慢性移植肾肾病中医辨证分型与移植肾功能的相关性分析  

Correlation between Syndrome Differentiation Classification of TCM and Renal Allograft Function in Patients with Chronic Allograft Nephropathy

作　　者：李夏玉[1] 李恒[1] 贺学林[1] 程军[1] 范永升 陈江华[1] 

机构地区：[1]浙江大学医学院附属第一医院,浙江杭州310003 [2]范永升全国名老中医药专家传承工作室,浙江杭州310005

出　　处：《中国中医急症》2012年第12期1899-1900,1932,共3页Journal of Emergency in Traditional Chinese Medicine

基　　金：浙江省中医药科技计划项目(No.2010ZA052)

摘　　要：目的探讨慢性移植肾肾病（CAN）患者中医辨证分型与移植肾功能的相关性。方法按CAN的临床及病理诊断标准及慢性肾脏病（CKD）分期标准,选择CAN及CKDⅡ~Ⅴ期患者84例,所有患者均行中医辨证分型,同时检测血清肌酐（SCr）及估算肾小球滤过率（eGFR）。结果 CAN患者肺肾气虚证分期以Ⅱ~Ⅲ期为主,脾肾阳虚证82.1%的患者为CKDⅣ~Ⅴ期,气阴两虚证及肝肾阴虚证CKD分期以Ⅲ~Ⅳ期为主。CAN患者气阴两虚证、肝肾阴虚证及脾肾阳虚证SCr显著高于肺肾气虚证,eGFR水平显著低于肺肾气虚证;气阴两虚证及肝肾阴虚证SCr及eGFR水平差异无统计学意义;脾肾阳虚证SCr显著高于其他3型,eGFR水平显著低于其他3型。78.6%（66例）患者兼血瘀证,CKDⅡ、Ⅲ、Ⅳ、Ⅴ期患者中兼血瘀证分别为50%、70%、88%及90.5%。85.7%（72例）患者兼湿阻证,水湿证患者CKD分期以Ⅱ~Ⅲ期为主;湿热证患者以CKDⅢ~Ⅴ期为主,湿浊证患者以CKDⅣ~Ⅴ期为主。结论 CAN患者不同中医证型与移植肾功能损伤程度相关。Objective： To analyze the correlation between syndrome differentiation classification of TCM and renal allograft function in patients with allograft nephropathy（CAN）.Methods： 84 patients with CAN and stage of chronic kidney disease（CKD） Ⅱ~Ⅴ according to clinical diagnostic criteria and CKD staging criteria,were assigned to be evaluated with syndrome differentiation classification of TCM and staging of CKD by measuring SCr（serum creatinine） and eGFR（estimated glomerular filtration rate）.Results： YIN-deficiency type of the lung and kidney was mainly seen in patients with stage of CKDⅡ-Ⅲ,Type of deficiency of both QI and YIN,YIN-deficiency type of the kidney and liver were mainly seen in stage of CKD Ⅲ-Ⅳ.82.1% patients with YANG-deficiency of spleen and kidney was stage of CKD Ⅳ-Ⅴ.SCr in patients with type of deficiency of both QI and YIN,YIN-deficiency type of the kidney and liver,YANG-deficiency of spleen and kidney was significantly higher than those patients with type of YIN-deficiency type of the lung and kidney.eGFR in patients with type of deficiency of both QI and YIN,YIN-deficiency type of the kidney and liver,YANG-deficiency of spleen and kidney was significantly lower than those patients with type of YIN-deficiency type of the lung and kidney.SCr in patients with type of YANG-deficiency of spleen and kidney was significantly higher than other type of syndrome differentiation of TCM.eGFR in patients with type of YANG-deficiency of spleen and kidney was significantly lower than other type of syndrome differentiation of TCM.Type of stasis was seen in 66CAN patients,with 50%,66.7%,84% and 90.5% of patients with stage of CKDⅡ～Ⅴ.Type of damp obstruction was seen in 72（85.7%） CAN patients.Type of water-dampness was mainly seen in patients with stage of CKDⅡ-Ⅲ,type of dampness-heat was mainly seen in patients with stage of CKDⅢ-Ⅳ,and type of dampness turbidity was mainly seen in patients with stage of CKD Ⅳ~Ⅴ.Conclusion：There are significant correlatio

关 键 词：慢性移植肾肾病 中医辨证分型 移植肾功能 

分 类 号：R617[医药卫生—外科学]