Ⅳ期糖尿病肾病患者中医辨证分型与“血瘀”状态相关实验室指标的规律性研究  

Study on the regularity of laboratory indicators related to TCM syndrome differentiation and typing and "blood stasis" status in patients with stage Ⅳ diabetic nephropathy

作　　者：赵雯红[1] 张江华[2] 孙姗姗[1] 牛姝 ZHAO Wenhong;ZHANG Jianghua;SUN Shanshan(Department of Nephrology, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, Hebei 050051)

机构地区：[1]河北省石家庄市中医院肾内科,河北石家庄050051 [2]河北医科大学中西医结合学院中医基础教研室,河北石家庄050017 [3]河北省石家庄市第一医院内分泌二科,河北石家庄050011

出　　处：《河北中医》2019年第3期337-341,371,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省科技计划项目(编号:152777162)

摘　　要：目的研究Ⅳ期糖尿病肾病(DN)患者中医辨证分型与"血瘀"状态相关实验室指标的规律性。方法回顾性横断面调查分析271例Ⅳ期DN患者的中医证型分布情况,并测定尿白蛋白排泄率(UAER)、血肌酐(Cr)、糖化血红蛋白(HbA_1c)及"血瘀"状态相关实验室指标总胆固醇(TC)、甘油三酯(TG)、同型半胱氨酸(Hcy)、纤维蛋白原(FIB)、红细胞沉降率(ESR)、血小板计数(PLT)。结果本研究271例Ⅳ期DN患者中,脾肾阳虚兼血瘀证所占比例最高,其次为脾肾阳虚兼湿浊证,气阴两虚兼血瘀证所占比例最低。与其余3个证型比较,脾肾阳虚兼湿浊证、气血两虚兼血瘀证、气血两虚兼湿浊证UAER均升高(P<0.05);与脾肾阳虚兼湿浊证比较,气血两虚兼湿浊证UAER升高(P<0.05);与其余4个证型比较,气血两虚兼血瘀证、气血两虚兼湿浊证Cr均升高(P<0.05),但气血两虚兼血瘀证与气血两虚兼湿浊证Cr比较差异无统计学意义(P>0.05);与其余5个证型比较,气阴两虚兼血瘀证HbA_1c升高(P<0.05)。与其余3个证型比较,脾肾阳虚兼血瘀证、脾肾阳虚兼湿浊证、气血两虚兼湿浊证TC均升高(P<0.05),但脾肾阳虚兼血瘀证、脾肾阳虚兼湿浊证、气血两虚兼湿浊证三者之间比较差异均无统计学意义(P>0.05);与其余4个证型比较,脾肾阳虚兼湿浊证、气血两虚兼湿浊证TG、Hcy均升高(P<0.05),但脾肾阳虚兼湿浊证与气血两虚兼湿浊证比较差异无统计学意义(P>0.05);与气阴两虚兼血瘀证比较,脾肾阳虚兼血瘀证、气血两虚兼血瘀证FIB均较高(P<0.05),但脾肾阳虚兼血瘀证与气血两虚兼血瘀证比较差异无统计学意义(P>0.05);与其余3个证型比较,气阴两虚兼血瘀证、气血两虚兼血瘀证、气血两虚兼湿浊证ESR较高(P<0.05),但气阴两虚兼血瘀证、气血两虚兼血瘀证、气血两虚兼湿浊证三者之间比较差异均无统计学意义(P>0.05);与其余3个证型比较,脾肾阳虚兼血瘀证、�Objective To study the regularity of laboratory indicators related to TCM syndrome differentiation and typing and "blood stasis" status in patients with stage Ⅳ diabetic nephropathy (DN). Methods A retrospective cross sectional study was conducted to investigate the distribution of syndromes in patients with stage IV DN, the urinary albumin excretion rate (UAER), serum creatinine (Cr), glycosylated hemoglobin (HbA 1c) and laboratory indicators related to "blood stasis" status, including total cholesterol (TC), triglyceride (TG), homocysteine (Hcy), fibrinogen (FIB), erythrocyte sedimentation rate (ESR), and platelet (PLT) were measured. Results In stage Ⅳ DN patients, the spleen kidney yang deficiency with blood stasis syndrome accounted for the highest proportion, followed by the spleen kidney yang deficiency with dampness turbidity syndrome, and the qi-yin deficiency with blood stasis syndrome accounted for the lowest proportion. Respectively compared with the other three syndromes, the levels of UAER in spleen kidney yang deficiency with dampness turbidity syndrome, qi-blood deficiency with blood stasis syndrome, qi-blood deficiency with dampness turbidity syndrome were increased ( P <0.05). Compared with spleen kidney yang deficiency with dampness turbidity syndrome, the level of UAER in qi-blood deficiency with dampness turbidity syndrome was increased ( P <0.05). Compared with the other four syndromes the levels of Cr in qi-blood deficiency with blood stasis and qi-blood deficiency dampness with turbidity syndrome were increased ( P <0.05), but there was no significant difference in the levels of Cr between the qi-blood deficiency with blood stasis syndrome and qi-blood deficiency with dampness turbidity syndrome ( P > 0.05 ). Compared with the other five syndromes, the level of HbA 1c in the qi-yin deficiency with blood stasis syndrome was increased ( P <0.05). Compared with the other three syndromes,the lelves of TC in spleen kidney Yang deficiency with blood stasis syndrome, spleen kidney yang defici

关 键 词：糖尿病肾病 辨证分型 血瘀 

分 类 号：R692.39[医药卫生—泌尿科学] R241[医药卫生—外科学]