259例常染色体显性遗传型多囊肾病患者中医证型分析  

Analysis on TCM Syndrome of 259 Cases with Autosomal Dominant Polycystic Kidney Disease

作　　者：张小鹿[1] 王振华 郁胜强[3] 王怡[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]杭州市半山人民医院,浙江杭州310022 [3]中国人民解放军第二军医大学附属上海长征医院,上海200003

出　　处：《中国中医药信息杂志》2012年第12期16-19,共4页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：上海市高校创新团队建设项目(2010-2012年)

摘　　要：目的通过对常染色体显性遗传型多囊肾病(简称"多囊肾病")的临床病例调查,初探多囊肾病的中医证型规律,及其与年龄、病程及肾功能情况的关系。方法采用现场问卷调查的方法,收集259例多囊肾病患者中医证候、肾功能及影像学检查等资料,进行流行病学的统计和分析,探索多囊肾病中医证候规律。结果多囊肾病患者出现概率超过1%的症状有腰膝酸软、腰背胀痛、舌紫黯、神疲乏力等27个症状。因子分析和聚类分析显示,在259例多囊肾病患者中常共同出现的症状有4类:第1类为虚兼气滞血瘀型,共76例,占29.34%;第2类为脾肾阳虚兼湿热型,共91例,占35.14%;第3类为寒湿凝聚型,共30例,占11.58%;第4类为肝肾阴虚型,共62例,占23.94%。肾虚兼气滞血瘀型、寒湿凝聚型血肌酐水平较脾肾阳虚兼湿热型、肝肾阴虚型降低;多囊肾病患者不同病程和慢性肾脏病分期的中医证型分布差异有统计学意义。结论多囊肾病中医证型可分为肾虚兼气滞血瘀、寒湿凝聚、脾肾阳虚兼湿热、肝肾阴虚4型。因子分析和聚类分析在一定程度上揭示了多囊肾病的中医证型特点,在中医证型研究中具有一定应用价值。Objective To investigate the TCM patterns of autosomal dominant polycystic kidney disease （ADPKD）, and explore its relationship with age, course and renal function by collection of clinical cases. Methods The materials of 259 cases of ADPKD patients including TCM symptoms, demographics, renal function and imaging information were collected by means of the site survey methods. The TCM patterns of ADPKD were explored by statistical and epidemiological analysis. Results In 259 cases of ADPKD patients, 76 patients （29.34%） were attributed to kidney deficiency with qi stagnation and blood stasis, 30 patients （11.58%） were attributed to stagnation of dampness-cold, 91 patients （35.14%） were attributed to deficiency in spleen and kidney yang with dampness-heat, 62 patients （23.94%） were attributed to yin deficiency of liver and kidney. The serum creatinine of kidney deficiency with qi stagnation and blood stasis patients and stagnation of dampness-cold patients was significantly lower than deficiency in spleen and kidney yang with dampness-heat patients and yin deficiency of liver and kidney patients. TCM patterns were significantly different in different disease duration and CKD stages. Conclusion The patterns of ADPKD can be divided into four types： kidney deficiency with qi stagnation and blood stasis, stagnation of dampness-cold, deficiency in spleen and kidney yang with dampness-heat, and yin deficiency of liver and kidney. To some extent, the TCM pattern features of ADPKD can be revealed by factor and cluster analysis. The application of multi-statistics has a certain value in study of TCM syndrome.

关 键 词：常染色体显性遗传型多囊肾病 中医证型 因子分析 聚类分析 

分 类 号：R277.52[医药卫生—中医学]