138例血液透析患者中医证候分布规律的调查

Investigation of the TCM Syndromes Distribution among 138 Cases Treated by Maintenance Hemodialysis

目的:观察138例长期维持性血液透析患者的中医证候分布。方法:通过临床观察138例长期维持性血液透析治疗的患者,研究其中医证候的临床分布特点及影响因素,进行统计分析。结果:(1)MHD患者中单纯虚证患者较多,占53.7%。本虚证以脾肾气虚证最多,占47.1%(65/138)。(2)该组MHD患者本虚证脾肾气虚证患者年龄小于肝肾阴虚证、气阴两虚证、阴阳两虚证,标实兼证中湿热证小于湿浊证(P<0.05);本虚证中脾肾气虚证及肝肾阴虚证透析时间长于气阴两虚证及阴阳两虚证(P<0.05);脾肾气虚证原发病以慢性肾小球肾炎为主,肝肾阴虚证以高血压病及慢性肾小球肾炎为主,气阴两虚证以慢性肾小球肾炎及糖尿病为主,阴阳两虚证以红斑狼疮、梗阻性肾病、多囊肾、痛风、肾癌为主。结论:(1)维持性血液透析患者中医证型特点表现为急证、重证较少,而慢证、轻证较多。(2)患者年龄因素、透析时间因素、原发病因素可以影响中医证候分布。

Objective：To observe the distribution of TCM syndromes among 138 cases treated by maintenance hemodialysis long-termly.Method：138 cases treated by maintenance hemodialysis long-termly were observed,and the clinical distribution feature of TCM syndromes was put into practice of studying as well as the influencing factors.Then the statistical analysis was done.Result：1） The analysis showed that the syndrome of pure deficiency is the majority type （53.7%）.And the syndrome of qi deficiency of spleen and kidney was the most （47.1%） （65/138） among them.2） The age of the cases with the syndrome of qi deficiency of spleen and kidney was younger than that of the syndrome of hepatic and renal yin deficiency,deficiency of both qi and yin and deficiency of both yin and yang.Among accompanied sthenia syndrome in superficiality the age of the cases with the syndrome of damp-heat was younger than that of the syndrome of turbid damp （P0.05）.The hemodialysis history among the syndrome of qi deficiency of spleen and kidney and of hepatic and renal yin deficiency was longer than that of the syndrome of deficiency of both qi and yin and of deficiency of both yin and yang （P0.05）.Chronic glomerulonephritis （CGN） mainly belonged to the syndrome of qi deficiency of spleen and kidney,hypertensive disease and CGN belonged to the syndrome of hepatic and renal yin deficiency,CGN and diabetes mellitus mostly belonged to the syndrome of deficiency of both qi and yin,and dermatitis glandularis erythematosa,obstructive nephropathy,ploycystic renal disease,arthrolithiasis and enal carcinoma mostly belonged to the syndrome of deficiency of both yin and yang.Conclusion：1） The distribution feature of TCM syndromes in the patient with maintenance hemodialysis mostly are less of emergent and serious diseases but more of chronic and slight.2） Age,hemodialysis history and primary disease are the influencing factors on the distribution of TCM syndromes.