糖尿病肾病中医证候分布研究

Distribution of TCM syndromes of diabetic nephropathy

目的探讨糖尿病肾病(DN)的中医证候特征、分布及演变规律。方法基于"十一五"临床数据采集平台,对DN中医证候进行多中心、分层、横断面调查。结果 DN症状以神疲乏力、咽干口渴、面足浮肿、口唇舌紫,或紫暗、瘀斑、舌下络脉色紫怒张等多见;气虚证、血瘀证3期构成比均在60%以上,阴虚构成比呈下降趋势,而阳虚呈现上升趋势,Ⅳ、Ⅴ期普遍存在湿浊证,Ⅴ期血虚证构成比为80%;证素组合多达几十种,组合规律表现为随病程发展由少及多、由简单及复杂趋势。结论 DN证候具有虚实夹杂、证素组合等多维复杂性特点,但其证候分布及演变具有一定规律性。

Objective To discuss the characteristics,distribution and development laws of TCM syndromes of diabetic nephropathy（DN）.Methods The multicenter,stratified and cross-sectional study was conducted on TCM syndromes based on clinical data collection platform.Results The common TCM syndromes of DN included lassitude of spirit and fatigue,dry throat and mouth,dropsy of face and foot,purplish or dark purplish lips and tongue with stasis maculae,and purple and engorgement of sublingual collateral vessels.The constituent ratio of qi-deficiency syndrome and blood-stasis syndrome in three phases of DN were all over 60%,that of yin-deficiency syndrome tended to decrease and that of yang-deficiency syndrome tended to increase.Dampness-turbidity syndrome was observed in IV and V phases of DN.The constituent ratio of blood-deficiency syndrome was 80% in V phase of DN.The combination of syndrome factors reached dozens and showed the trend as follows： from less to more and from simple to complex.Conclusion TCM syndromes of DN have the characteristics of deficiency complicated with excessiveness,and syndrome factor combination,but the syndrome distribution and development has some regularity.