肾病综合征的中医证候与临床理化指标的相关性研究  

A study on the correlation between TCM syndromes and clinical physiochemical index of nephrotic syndrome

作　　者：李洁[1] 王东[2] 王亿平[2] LI Jie;WANG Dong;WANG Yiping

机构地区：[1]安徽中医药大学,安徽合肥230038 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医临床研究》2023年第6期15-19,共5页Clinical Journal Of Chinese Medicine

基　　金：安徽中医药领军人才项目[中医药发展秘﹝2018﹞23号];2020年度安徽中医药大学校级教学研究重点项目(2020xjjy_zd026);2020年度安徽高校自然科学研究重点项目(KJ2020A0402);2021安徽省重大疑难疾病中西医协同攻关项目计划(中医药发展秘[2021]70号);2021省级医疗卫生重点专科建设项目;2021安徽省重点研究与开发计划项目(人口健康专项,202104j07020014)。

摘　　要：目的:研究分析肾病综合征(Nephrotic Syndrome,NS)的中医证候、临床理化指标特点并初步探究两者的相关性,进而为临床中医辨证及治疗提供一定的参考价值。方法:回顾性收集自2020年5月―2021年11月在肾内科诊断为NS并收治入院的患者102例,根据中医辨证将其划分为风水泛滥证、湿热蕴结证、肾络瘀阻证、脾肾阳虚证、肝肾阴虚证5组。运用Kruskal-Wallis H秩和检验比较5组的尿白蛋白/尿肌酐(Urinary Albumin/Creatinine Ratio,ACR)、尿总蛋白/尿肌酐(Urinary protein/Creatinine Ratio,TPCR)、24 h尿蛋白定量(24-hour Urinary Protein Quantity,24 h Upro)、尿素氮(Blood Ure Nitrogen,BUN)、胱抑素C(Cystatin C,CysC)、血肌酐(Serum Creatinine,Scr)、血尿酸(Uric Acid,UA)及血浆总蛋白(Total Protein,TP)、血浆白蛋白(Albumin,ALB)、三酰甘油(Triglyceride,TG)、总胆固醇(Total Cholesterol,TC)、脂蛋白a(Lipoprotein a,LP-a)、低密度脂蛋白(Low Density Lipoprotein,LDL)的差异及与NS的中医证候的相关性。结果:在中医证候分型里湿热蕴结证居多,共30例(29.41%),其次是脾肾阳虚证[25例(24.51%)]、风水泛滥证[18例(17.65%)]、肾络瘀阻证[17例(16.67%)]、肝肾阴虚证[12例(11.76%)]。其中男66例,女36例,平均年龄(49.84±18.04)岁,5组中脾肾阳虚证患者平均年龄最大,各组患者性别及年龄的差异无统计学意义(P>0.05)。与其他4组中医证候相比,湿热蕴结证的ACR、TPCR、24 h Upro、TG、TC、LP-a、LDL水平偏高,TP、ALB水平偏低,在中医证型中的差异有统计学意义(P<0.05);各组中BUN、Cys C、Scr、UA这4个指标的差异无统计学意义(P>0.05)。结论:NS的中医证候与ACR、TPCR、24 h Upro、TC、TG、LP-a、LDL等指标存在一定相关,可为鉴别NS中医证候提供参考依据。Objective:To study and analyze the characteristics of traditional Chinese medicine syndromes and clinical physicochemical indexes of nephrotic syndrome(NS),and preliminarily explore the correlation between them,so as to provide certain reference value for clinical TCM syndrome differentiation and treatment.Methods:102 patients diagnosed with nephrotic syndrome from May 2020 to November 2021 were retrospectively analyzed.According to TCM syndrome differentiation,they were divided into five groups:the syndrome of flooding with wind and water,the syndrome of dampness-heat accumulation,the syndrome of renal collateral stasis,the syndrome of Yang(阳)deficiency of spleen and kidney,and the syndrome of Yin(阴)deficiency of liver and kidney.Kruskal-Wallis H rank sum test was used to compare urinary albumin/urinary creatinine(ACR),urinary total protein/urinary creatinine(TPCR),24 h urinary protein quantification(24 h Upro),urea nitrogen(BUN),cystatin C(Cys C),serum creatinine(Scr)and serum uric acid(UA),plasma total protein(TP),plasma albumin(ALB),triglyceride(TG),total cholesterol(TC),lipoprotein a(LP-a),low density lipoprotein(LDL)in 5 groups,and the correlation between the above indexes and TCM syndromes of NS.Results:In TCM syndrome classification,dampness-heat accumulation syndrome was the most common(30 cases,29.41%),which was followed by spleen and kidney Yang deficiency syndrome(25 cases,24.51%),flood with wind and water syndrome(18 cases,17.65%),renal collateral stasis syndrome(17 cases,16.67%),liver and kidney Yin deficiency syndrome(12 cases,11.76%).There were 66 males and 36 females,with an average age of(49.84±18.04)years.The average age of Yang deficiency spleen and kidney syndrome was the largest among the 5 groups,and there was no significant difference in gender and age among all groups(P>0.05).Compared with the other 4 groups of TCM syndrome,the levels of ACR,TPCR,24 h Upro,TG,TC,LP-a and LDL of dampness-heat accumulation syndrome were higher,while the levels of TP and ALB were lower,and the differenc

关 键 词：肾病综合征 中医证候 理化指标 相关性 

分 类 号：R692[医药卫生—泌尿科学]