“肾虚湿瘀”理论下的慢性肾脏病中医证候学研究

TCM Syndrome Research of Chronic Kidney Disease Based on the Theory of“Kidney Deficiency and Damp-Blood Stasis”

目的探究"肾虚湿瘀"理论下慢性肾脏病不同分期的中医证型分布有何特点,并运用数据挖掘技术探索常见证型的辨证要点。方法通过对中国肾脏病应用创新联盟大数据平台中2012年9月1日至2019年9月30日于江苏省中医院孙伟主任医师处就诊的2899例患者中四诊信息齐全的慢性肾脏病人共计1445例进行证型分布、证型兼夹特点、四诊信息统计,并将相似症状进行规范合并,通过数据挖掘技术与名医经验结合探究常见证型辨证要点。结论脾肾气虚证是慢性肾脏病本虚证的核心;血瘀证、湿浊证、湿热证是慢性肾脏病的主要标实证,湿毒证只有在慢性肾脏病(Chronic Kidney Disease,CKD)5期有较多分布,其他各分期均少见。并得出这5个常见证型的辨证要点。

Objective To explore the characteristics of the distribution of TCM syndrome types in different stages of chronic kidney disease(CKD)under the theory of“kidney deficiency and dampness stasis”,and use data mining technology to explore the diagnostic criteria of common syndrome types.Methods The information of the CKD patients was extracted with complete data of the four diagnostic who were treated by the Chief Physician Sun Wei in Jiangsu Provincial Hospital of Traditional Chinese Medicine from September 1,2012 to September 30,2019 from“China Kidney Diseases Application Innovation Alliance Big Data Platform”.The distribution of syndrome types,the intermingled different syndrome types,and the distribution of four diagnosis information based on this information were calculated.The similar symptoms were standardized and merged,and the syndrome differentiation key points of common syndromes were explored through data mining technology and the experience of famous doctors.Results Of all CKD patients whether in different stages or in different protopathies,the most common deficiency syndrome was deficiency of spleen and kidney qi,and the most common excess syndrome was blood stasis,and damp-heat and damp pathogen.Only in CKD 5 stage,there were many cases of damp-toxin syndrome.Diagnosis criteria for 5 common syndrome types were drawn.Conclusion Spleen and kidney qi deficiency syndrome is the core of chronic kidney disease.Blood stasis syndrome,dampness turbidity syndrome and dampness heat syndrome are the main signs of CKD.Dampness toxin syndrome is only more distributed in CKD 5 stage,and other stages are rare.The key points of syndrome differentiation of these 5 common syndrome types are obtained.