血液透析营养不良患者中医证型与C反应蛋白及胰岛素抵抗的关系  

Study of the Relationship Between C Reactive Protein and Insulin Resistance in Maintenance Hemodialysis Patients with Malnutrition and the Syndrome Patterns in TCM Differential Diagnostics

作　　者：刘先英 李建英 孙红 于俊生 

机构地区：[1]青岛市海慈医疗集团肾内科,山东青岛266033

出　　处：《中华中医药学刊》2011年第1期157-159,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：青岛市科技局立项项目(05-1-NS-75)

摘　　要：目的:探讨血液透析营养不良患者中医证型与血清C-反应蛋白(CRP)、胰岛素抵抗的关系,探寻中医辨治本病的规律。方法:114例尿毒症维持性血液透析(MHD)患者,根据主观综合营养评分法(SGA评分)符合营养不良,根据慢性肾衰竭中医辨证分型标准进行辨证分型。另设健康对照组30例。检测血清CRP、空腹胰岛素(FINS)、空腹血糖(FBS)等指标,计算稳态模型胰岛素抵抗指数(HOMA-IR)作为胰岛素抵抗指标,分析不同中医证型与各项参数的关系。结果:MHD组患者血清CRP、FBG、FINS、HOMA-IR均高于健康对照组(P<0.01或P<0.05),主证中肝肾阴虚证、阴阳两虚证及兼证证中湿热证患者血清CRP、FBG、FINS、HOMA-IR较其他3组均明显增高(P<0.01或P<0.05)。血清CRP与FINS、HOMA-IR呈正相关关系。结论:血液透析营养不良患者普遍存在微炎症状态及胰岛素抵抗,微炎症状态及胰岛素抵抗密切相关,在肝肾阴虚证、阴阳两虚证、湿热证表现最明显。Objective： To study the relationship between C-reactive protein（CRP） and insulin resistance in maintenance hemodialysis patients（MHD） with malnutrition and the syndrome patterns in TCM differential diagnostics.Methods： Selected 114 MHD patients with malnutrition according to subjective global assessment（SGA）.All patients were carried out syndrome differentiation according to the standard of the syndrome differentiation of TCM,Healthy control group included 30 cases.All patients were detected serum CRP,fasting insulin（FINS）,fasting blood sugar（FBS）,Insulin resistance was evaluated using HOMA-IR.Investigated the relationship between the laboratory parameters and the syndrome patterns in TCM differential diagnostic.Results： The level of serum CRP,FBG,FINS and HOMA-IR in MHD group were all higher than that in the healthy control group（P〈0.01 or P〈0.05）.CRP,FBG,FINS,HOMA-IR in Yang-deficiency of spleen and kidney syndrome、Yin and Yang deficiency syndrome and turbid damp syndrome patients were higher than that in the other groups obviously（P〈0.01 or 0.05）.Serum CRP in MHD group was positively correlated to FINS,HOMA-IR.Conclusions： The micro-inflammation state and IR are universally reside in MHD malnutrition patients,The micro-inflammation state is correlative with IR,and they are correlative with Yang-deficiency of spleen and kidney syndrome、Yin and Yang deficiency syndrome and turbid damp syndrome.

关 键 词：血液透析 营养不良 C-反应蛋白 胰岛素抵抗 中医证型 

分 类 号：R459.5[医药卫生—治疗学]