不同中医证型慢性肾脏病G5D期维持性血液透析伴甲状旁腺切除术患者相关指标的差异研究  

Study on Differences of Relevant Indexes in Patients with G5D Stage of Chronic Kidney Disease with Different Traditional Chinese Medicine Syndrome Types Who Underwent Maintenance Hemodialysis with Parathyroidectomy

作　　者：甘沛敏 刘琳娜 GAN Peimin;LIU Linna(Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006,China;Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Zhongshan Guangdong 528400,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广州中医药大学附属中山中医院,广东中山528400

出　　处：《新中医》2023年第24期80-85,共6页New Chinese Medicine

基　　金：中山市医疗卫生重点项目(2020B3005)。

摘　　要：目的:观察不同中医证型慢性肾脏病(CKD) G5D期维持性血液透析(MHD)伴甲状旁腺切除术(PTX)患者一般资料、实验室指标的差异。方法:收集不同中医证型患者的一般资料(性别、年龄、透析龄、原发病、开始透析年龄、全段甲状旁腺激素(iPTH)升高至行PTX治疗的间隔时间)及实验室指标[术前和术后1个月血红蛋白(Hb)、iPTH、血钙(Ca)、血磷(P)]。结果:不同中医证型患者年龄及开始透析年龄整体比较,差异均有统计学意义(P<0.05)。其中,肾阳亏虚证患者年龄大于脾阳虚衰证及湿热蕴结证患者,肝肾阴虚证患者年龄大于湿热蕴结证患者,肝肾阴虚证及肾阳亏虚证患者开始透析年龄均大于湿热蕴结证患者,差异均有统计学意义(P<0.05)。不同中医证型患者性别及iPTH升高至行PTX治疗的间隔时间、透析龄整体比较,差异均无统计学意义(P>0.05)。高血压病、肾小球肾炎、肾性贫血及其他基础疾病在不同中医证型患者中占比比较,差异均无统计学意义(P>0.05)。术前,不同中医证型患者Hb、iPTH水平整体比较,差异均有统计学意义(P<0.05)。其中,湿热蕴结证患者Hb水平低于脾阳虚衰证患者,湿热蕴结证与肾阳亏虚证患者iPTH水平均高于脾阳虚衰证和肝肾阴虚证,差异均有统计学意义(P<0.05)。不同中医证型患者血P及血Ca水平整体比较,差异均无统计学意义(P>0.05)。术后1个月,不同中医证型患者Hb水平整体比较,差异有统计学意义(P<0.05)。其中,湿热蕴结证患者Hb水平低于脾阳虚衰证患者,差异有统计学意义(P<0.05)。不同中医证型患者血P、血Ca、iPTH水平整体比较,差异均无统计学意义(P>0.05)。结论:MHD伴PTX术后患者中医证型以脾阳虚衰证为主。不同中医证型患者的年龄、开始透析年龄、术前及术后1个月Hb、i PTH水平存在显著差异。Objective:To observe the differences of general data and laboratory indexes in patients with G5D stage of chronic kidney disease(CKD) with different traditional Chinese medicine(TCM) syndrome types who underwent maintenance hemodialysis(MHD) and parathyroidectomy(PTX).Methods:The general data of patients with different TCM syndorme types were collected,including gender,age,dialysis duration,primary affection,age of starting dialysis,interval between intact parathyroid hormone(iPTH) elevation and PTX,and the laboratory indexes,including hemoglobin(Hb),i PTH,blood calcium(Ca) and blood phosphorus(P).Results:Comparing the age and age of starting dialysis of patients with different TCM syndrome types showed significance in the differences(P<0.05).Specifically,the patients with syndrome of kidney yang depletion were older than those with syndrome of spleen yang deficiency and syndrome of accumulated damp-heat,patients with liver-kidney yin deficiency syndrome were older than those with syndrome of accumulated damp-heat,and patients with syndrome of kidney yang depletion and liver-kidney yin deficiency syndrome firstly received dialysis at an older age than those with syndrome of accumulated damp-heat,differences being significant(P<0.05).There was no significant difference being found in the overall comparisons of gender,interval among iPTH and PTX treatment and dialysis duration among patients with different TCM syndrome types(P>0.05).There was no significant difference being found in the comparisons of proportions of hypertension,glomerular nephropathy,renal anemia and other basic diseases among patients with different TCM syndrome types(P>0.05).Before surgery,the comparisons of levels of Hb and iPTH among patients with different TCM syndrome types(P<0.05).The Hb levels of patients with syndrome of accumulated damp-heat were lower than those of patients with syndrome of spleen yang deficiency,and the iPTH levels of patients with syndrome of accumulated dampheat and syndrome of kidney yang depletion were higher than

关 键 词：慢性肾脏病 G5D期 维持性血液透析 甲状旁腺切除术 中医证型 

分 类 号：R692[医药卫生—泌尿科学]