马兜铃酸肾病的中医证候与临床因素相关性研究

Correlation between TCM syndromes and clinical factors in patients with aristolochic acid nephropathy

目的通过分析马兜铃酸肾病(AAN)患者的中医证候分型及临床指标,为AAN的中医证候诊断规范化提供依据。方法选择33例AAN患者为研究对象,观察患者中医证候分型情况,并对临床指标进行比较。结果中医证候正虚方面33例中脾肾阳虚证27例,占81.82%;非脾肾阳虚证6例,占18.18%。邪实方面33例中湿浊证18例,占54.55%;非湿浊证15例,占45.45%。脾肾阳虚组24h尿蛋白高于非脾肾阳虚组(P<0.05),其他临床指标2组比较差异均无统计学意义(P>0.05)。湿浊组血清总胆固醇(TC)、尿比重(SG)均高于非湿浊组(P<0.05),其他临床指标2组比较差异均无统计学意义(P>0.05)。结论 AAN患者中医证属虚实夹杂,脾肾阳虚为本、湿浊血瘀为标;其临床指标与证候分型有一定相关性。

Objective To analyze the types of TCM syndromes and clinical indexes in patients with aristolochic acid nephropathy （AAN） and provide the evidence for the standardization of AAN diagnosis. Methods The types of TCM syndromes were observed and clinical indexes were compared in AAN patients （n=33） selected as study objects. Results Involving deficiency of healthy qi and among 33 cases, there were 27 with syndrome of spleen-kidney yang deficiency （81.82%）, and 6 without syndrome of spleen-kidney yang deficiency （18.18%）. Involving excess of pathogenic qi and among 33 cases, there were 18 with dampness turbidity syndrome （54.55%）, and 15 without dampness turbidity syndrome （45.45%）. The level of 24-hour urine protein was higher in group of spleen-kidney yang deficiency than that in group of non-spleen-kidney yang deficiency （P〈0.05）, and there was no statistical significance in other clinical indexes between two groups （P〉0.05）. The level of serum total cholesterol （TC） and urine specific gravity were higher in dampness turbidity group than those in non-dampness turbidity group （P〈0.05）, and there was no statistical significance in other clinical indexes between two groups （P〉0.05）. Conclusion The TCM syndromes are showed as mixture of deficiency and excess in AAN patients with spleen-kidney yang deficiency as the root, and dampness turbidity and blood stasis as the tip. There is a correlation between clinical indexes and syndrome types.