthenia syndrome often emerged in MS group was splenonephro-Qi deficiency syndrome,while in non-MS group was Qi-Yin deficiency syndrome.Blood stasis,phlegmatic hygrosis,excessive heat were often showed in MS group,while damp-heat syndrome,blood stasis were often showed in non-MS group.Two or more than two kinds of excess syndrome or more were more common in MS group than in non-MS group.Incorporation syndrome of blood stasis and excessive heat,blood stasis and phlegmatic hygrosis,blood stasis,phlegmatic hygrosis and excessive heat were more frequent in MS group than in non-MS group.Incorporation syndrome of damp-heat and blood stasis,damp-heat and excessive heat were more common in non-MS group than in MS group （P0.05）.The characteristic of syndrome of MS group and non-MS group showed deficiency and excess.Conclusion：The characteristic of syndrome of CKD complicated with MS showed combination of many a syndrome,deficiency and excess,splenonephro-Qi deficiency syndrome was mainly common in deficiency syndrome,while blood stasis,phlegmatic hygrosis,excessive heat syndrome were often showed in excess syndrome.
出处
《中国中西医结合肾病杂志》
2012年第1期25-29,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
关键词
慢性肾脏病
代谢综合征
中医证候
Chronic kidney disease Metabolic syndrome TCM syndrome
