慢性移植肾肾病中医辨证分型与移植肾功能的相关性分析

摘要

Objective: To analyze the correlation between syndrome differentiation classification of TCM and renal allograft function in patients with allograft nephropathy (CAN). Methods: 84 patients with CAN and stage of chronic kidney disease (CKD) Ⅱ～ Ⅴ according to clinical diagnostic criteria and CKD staging criteria, were assigned to be evaluated with syndrome differentiation classification of TCM and staging of CKD by measuring SCr (serum creati-nine) and eGFR (estimated glomerular filtration rate). Results: YIN-deficiency type of the lung and kidney was mainly seen in patients with stage of CKD Ⅱ-Ⅲ , Type of deficiency of both QI and YIN, YIN-deficiency type of the kidney and liver were mainly seen in stage of CKD Ⅲ-Ⅳ. 82.1 % patients with YANG-deficiency of spleen and kidney was stage of CKD Ⅳ-Ⅴ. SCr in patients with type of deficiency of both QI and YIN, YIN-deficiency type of the kidney and liver,YANG-deficiency of spleen and kidney was significantly higher than those patients with type of YIN-deficieney type of the lung and kidney. eGFR in patients with type of deficiency of both QI and YIN, YIN-deficiency type of the kidney and liver, YANG-deficiency of spleen and kidney was significantly lower than those patients with type of YIN-deficiency type of the lung and kidney. SCr in patients with type of YANG-deficiency of spleen and kidney was significantly higher than other type of syndrome differentiation of TCM. eGFR in patients with type of YANG-deficiency of spleen and kidney was significantly lower than other type of syndrome differentiation of TCM. Type of stasis was seen in 66CAN patients, with 50%, 66.7%, 84% and 90.5% of patients with stage of CKD Ⅱ ～ Ⅴ. Type of damp obstruction was seen in 72 (85.7%) CAN patients. Type of water-dampness was mainly seen in patients with stage of CKD Ⅱ-Ⅲ ,type of dampness-heat was mainly seen in patients with stage of CKD Ⅲ-Ⅳ,and type of dampness turbidity was mainly seen in patients with stage of CKD Ⅳ～ Ⅴ. Conclusion:There are significant correlation between syndrome differentiation classification of TCM and renal allograft function in patients with CAN.%目的 探讨慢性移植肾肾病(CAN)患者中医辨证分型与移植肾功能的相关性.方法 按CAN的临床及病理诊断标准及慢性肾脏病(CKD)分期标准,选择CAN及CKDⅡ～Ⅴ期患者84例,所有患者均行中医辨证分型,同时检测血清肌酐(SCr)及估算肾小球滤过率(eGFR).结果 CAN患者肺肾气虚证分期以Ⅱ～Ⅲ期为主,脾肾阳虚证82.1％的患者为CKDⅣ～Ⅴ期,气阴两虚证及肝肾阴虚证CKD分期以Ⅲ～Ⅳ期为主.CAN患者气阴两虚证、肝肾阴虚证及脾肾阳虚证SCr显著高于肺肾气虚证,eGFR水平显著低于肺肾气虚证；气阴两虚证及肝肾阴虚证SCr及eGFR水平差异无统计学意义；脾肾阳虚证SCr显著高于其他3型,eGFR水平显著低于其他3型.78.6％(66例)患者兼血瘀证,CKDⅡ、Ⅲ、Ⅳ、Ⅴ期患者中兼血瘀证分别为50％、70％、88％及90.5％.85.7％(72例)患者兼湿阻证,水湿证患者CKD分期以Ⅱ～Ⅲ期为主；湿热证患者以CKD Ⅲ～Ⅴ期为主,湿浊证患者以CKDⅣ～Ⅴ期为主.结论 CAN患者不同中医证型与移植肾功能损伤程度相关.