350例2型糖尿病肾病患者中医证候分布及其与实验室指标的相关分析  

Canonical correlation analysis of TCM syndrome and laboratory parameters in 350 patients with diabetic nephropathy

作　　者：杨丽平[1,2] 李平[2] 杜金行[2] 李靖[3] 邓德强[3] 占永立[4] 倪青[4] 谢院生[5] 金秀萍[6] 史丽萍 房辉 刘阁玲 

机构地区：[1]北京中医药大学,北京100029 [2]中日友好医院,北京100029 [3]北京中医药大学东直门医院,北京100700 [4]中国中医科学院广安门医院,北京100053 [5]中国人民解放军总医院肾病研究所,北京100039 [6]河北省唐山市华北煤炭医学院附属医院,唐山063000 [7]河北省唐山市开滦煤炭集团医院,唐山063000 [8]河北省唐山市工人医院,唐山063000

出　　处：《中华中医药杂志》2010年第5期686-689,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点基础研究项目973计划(No.2005CB523503);首都医学科技发展基金项目(No.2005-SF-I-015);科技部国际科技合作计划项目(No.2006DFB31480)~~

摘　　要：目的:分析糖尿病肾病(DN)中医证候分布规律及其与实验室指标的典型相关性,探讨中医证候与DN危险因素的内在联系。方法:采用多中心流行病学调查的方法,收集符合纳入标准的DNⅢ期、Ⅳ期和Ⅴ期患者共350例,分析DN各期患者中医证候学和实验室指标的异同,对证候积分与15项常用实验室指标进行典型相关分析。结果:①证候学分析:DNⅢ期本虚证以气虚、阴虚为主,Ⅳ期以阴虚、阳虚为主,Ⅴ期以阴虚、阳虚和血虚为主。各期标实证均以血瘀证为主。②证候与实验室指标的典型相关分析:血肌酐与阳虚证、餐后血糖与阴虚证、低密度脂蛋白胆固醇与湿热证具有典型相关关系。结论:DN中医证候演变是从气阴两虚到阴阳两虚最终发展到气血阴阳俱虚的过程,血瘀证贯穿疾病始终。实验室指标与证候积分的典型相关分析为中医药防治DN提供了依据,也为开展中医药多中心临床研究奠定了客观评价基础。Objective：To investigate the distribution pattern of TCM syndrome of diabetic nephropathy（DN） patients,and their relationship with main risk factors of DN.Methods：Multi-centric epidemiological field survey was adopted to collect the main clinical data of 350 DN patients fit to the inclusive/exclusive criteria.The TCM syndrome and laboratory parameters were compared based on different stages.The canonical correlation relationship between TCM syndrome score and fifteen commonly used laboratory parameters were analyzed.Results：① Distribution pattern of TCM syndrome：the main def iciency syndromes of DN stage Ⅲ were yin and qi deficiency;the main deficiency syndrome of DN stage Ⅳ were yin and yang deficiency,and stage Ⅴ were yin,yang and blood deficiency,while blood stasis was the main excess syndrome of DN.② The results of canonical correlation analysis revealed that there were canonical correlation between serum creatinine and yang deficiency syndrome,postprandial blood glucose and yin deficiency syndrome,low density lipoprotein and damp-heat.Conclusion：The developmental process of TCM syndrome of diabetic nephropathy was qi and yin deficiency firstly,and then yin and yang deficiency and finally to universal deficiency of qi,blood,yin and yang.Blood stasis was the most important excess syndrome.The canonical correlation between TCM syndrome score and laboratory parameters may provide evidence for treating and preventing DN by TCM means.

关 键 词：糖尿病肾病 中医证候 影响因素 典型相关分析 

分 类 号：R259[医药卫生—中西医结合]