125例慢性原发性肾小球肾炎中医证候与实验室检查的相关性分析
发布时间：2018-12-18 05:37
【摘要】：目的:收集整理125例慢性原发性肾小球肾炎(Chronic primary glomerulonephritis CPGN)病例,采用回顾性分析方法,观察中医证候分布规律,并比较其与临床实验室检查指标之间的相关性,将中医宏观思维与西医微观思维相结合,使中医辨证论治更加客观、规范。材料与方法:选取2014年10月至2015年11月就诊于辽宁中医药大学附属医院肾内科,病例资料完整的125例CPGN患者作为研究对象,将其按中医辨证分为本证和标证,应用SPSS17.0统计软件分析125例CPGN患者的中医证候与性别、年龄、病程等因素及临床实验室指标是否存在相关性。结果:1.125例CPGN患者性别分布以女性多见;年龄多为38-57岁。2.病程较短,多在1年以内,多数不超过5年。3.中医症状出现频率前五的是腰酸痛、膝软乏力、尿色淡黄、尿中有泡沫、畏寒肢冷。4.中医舌脉出现频率前五的是舌质暗、脉沉、舌质淡、脉细、苔黄。5.CPGN证候以本虚标实为主,本证以肾气虚证多见,标证以湿热+瘀血证多见。6.CKD分期以CKD1期多见,CKD1-3期以肾气虚证多见。7.不同中医证候患者的PRO严重程度及24小时尿蛋白定量无明显差异。8.不同中医证候患者的镜检红细胞个数无明显差异,但两两比较,肾气虚证组与肾阴虚证组之间在镜检红细胞个数总体分布上存在差异(P0.05)。9.本证血清白蛋白正常组与异常组存在差异(P0.01);本证总胆固醇正常组与异常组存在差异(P0.05)。10.肾气虚证组血肌酐高于非肾气虚证组;瘀血证组尿素氮高于非瘀血证组。湿热证组血红细胞高于非湿热证组。(血肌酐、尿素氮、血红细胞均在正常值范围内增高)。结论:1.肾气虚是CPGN的主要发病基础;湿热、瘀血是疾病发展的重要病理因素。2.肾阴虚证组镜检红细胞个数多于肾气虚证组3.肾阳虚证、阴阳两虚证有血清白蛋白低于正常值的现象,但样本数较少,需进一步研究4.肾阴虚证、阴阳两虚证有总胆固醇高于正常值的现象,但样本数较少,需进一步研究。
[Abstract]:Objective: to investigate the distribution of TCM syndromes in 125 cases of chronic primary glomerulonephritis (Chronic primary glomerulonephritis CPGN) by retrospective analysis, and to compare the correlation between TCM syndromes and clinical laboratory examination. The combination of macro-thinking of TCM and micro-thinking of western medicine makes TCM dialectical treatment more objective and standardized. Materials and methods: 125 patients with CPGN were selected from October 2014 to November 2015 in Department of Nephrology, affiliated Hospital of Liaoning University of traditional Chinese Medicine. The correlation of TCM syndromes with sex, age, course of disease and clinical laboratory indexes in 125 patients with CPGN was analyzed by SPSS17.0 software. Results: the sex distribution of 1.125 patients with CPGN was mostly female, the age was 38-57 years old. The course of disease is relatively short, many in 1 year, most do not exceed 5 years 3. 3. TCM symptoms appear in the first five lumbar pain, knee weakness, yellowish urine color, urine foam, cold limbs. 4. 4. In Chinese medicine, the first five types of tongue appear in frequency are dark tongue, deep vein, light tongue, fine vein and yellow fur. 5.CPGN syndrome is characterized by deficiency of kidney qi, deficiency of kidney qi and blood stasis of dampness and heat. 6.CKD stage is more common in CKD1 stage. Kidney qi deficiency syndrome was more common in CKD1-3 stage. 7. 7%. There was no significant difference in PRO severity and 24 hour urinary protein quantification among patients with different TCM syndromes. There was no significant difference in the number of erythrocytes in different TCM syndromes, but there was significant difference in the total distribution of erythrocyte number between kidney qi deficiency syndrome group and kidney yin deficiency syndrome group (P0.05). There was difference between normal group and abnormal group (P0.01), and between normal group and abnormal group (P0.05). The blood creatinine of kidney qi deficiency group was higher than that of non-kidney qi deficiency group, and the urea nitrogen of blood stasis syndrome group was higher than that of non-blood stasis syndrome group. The red blood cell of damp-heat syndrome group was higher than that of non-damp-heat syndrome group. The levels of serum creatinine, urea nitrogen and erythrocyte were all increased within the normal range. Conclusion: 1. Deficiency of kidney qi is the main pathogenesis of CPGN, dampness and heat and blood stasis are important pathological factors in the development of CPGN. 2. The number of erythrocytes examined by microscope in the group of deficiency of kidney yin was more than that in the group of deficiency of kidney qi. There is a phenomenon that the serum albumin is lower than the normal value in kidney yang deficiency syndrome and yin and yang deficiency syndrome, but the sample number is less, so it is necessary to further study 4. 5%. Kidney yin deficiency syndrome, yin and yang deficiency syndrome have the phenomenon that total cholesterol is higher than normal value, but the sample number is less, need further study.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5
，
本文编号：2385431
[Abstract]:Objective: to investigate the distribution of TCM syndromes in 125 cases of chronic primary glomerulonephritis (Chronic primary glomerulonephritis CPGN) by retrospective analysis, and to compare the correlation between TCM syndromes and clinical laboratory examination. The combination of macro-thinking of TCM and micro-thinking of western medicine makes TCM dialectical treatment more objective and standardized. Materials and methods: 125 patients with CPGN were selected from October 2014 to November 2015 in Department of Nephrology, affiliated Hospital of Liaoning University of traditional Chinese Medicine. The correlation of TCM syndromes with sex, age, course of disease and clinical laboratory indexes in 125 patients with CPGN was analyzed by SPSS17.0 software. Results: the sex distribution of 1.125 patients with CPGN was mostly female, the age was 38-57 years old. The course of disease is relatively short, many in 1 year, most do not exceed 5 years 3. 3. TCM symptoms appear in the first five lumbar pain, knee weakness, yellowish urine color, urine foam, cold limbs. 4. 4. In Chinese medicine, the first five types of tongue appear in frequency are dark tongue, deep vein, light tongue, fine vein and yellow fur. 5.CPGN syndrome is characterized by deficiency of kidney qi, deficiency of kidney qi and blood stasis of dampness and heat. 6.CKD stage is more common in CKD1 stage. Kidney qi deficiency syndrome was more common in CKD1-3 stage. 7. 7%. There was no significant difference in PRO severity and 24 hour urinary protein quantification among patients with different TCM syndromes. There was no significant difference in the number of erythrocytes in different TCM syndromes, but there was significant difference in the total distribution of erythrocyte number between kidney qi deficiency syndrome group and kidney yin deficiency syndrome group (P0.05). There was difference between normal group and abnormal group (P0.01), and between normal group and abnormal group (P0.05). The blood creatinine of kidney qi deficiency group was higher than that of non-kidney qi deficiency group, and the urea nitrogen of blood stasis syndrome group was higher than that of non-blood stasis syndrome group. The red blood cell of damp-heat syndrome group was higher than that of non-damp-heat syndrome group. The levels of serum creatinine, urea nitrogen and erythrocyte were all increased within the normal range. Conclusion: 1. Deficiency of kidney qi is the main pathogenesis of CPGN, dampness and heat and blood stasis are important pathological factors in the development of CPGN. 2. The number of erythrocytes examined by microscope in the group of deficiency of kidney yin was more than that in the group of deficiency of kidney qi. There is a phenomenon that the serum albumin is lower than the normal value in kidney yang deficiency syndrome and yin and yang deficiency syndrome, but the sample number is less, so it is necessary to further study 4. 5%. Kidney yin deficiency syndrome, yin and yang deficiency syndrome have the phenomenon that total cholesterol is higher than normal value, but the sample number is less, need further study.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5
，
本文编号：2385431
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