713例单纯性肾囊肿中医证型与临床特征相关性研究

Correlation Between Traditional Chinese Medicine Syndromes and Clinical Characteristics of Simple Renal Cysts:An Analysis of 713 Cases

【目的】总结分析单纯性肾囊肿(SRCs)的中医证型与临床特征的相关性。【方法】对713例SRCs患者进行回顾性研究,收集患者的年龄、血肌酐、肾小球滤过率(eGFR)、血尿酸以及是否合并肾结石等临床特征,分析中医证型与临床特征的相关性。【结果】(1)中医证型分布情况:本虚证以气阴两虚为主,其次为脾肾气虚、脾肾阳虚、肝肾阴虚;标实证以湿热证为主,其次为湿浊证、血瘀证。(2)各中医证型年龄分布情况:本虚证中,脾肾阳虚型年龄最大,其次为肝肾阴虚、气阴两虚、脾肾气虚;其中脾肾气虚与气阴两虚、脾肾阳虚的证型间年龄比较,差异有统计学意义(P <0.05)。标实证中,湿浊证年龄最大,其次为血瘀证、湿热证;其中湿浊证与湿热证、血瘀证的证型间年龄比较,差异有统计学意义(P <0.05)。(3)本虚证中,血肌酐浓度由高至低、eGFR由低至高依次为脾肾阳虚、肝肾阴虚、气阴两虚、脾肾气虚;其中脾肾气虚与气阴两虚、脾肾阳虚,气阴两虚与脾肾阳虚的证型间血肌酐、eGFR比较,差异有统计学意义(P <0.05)。血尿酸浓度由高至低依次为脾肾阳虚、气阴两虚、肝肾阴虚、脾肾气虚;除脾肾气虚与肝肾阴虚外,其余各证型间的血尿酸浓度比较,差异均有统计学意义(P <0.05)。标实证中,血肌酐、血尿酸浓度由高至低、eGFR由低至高依次为湿浊证、湿热证、血瘀证;各标实证的证型间血肌酐浓度、eGFR、血尿酸浓度比较,差异均有统计学意义(P <0.05)。(4)肾结石并发率情况:本虚证中,肾结石并发率由高至低依次为肝肾阴虚、气阴两虚、脾肾气虚、脾肾阳虚;其中气阴两虚与脾肾气虚、脾肾阳虚的证型间肾结石并发率比较,差异有统计学意义(P <0.05)。标实证中,肾结石并发率由高至低依次为湿热证、湿浊证、血瘀证;各标实证的证型间肾结石并发率比较,差异均有统计学意义(P <0.05)。【结论】中医证型与年龄分布、肾功能损害、高尿酸血症、合并肾结石等临床特征密切相关。

Objective To analyze the correlation of traditional Chinese medicine (TCM) syndromes of simple renal cysts (SRCs) with the clinical characteristics. Methods A retrospective survey was conducted in 713 SRCs. The data of clinical characteristics such as age, serum creatinine, estimated glomerular filtration rate (eGFR), serum uric acid, and the complication of urolithiasis were collected for the analysis of the correlation between TCM syndromes and clinical characteristics of SRCs. Results (1) The distribution of TCM syndromes: healthy- Qi deficiency syndromes were manifested mainly as Qi-yin deficiency, and then as spleen- kidney Qi deficiency,spleen- kidney yang deficiency, and liver- kidney yin deficiency;pathogenic- Qi excess syndromes were manifested mainly as damp- heat, and then as damp turbidity and blood stasis.(2) The correlation of TCM syndromes with age: of healthy-Qi deficiency syndromes, spleen-kidney yang deficiency was seen in the eldest age, and liver-kidney yin deficiency, Qi-yin deficiency, and spleen-kidney Qi deficiency occurred in the elder age;the difference of age of spleen-kidney Qi deficiency in comparison with Qi-yin deficiency and spleen-kidney yang deficiency was significant (P < 0.05). Of pathogenic-Qi excess syndromes, damp-heat was seen in the eldest age, and damp turbidity and blood stasis occurred in the elder age;the difference of age of damp turbidity in comparison with damp-heat and blood stasis was significant (P < 0.05).(3)In healthy-Qi deficiency syndromes, serum creatinine in decreasing sequence and eGFR in increasing sequence were showed in the syndromes of spleen-kidney yang deficiency, liver-kidney yin deficiency, Qi-yin deficiency, spleen-kidney Qi deficiency;the differences of serum creatinine and eGFR of spleen-kidney Qi deficiency in comparison with Qi-yin deficiency and spleen- kidney yang deficiency, and between Qi- yin deficiency and spleen- kidney yang deficiency were significant (P < 0.05). Serum uric acid in decreasing sequence was shown in the syndromes of spleen-kidney yang deficiency, Qi- yin deficiency, liver- kidney yin deficiency, spleen- kidney Qi deficiency;except for the syndromes of spleen- kidney Qi deficiency and liver- kidney yin deficiency, the differences of serum uric acid among various syndromes were significant (P < 0.05). In pathogenic-Qi excess syndromes, serum creatinine and serum uric acid in decreasing sequence and eGFR in increasing sequence were showed in the syndromes of damp turbidity, damp- heat, and blood stasis;the differences of serum creatinine, serum uric acid and eGFR in various pathogenic-Qi excess syndromes were significant (P < 0.05).(4)In healthy-Qi deficiency syndromes, the incidence of the complication of urolithiasis in decreasing sequence was showed in the syndromes of liver-kidney yin deficiency, Qi- yin deficiency, spleen- kidney Qi deficiency, and spleen- kidney yang deficiency;the difference of the incidence of urolithiasis of Qi-yin deficiency in comparison with spleen-kidney Qi deficiency and spleen-kidney yang deficiency was significant (P < 0.05). In pathogenic-Qi excess syndromes, the incidence of the complication of urolithiasis in decreasing sequence was showed in the syndromes of damp- heat, damp turbidity, and blood stasis;the difference among various syndromes was significant (P < 0.05). Conclusion TCM syndromes of SRCs are closely correlated with the age, renal function injury, hyperuricemia and the complication of urolithiasis.