315例成人型多囊肾中医虚证证型与临床特征相关性研究  

Correlation of Traditional Chinese Medicine Deficiency Syndrome Types with Clinical Features of Autosomal Dominant Polycystic Kidney Disease:An Analysis of 315 Cases

作　　者：石华林 金钟大 SHI Hua-Lin;JIN Zhong-Da(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Nephrology,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广州中医药大学第二附属医院肾内科,广东广州510120

出　　处：《广州中医药大学学报》2023年第3期533-537,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81373523)。

摘　　要：【目的】总结分析成人型多囊肾(ADPKD)的中医虚证证型与临床特征的相关性。【方法】对315例ADPKD患者进行回顾性研究,收集患者的性别、年龄、收缩压、舒张压、血肌酐、肾小球滤过率(eGFR)、血红蛋白、血尿酸、总胆固醇、甘油三酯、尿素氮等临床特征,将本虚证分为脾肾气虚证、气阴两虚证、肝肾阴虚证、脾肾阳虚证等4种证型,分析中医虚证证型与临床特征的相关性。【结果】(1)各本虚证之间的年龄、收缩压、血肌酐、eGFR、血红蛋白、血尿酸、尿素氮比较,差异有统计学意义(P<0.05或P<0.01)。其中脾肾阳虚证患者年龄最大,收缩压最高,血肌酐最高,eGFR最低,这表明脾肾阳虚证患者的肾功能损害最严重。(2)采用单因素Logistic回归方程法筛选出有显著性差异的变量,再进行多因素Logistic回归分析,结果显示:消除自变量混杂因素后,ADPKD患者中医虚证分型与年龄的大小和血肌酐、总胆固醇、尿素氮的水平高低有关,差异均有统计学意义(P<0.05或P<0.01)。【结论】ADPKD患者以脾肾阳虚证的肾功能损害最严重,其中医证型与年龄分布、血肌酐、总胆固醇、尿素氮等临床特征密切相关。Objective To explore the correlation between the traditional Chinese medicine(TCM) deficiency syndrome types and clinical features in autosomal dominant polycystic kidney disease(ADPKD). Methods A retrospective study was conducted in 315 patients with ADPKD. The clinical information of gender,age,systolic blood pressure, diastolic blood pressure, serum creatinine, estimated glomerular filtration rate(eGFR),hemoglobin, blood uric acid, total cholesterol, triglyceride and blood urea nitrogen in the 315 patients was collected. The deficiency syndromes of the patients were classified into four types, i.e., spleen and kidney qi deficiency syndrome,qi and yin deficiency syndrome,liver and kidney yin deficiency syndrome,and spleen and kidney yang deficiency syndrome. And then the correlation of the deficiency syndrome types with the clinical features of the patients was analyzed. Results (1)There were significant differences in age, systolic blood pressure, serum creatinine, e GFR, hemoglobin, blood uric acid and urea nitrogen among various deficiency syndromes(P<0.05 or P<0.01). The patients with spleen and kidney yang deficiency were the oldest,had the highest systolic blood pressure and serum blood creatinine level,and presented the lowest eGFR,which indicated that the patients with spleen and kidney yang deficiency syndrome had the severest impairment of renal function.(2)One-way logistic regression equation method was used to screen out the variables with significant differences,and then multi-factor logistic regression analysis was performed. The results showed that after eliminating the confounding factors of the independent variables,the TCM deficiency syndromes were correlated with the age and the levels of serum creatinine,total cholesterol and blood urea nitrogen,and the differences were all statistically significant(P<0.05 or P<0.01). Conclusion Patients with ADPKD of spleen and kidney yang deficiency syndrome have the severest renal function impairment, and the syndrome types of ADPKD patients are closely r

关 键 词：成人型多囊肾 中医虚证 脾肾阳虚 临床特征 回顾性研究 LOGISTIC回归分析 

分 类 号：R277.5[医药卫生—中医学]