血液透析合并钙磷代谢紊乱患者中医证型与血清炎症因子的关系

Relationship between Traditional Chinese Medicine Syndromes and Serum Inflammatory Factors for Patients with Hemodialysis Complicated with Calcium-phosphorus Metabolism Disorder

目的:分析血液透析合并钙磷代谢紊乱患者中医证型与血清炎症因子的关系。方法:选取2020年1月~2020年9月我院收治的117例血液透析合并钙磷代谢紊乱患者作为观察组,另选取同时期我院进行体检的30例健康志愿者为对照组,比较两组微炎症指标[血清C反应蛋白(CRP)]、钙磷代谢指标[钙(Ca)、磷(P)、甲状旁腺激素(PTH)]水平,分析观察组CRP与Ca、P、PTH水平之间的相关性,将观察组分为不同的中医辨证分型亚组,比较不同的中医辨证分型亚组之间CRP水平。结果:观察组血清CRP、P、PTH水平均明显高于对照组,Ca水平明显低于对照组(P<0.05)。Pearson相关性分析显示,血液透析合并钙磷代谢紊乱患者CRP与Ca、PTH水平均有显著相关性(P<0.05),CRP与P水平没有相关性(P>0.05)。阴阳两虚证与气阴两虚证的CRP水平明显高于其余三种中医辨证分型,并且阴阳两虚证CRP水平明显高于其余四种中医辨证分型(P<0.05)。结论:血液透析合并钙磷代谢紊乱患者以脾肾气虚证较为多见,患者血清炎症因子CRP水平明显升高,且钙磷代谢紊乱与患者机体炎症状态相关,微炎症状态在阴阳两虚证与气阴两虚证中表现较为显著。

Objective: To analyze the relationship between TCM syndromes and serum inflammatory factors for patients with hemodialysis complicated with calcium-phosphorus metabolism disorder. Methods: Totally 117 patients with hemodialysis complicated with calcium-phosphorus metabolism disorder admitted to our hospital from January 2020 to September 2020 were selected as an observation group, and 30 healthy volunteers who underwent physical examination in our hospital during the same period were selected as a controlled group. The levels of micro-inflammatory index [serum C-reactive protein(CRP)] and calcium-phosphorus metabolism indexes [calcium(Ca), phosphorus(P), parathyroid hormone(PTH)] were compared between the two groups. The correlation between CRP and Ca, P and PTH was analyzed in the observation group, and the patients in the observation group were divided into different TCM syndrome differentiation subgroups, and the CRP level was compared among different TCM syndrome differentiation subgroups. Results: The levels of serum CRP, P and PTH in the observation group were significantly higher than those in the controlled group while the Ca level was significantly lower than that in the controlled group(P < 0.05). Pearson correlation analysis showed that there was a significant correlation between CRP and Ca and PTH in patients with hemodialysis complicated with calcium-phosphorus metabolism disorder(P < 0.05), and there was no correlation between CRP and P(P > 0.05). The CRP level of Yin-Yang deficiency syndrome or Qi-Yin deficiency syndrome was significantly higher than the other three TCM syndromes, and the CRP level of Yin-Yang deficiency syndrome was significantly higher than that of the other four TCM syndromes(P < 0.05). Conclusion: Spleen-kidney Qi deficiency syndrome is more common among patients with hemodialysis complicated with calcium-phosphorus metabolism disorder. Serum inflammatory factor CRP level is significantly increased, and calcium-phosphorus metabolism disorder is related to the body’s inflammation status of patients, and the micro-inflammatory status is more obvious in Yin-Yang deficiency syndrome and Qi-Yin deficiency syndrome.