糖尿病肾病不同分期中医证型及与实验室指标的相关性研究

A study on correlation between TCM syndromes of different stages of diabetic nephropathy and laboratory indexes

目的:研究分析糖尿病肾病(Diabetic Nephropathy,DN)不同分期中医证型与实验室指标的相关性。方法:选取2017年3月-2019年5月期间在我院肾病科以及内分泌科接受治疗的2型糖尿病患者、DNⅢ期患者、DNⅣ期患者、DNⅤ期患者各30例作为本次的研究对象,另选择120例正常体检者作为对照。检测全部患者以及对照者的血肌酐(Serum Creatinine,Scr)、胱抑素-C(Cystatin C,Cys-C)、肾小球滤过率(Glomerular Filtration Rate,eGFR)、尿素氮(Blood Urea Nitrogen,BUN)、血清蛋白(Serum Albumin,ALB)等血流动力学指标,根据实验数据分析中医证型与实验室指标之间的相关性。结果:2型糖尿病患者主要临床表现为脾肾气虚与阴阳两虚。DNⅢ期主要临床表现为脾肾气虚,DNⅣ期临床表现与2型糖尿病患者临床表现相同,DNⅤ期临床表现为阴阳两虚。而糖尿病从中医证型的角度分析,其主要临床表现就是湿证与瘀证。对比检查结果得知,糖尿病患者证型的演变与尿素氮、胱抑素-C、尿蛋白含量呈正相关,与血清和肾小球过滤呈负相关。结论:糖尿病肾病患者随着病情的不断发展,期数的不断上升,其中医证型的变化规律为阴阳燥热-阴阳气虚-脾肾两虚-阴阳气虚。由此可知,糖尿病肾病患者的中医证型与检验指标可能有一定相关性。

Objective:To study the correlation between TCM syndromes and laboratory indexes in different stages of diabetic nephropathy.Methods:From March 2017 to May 2019,30 patients with type 2 diabetes,DN III stage,DN IV stage,and DNⅤstage who were treated in the nephrology department and endocrinology department of our hospital were selected As the object of this study,another 120 normal medical examinations were selected as controls.Serum creatinine,Cystatin-C,glomerular filtration rate,and blood urea nitrogen were measured in all patients and controls,serum albumin and other hemodynamic indicators,based on experimental data to analyze the correlation between TCM syndrome and laboratory indicators.Results:The main clinical manifestations of patients with type 2 diabetes are Pishen Qixu(脾肾气虚)and Yinyang Liangxu(阴阳两虚).The main clinical manifestations of stage DNⅢare Pishen Qixu,the clinical manifestations of stage DNⅣare the same as those of patients with type 2 diabetes,and the clinical manifestations of stage DNⅤare Yinyang Liangxu.From the perspective of TCM syndrome type,the main clinical manifestations of diabetes are Shi(湿)syndrome and Yu(瘀)syndrome.Conclusion:With the continuous development of the diabetic nephropathy patients,the number of periods continues to rise.The change pattern of medical syndrome types is:Yinyang Zaore(阴阳燥热)—Yinyang Qixu(阴阳气虚)—Pishen Liangxu(脾肾两虚)—Yinyang Qixu.It can be seen there may be some correlation between TCM syndrome and test indicators in patients with diabetic nephropathy.