急性肾功能衰竭患者中医辨证分型与尿蛋白定量的关系

Relationship between Traditional Chinese Medicine Syndrome Differentiation Typing and Urine Protein Quantitation in Patients with Acute Renal Failure

目的:探究急性肾功能衰竭(ARF)患者中医辨证分型与尿蛋白定量的关系。方法:选取2019年1月~2021年1月期间于我院就诊的120例ARF患者作为研究对象,对所有患者进行中医辨证分型,并收集肾脏生化指标(尿蛋白定量、血清肌酐、血清白蛋白)水平,比较不同辨证分型ARF患者肾脏生化指标差异,采用Logistic回归分析模型分析ARF患者不同中医辨证分型与肾脏生化指标的相关性。结果:所有患者中医辨证分型依据数量多少可依次分为湿热内蕴证(31.67%)、水湿浸渍证(27.50%)、脾肾阳虚证(20.83%)、脾肾气虚证(11.67%)、水瘀交阻证(8.33%)。脾肾阳虚证、脾肾气虚证患者尿蛋白定量显著高于其他各证型患者(P<0.05),水湿浸渍证、湿热内蕴证血清肌酐水平显著高于其他各证型患者(P<0.05),脾肾阳虚证、脾肾气虚证患者血清白蛋白水平显著低于除水瘀交阻证其他各证型患者(P<0.05)。Logistic回归分析得出,湿热内蕴证、水湿浸渍证与血清肌酐水平具有显著相关性(P<0.05),脾肾阳虚证、脾肾气虚证与尿蛋白定量、血清白蛋白水平具有显著相关性(P<0.05)。结论:ARF患者临床常见的证型为湿热内蕴证、水湿浸渍证,其中后者尿蛋白定量及血清肌酐表达水平更高,肾功能损害情况更为严重,可为中医证型判断提供一定参考。

Objective:To explore the relationship between TCM syndrome differentiation typing and urine protein quantification in patients with acute renal failure(ARF).Methods:120 patients with ARF who were treated in the hospital between January 2019 and January 2021 were selected as the research subjects.TCM syndrome differentiation typing was performed on all patients,and the levels of renal biochemical indicators(urine protein quantitation,serum creatinine,serum albumin)were collected and the differences in renal biochemical indicators were compared among patients with ARF of different TCM syndrome differentiation types.Logistic regression analysis model was used to analyze the correlation between different TCM syndrome differentiation types and renal biochemical indicators in patients with ARF.Results:The TCM syndrome differentiation types of all patients could be divided into syndrome of interior dampness-heat(31.67%),water-dampness immersion syndrome(27.50%),spleen-kidney Yang deficiency syndrome(20.83%),spleen-kidney Qi deficiency syndrome(11.67%)and blood stasis obstruction syndrome(8.33%)according to the number of types.The quantitative urine protein of patients with spleen-kidney-Yang deficiency and spleen-kidney-Qi deficiency was significantly higher than that of patients with other syndrome types(P<0.05).The serum albumin level of patients with spleen and kidney Yang deficiency and spleen and kidney Qi deficiency was significantly lower than that of patients with other syndromes(P<0.05).Logistic regression analysis showed that syndrome of interior dampness-heat,water-dampness immersion syndrome were significantly correlated with serum creatinine level(P<0.05),and spleen-kidney Yang deficiency syndrome and spleen-kidney Qi deficiency syndrome were significantly correlated with urine protein quantitation and serum albumin level(P<0.05).Conclusion:The common clinical syndromes of patients with ARF are syndrome of interior dampness-heat and water-dampness immersion syndrome.The latter syndrome has higher urine protein quantitation and serum creatinine expression level and more serious renal function damage,which can provide a certain reference for the judgment of TCM syndrome types.