糖尿病肾病中医证型分布特征及其与血清纤维化因子的关系

摘要

Objective To investigate the distribution characteristics of traditional Chinese medicine; symptoms in diabctic nephropathy( DM ) and its relationship vviLh serum fibrosis factors including type Ⅲ collagen fiber{ CoL-Ⅲ ),Lype Ⅳ collagen fiber( CoL-Ⅳ ) and Laminin( LN ). Methods The clinical stages and syndrome Lype of LradiLional Chinese medicine were described in 360 paLienLs wkh diabeLic nephropaLhy by means of sLaLisLics,and enzyme-linked immnnosorbenL assay was performed to detect the level of CoL-Ⅲ,CoL-Ⅳ and LN. Results There were 136 DM paLienLs in stage Ⅲ, 144 patients in stage Ⅳ, and 80 patienLs in sLage V. PaLienLs wkh syndrome type of traditional Chinese medicine in sLage Ⅲ mainly showed Yin deficiency of liver and kidney , while patienLs in stage Ⅳ mainly showed deficiency of Qi and Yin,and paLienLs in sLage V showed Yang deficiency of spleen and kidney. There was the law of developmenL from Yin deficiency Lo dual deficiency of Qi and Yin,Lhen Lo deficiency of Yang in LradiLional Chinese medicine symptoms in DN patients. The levels of CoL-Ⅲ , CoL-Ⅳ and LN increased in DM paLenLs in each sLage( P ＜ 0. 05 ); The increase was highesL in patients in stage Ⅲ,but. lowest in patients in sLage V( P＜0.05 ). Conclusion DiabeLic nephmpaLhy develops according to the law from Yin deficiency to dual deficiency of Qi and Yin, then to deficiency of Yang. Sacrificial traditional Chinese medicine symptoms in diabetic nephropathy is dominaLed by blood stasis and damp-turbidiLy sympLoms. The levels of CoL-Ⅲ,CoL-Ⅳ and LM are not only regarded as the early diagnosis indices of DM,but also have cerLain significance for judgement of DN stage,severky of disease and prognosis.%目的 探讨糖尿病肾病(DN)中医证型分布特征及其与血清Ⅲ型胶原纤维(CoL-Ⅲ)、Ⅳ型胶原纤维(CoL-Ⅳ)、层黏连蛋白(LN)的关系.方法 对360例DN患者的临床分期进行中医证型统计,并采用酶联免疫吸附法检测患者血清CoL-Ⅲ、CoL-Ⅳ、LN水平.结果 DN Ⅲ期136例,DN Ⅳ期144例,DN Ⅴ期80例,Ⅲ期组患者中医证型以肝肾阴虚证为主,Ⅳ期以气阴两虚证为主,Ⅴ期以脾肾阳虚为主,其证型演变规律为阴虚-气阴两虚-阳虚.标证的分布各期则以瘀血和湿浊为多见.DN各期患者血清CoL-Ⅲ、CoL-Ⅳ、LN水平均升高(P＜0.05),其升高呈Ⅲ期＜Ⅳ期＜Ⅴ期(P＜0.05).结论 DN中医证型演变规律为阴虚-气阴两虚-阳虚,标证则以瘀血和湿浊为主,CoL-Ⅲ、CoL-Ⅳ和LN不仅可作为DN的早期诊断指标,对DN的分期、疾病的严重程度及预后判断有一定意义.