慢性肾功能衰竭微炎症状态与中医证型关系研究

Relation study between micro-inflammatory state of chronic renal failure and traditional Chinese medical type of syndrome

目的探讨慢性肾功能衰竭(CRF)微炎症状态及其与中医证型的关系。方法选择非透析的CRF患者69例,测定其C反应蛋白(CRP)、IL-6、TNF-α、Alb、Hb及SCr,并与健康对照组20例比较。结果①CRF组血CRP、IL-6及TNF-α均显著高于健康对照组(P均<0.01),微炎症状态发生率35%。②CRP增高组Alb低于CRP不增高组(P<0.05)。③CRF 2期、3期及4期CRP、IL-6及TNF-α均无显著性差异(P>0.05)。④各中医证型CRP、IL-6及TNF-α均高于健康对照组(P<0.01或0.05),脾肾阳虚型及阴阳两虚型CRP及IL-6低于肝肾阴虚型(P<0.01或0.05),而脾肾气虚及气阴两虚型CRP、IL-6与肝肾阴虚无显著性差异(P>0.05)。夹湿浊证及夹湿热证CRP及IL-6高于各型虚证(P<0.05)。结论①CRF普遍存在微炎症状态,微炎症状态是引起营养不良的重要原因。②各中医证型均存在微炎症状态,但不同证型微炎症状态程度有一定差异,其中夹湿浊或夹湿热证者微炎症状态程度最明显。微炎症状态程度可作为湿浊证及湿热证的辨证参考。

Objective It is to study the micro- inflammatory state of chronic renal failure （CRF） and the relation between it and traditional Chinese medical type of syndrome. Methods 69 CRF patients that were lack of dialysis were chosen. Their C reactive protein （CRP）, IL-6, TNF-α, Alb, Hb and SCr were determined and compared with that of 20 cases in health control group. Results ①CRP, IL-6 and TNF-α in CRF group were all significantly higher than that in health control group （P 〈 0.01 ）. The incidence rate of micro-inflammatory state was 35 % . ②Alb in CRP heighten group was lower than that in CRP non-heighten group （P〈0.05）. ③There were no significant difference on CRP, IL- 6 and TNF-α among stage 2, stage 3 and stage 4 of CRF （P 〉0.05）. ④CRP, IL- 6 and TNF-α in each traditional Chinese medical type of syndrome were all higher than that in health control group （P 〈 0.01 or 0.05）. CRP and IL- 6 in splenonephro-Yang deficiency type and both Yin and Yang deficiency type were all lower than that in hepatic and renal Yin deficiency type （P 〈 0.01 or 0.05）. CRP and IL- 6 in spleen and renal vital energy deficiency type and both vital energy and Yin deficiency type had no significant difference compared with that in hepatic and renal yin deficiency type （P〉0.05）. CRP and IL- 6 in humid turbid syndrome and humid heat syndrome were all higher than that in every type of deficient syndrome （P 〈 0.05）. Conclusion ①The micro-inflammatory state is universally reside in CRF. The micro-inflammatory state is important reason that causing malnutrition. ②The micro-inflammatory state is reside in every traditional Chinese medical type of syndrome. But the degree of the micro-inflammatory state in different type of syndrome has definite difference, among the total, the degree of the micro-inflammatory state in humid turbid syndrome and humid heat syndrome are the most obvious. The degree of the micro-inflammatory state can be taken as differentiation of symptoms and signs reference of humid turbid syndrome and humid heat syndrome.