中医四诊仪客观观测464例慢性肾脏病3～5期非替代治疗患者的中医证型分布规律
The distribution of TCM syndromes in 464 patients with stage 3-5 chronic kidney disease without alternative treatment with objective information of four diagnostic instruments of traditional Chinese medicine
张良 1何立群 1郑淇丹 2陈刚1
作者信息
- 1. 上海中医药大学附属曙光医院肾病科,上海 201203
- 2. 上海市长宁区天山中医医院内科,上海 200051
- 折叠
摘要
目的 探讨中医四诊仪客观观测慢性肾脏病(CKD)3～5期非替代治疗患者中医证型分布规律.方法 运用中医四诊仪收集CKD 3～5期非替代治疗患者的四诊信息,进行证候判定,同时分析中医证候与患者基本病情特点的相关性.结果 464例CKD3～5期非替代治疗患者中医证型分布以虚证为本,兼有标实之证.本虚证中以脾气虚证最为多见,占24.6％(114/464),后依次为肾阳虚证、心气虚证、肾阴虚证、心血虚证、脾阳虚证、肺阴虚证;标实证按构成比由大到小依次为瘀血、湿热、水气、湿浊、浊毒.不同CKD分期患者性别、年龄分布比较,差异无统计学意义(P＞0.05),但随年龄增长,虚证比例逐渐增高.不同CKD分期与中医本虚证分布存在差异(x2=57.48,P＜0.001),与本虚标实证分布无差异(x2=2.59,P=0.957).结论 经中医四诊仪测定,CKD3～5期非替代治疗患者中医证型分布以虚证为本,兼有标实之证.CKD3期中医证型以脾气虚证、肾气虚证为主,CKD4期以脾气虚证、肾阳虚证为主,CKD5期以心气虚证、肾阳虚证为主.
Abstract
Objective This study was designed to explore the distribution pattern of TCM syndrome types in patients with Chronic Kidney Disease(CKD)stage 3-5 without alternative treatment after objective collection of TCM quad-diagnostic instruments.Methods The four-diagnostic instruments of Chinese medicine were used to collect the four-diagnostic information of patients with stage CKD 3-5 non-alternative treatment for syndrome determination,and the correlation between TCM syndrome and basic disease characteristics of patients was analyzed.Results The distribution of TCM syndrome types in 464 patients with CKD 3-5 stage non-substitution therapy was based on deficiency syndrome,and had both standard and solid syndrome.Qi-deficiency syndrome was the most common type,accounting for 24.6％(114/464),followed by kidney-yang deficiency syndrome,heart-qi deficiency syndrome,kidney-yin deficiency syndrome,heart-blood deficiency syndrome,spleen-yang deficiency syndrome and lung-yin deficiency syndrome.The positivism type of this deficiency is blood stasis,dampness-heat,moisture,turbidity and turbidity toxicity.There was no significant difference in gender and age distribution among patients with different CKD stages(P＞0.05),but the proportion of deficiency syndrome gradually increased with the increase of age.There were differences in the distribution of primary deficiency syndrome in different CKD stages(x2=57.48,P＜0.001),but no difference in the distribution of primary deficiency syndrome(x2=2.59,P=0.957).Conclusions According to the four diagnostic instrument of traditional Chinese medicine,the distribution of TCM syndrome types in patients with stage CKD3-5 non-alternative treatment is based on deficiency syndrome,combined with deficiency of primary and solid syndrome.The syndrome types in CKD3 stage were mainly qi deficiency and kidney qi deficiency,while the TCM syndrome types in CKD stage 4 were qi deficiency and kidney Yang deficiency.With the progression of the disease,the TCM syndromes of stage 5 CKD were mainly heart-qi deficiency and kidney-yang deficiency.
关键词
肾功能不全,慢性/中医四诊仪/中医证型Key words
Renal insufficiency,chronic/Four diagnostic instruments of Chinese medicine/TCM syndrome type引用本文复制引用
基金项目
何立群上海市名老中医学术经验研究工作室(SHGZS-2017027)
出版年
2024
NETL
NSTL
万方数据