慢性肾脏病3期中医证候分布与实验室指标的相关性研究

The relevance of distribution of traditional chinese medicine syndrome with laboratory indexes of chronic kidney disease in stage 3

目的分析慢性肾脏病（CKD）3期患者中医证候与实验室指标相关性。方法将60例慢性原发性肾小球疾病、CKD3期（肾小球滤过率30-59ml／min）、中医辨证均符合气阴（血）两虚证、肾络瘀痹、风湿内扰证或湿热内蕴证的患者为研究对象，按照统一的标准对患者进行询问调查，并详细填写凋查表。结果60例患者中医证候主要以肾气阴（血）两虚为主，所占比例达60％，湿热内蕴证占2%。风湿内扰证患者的24h尿蛋白定量明显高于非风湿内扰证患者。肾络瘀痹较非肾络瘀痹肾功能下降明显。各证型组间血常规、血尿素氮、血尿酸比较无显著差异。中医证候总积分与24h尿蛋白定量、三酰甘油（TG）和总胆同醇（TC）水平呈正相关，与肾小球滤过率水平呈负相关。结论CKD3期中医证候分布和实验室指标有一定的相关性，对于评估预后、指导临床治疗有一定意义。

Objective To observe the relevance of distribution of traditional chinese medicine （TCM）syndrome with laboratory indexes of chronic kidney disease（CKD）in stage 3. Methods Fulfil ling surveys based on the request of the features of TCM syndromes on the patients which were divided into four parts：deficiency of the kidney-qi-yin（blood）, kidney-collateral blood-stasis, harass with wind dampness and damp heat brewing internally. Sixty cases of primary glomerulopathy and stage 3 CKD were enrolled. Results In 60 cases,patients with deficiency of the kidney-qi-yin（blood）accounted for 60% and damp-heat brewing internally accounted for 2%o. 24 h proteinuria level in Harass with winddampness was higher than no-harass with wind dampness. Renal dysfunction in patients with kidney collateral blood stasis was more severe than in those with no-kidney collateral blood-stasis. There was no statistically significant difference in blood routine, BUN and uric acid. Score of TCM syndrome showed a positive correlation with 24 h proteinuria, triglyccride and total cholesterol, but a negative correlation with GFR. Conclusions There were some correlation between distribution of TCM syndromes and laboratory index in stage 3 CKD.