基于证素辨证原理的慢性肾功能衰竭中医证候研究

Study on Chinese Syndromes of Chronic Renal Failure

目的:"证素"辨证体系将辨证通过确定证候要素(即病位和病性)进行分析。本研究运用证素辨证原理,对福建省慢性肾功能衰竭(CRF)患者进行证素研究。方法:收集CRF患者141例,研究本病主要病位、病性及其主次。结果:原发病以慢性肾炎为主,其次为糖尿病肾病、高血压肾病;病位以肾、脾、肝、胃、肺等为主,病性以气虚、阳虚、湿、血虚、阴虚、痰、气滞等为主。结论:本病原发病以慢性肾炎为主,糖尿病肾病为第2大致病因素;病位以肾、脾为主,涉及肝、肺表、心、经络、筋骨等;病性虚实相兼夹杂,以虚为主,同时病性病位间相互影响。总病机为脾肾衰败、气血阴阳不足,湿热瘀毒内蕴,气机逆乱。

Objective： To research the elements syndrome evolution in chronic renal failure（short for CRF） of Fujian patients,this research studies base on syndrome elements differentiation principle,who studies symptom complex through determining the locations and natures of diseases,namely element of Symptom Complex. Methods： This study collects 141 cases,and studies the locations and natures of diseases by collectivity,and also desides the main element. Results： The primary disease constitutes chiefly by chronic glomerulonephritis,secondly by diabetic nephropathy（DN） and hypertention nephritis; the main locations of deseases are kidney,spleen,liver,stomach and lung,the main natures of diseases are Qi deficiency,Yang ddficiency,pathogenic dampness,blood deficiency,Yin deficiency,Sputum,Qi stagnation,and there are significant differences between each Syndrome elements. Conclusions： Chronic glomerulonephritis is mainly primary disease of CRF,which is followed by DN. The main locations of deseases are kidney and spleen,involve many Zang Fu visceras,such as liver,lung,exterior,heart,meridians,tendons and bones. And its natures of diseases is intermingled deficiency and excess,which mostly sign as asthenia syndrome,and locations and natures of diseases react upon each other. Pathogenesis of CRF is accordant,that is： ruin of spleen and kidney,Qi Blood Yin Yang concurrent deficiency,dampness heat goes with blood stasis blocking,toxin accumulating,and disorder of Qi movement.