糖尿病肾病中医辨证分型与生化指标相关性研究

发布时间：2018-11-11 12:31

【摘要】：目的：观察糖尿病肾病中医证型规律,及初步探讨其与肾功能、尿蛋白、血糖和血脂的相关性。方法：对335例DN患者的分期、中医主证和标证进行分析统计,并检测24h尿蛋白定量、血尿素氮(BUN)、血肌酐(SCr)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)。结果：临床前期136例,早期102例,临床期55例,终末期42例,其中临床前期及早期患者中均为气阴两虚证发生率最高,其次为阴虚燥热证,均未出现阴阳两虚证；临床期、终末期患者中阴阳两虚证发生率上升至首位,分别占63.64%、80.95%。阴虚燥热证和气阴两虚证患者的尿蛋白、BUN和SCr差异无统计学意义(p0.05)。而与阴虚燥热证和气阴两虚证相比较,阴阳两虚证患者的尿蛋白、BUN、SCr、TC、TG、LDL-C明显升高,差异有统计学意义(p＜0.01),但糖化血红蛋白与中医证型无关；与瘀血证比较,痰湿证及水湿证的尿蛋白、BUN、SCr、TC、 TG、LDL-C水平明显升高,差异有统计学意义(p0.05或p0.01)。水湿证患者SCr水平高于痰湿证,二者相比较差异有统计学意义(p0.01)。结论：DN演变规律阴虚燥热-气阴两虚-阴阳两虚。糖尿病肾病患者的尿蛋白、BUN、SCr、TC、TG、LDL-C水平与中医证型可能存在一定的相关性。
[Abstract]:Objective: to investigate the relationship between diabetic nephropathy and renal function, urine protein, blood glucose and blood lipid. Methods: the staging, TCM main syndrome and standard syndrome of 335 patients with DN were analyzed and statistically analyzed, and 24 hours urine protein quantification, blood urea nitrogen (BUN), serum creatinine, (SCr), glycosylated hemoglobin, (HbAlc), total cholesterol (TC), were detected. Triglyceride (TG), low density lipoprotein (LDL-C). Results: 136 cases of pre-clinical stage, 102 cases of early stage, 55 cases of clinical stage and 42 cases of end-stage. In the clinical stage, the incidence of yin and yang deficiency syndrome increased to the first place, accounting for 63.64% and 80.955cm respectively. There was no significant difference in urine protein, BUN and SCr between patients with deficiency of Yin and deficiency of Qi and Yin (p0. 05). Compared with the syndrome of deficiency of Yin and deficiency of Qi and Yin, the urine protein and BUN,SCr,TC,TG,LDL-C of the patients with Yin and Yang deficiency were significantly increased (p < 0. 01), but glycosylated hemoglobin was not related to the type of TCM syndrome. Compared with blood stasis syndrome, the level of urine protein and BUN,SCr,TC, TG,LDL-C in phlegm-dampness syndrome and water-dampness syndrome were significantly increased (p0. 05 or p0. 01). The level of SCr in patients with water dampness syndrome was higher than that in phlegm dampness syndrome, and the difference was statistically significant (p 0.01). Conclusion: the law of DN evolution is deficiency of yin and heat, deficiency of qi and yin, deficiency of yin and yang. The level of urinary protein and BUN,SCr,TC,TG,LDL-C in diabetic nephropathy patients may be correlated with TCM syndrome type.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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