腹膜透析患者伴微炎症状态与中医证型的相关性研究

Study on the correlation between peritoneal dialysis patients with microinflammation and TCM syndrome types

目的:探讨腹膜透析(PD)患者伴微炎症状态与中医证型的相关性。方法:选择2019年6月—2022年6月收治的PD患者120例,统计中医证型分布情况,检测血红蛋白(Hb)、血尿素氮(BUN)、血肌酐(Scr)、白蛋白(ALB)、前白蛋白(PAB)、血清转铁蛋白(TRF)、超敏C反应蛋白(hs-CRP)水平,并记录每周尿素清除指数(Kt/v),统计不同中医证型患者上述指标间的差异。结果:120例患者中脾肾气虚证49例(40.83%),占比最高,其他依次为脾肾阳虚证34例(28.33%)、阴阳两虚证17例(14.17%)、气阴两虚证12例(10.00%)、肝肾阴虚证8例(6.67%)。脾肾气虚证患者Hb和TRF高于其他证型,hs-CRP低于其他证型,BUN低于气阴两虚证、脾肾阳虚证、阴阳两虚证患者,PAB高于气阴两虚证、脾肾阳虚证、阴阳两虚证患者,Kt/v高于气阴两虚证、阴阳两虚证,差异有统计学意义(P<0.05);其他证型间Hb,BUN,PAB,TRF,hs-CRP,Kt/v相比,差异有统计学意义(P<0.05)。结论:PD患者中医证型主要以脾肾气虚证多见,且微炎症状态与中医证型关系密切,阴阳两虚证患者炎症反应最严重,可为中医药治疗提供重要指导。

Objective:To explore the correlation between the state of micro inflammation and TCM syndrome type in patients with peritoneal dialysis(PD).Methods:All 120 patients with PD admitted to hospital from June 2019 to June 2022 were selected as the research objects,and the distribution of TCM syndrome types was analyzed.Blood samples were collected to detect the levels of hemoglobin(Hb),blood urea nitrogen(BUN),blood creatinine(Scr),albumin(ALB),prealbumin(PAB),serum transferrin(TRF),hypersensitive C-reactive protein(hs-CRP),and weekly urea clearance index(Kt/v)were recorded,and the differences among the above indexes among patients with different TCM syndrome types were statistically analyzed.Results:Among the 120 patients,the deficiency of spleen and kidney Qi accounted for the highest proportion in 49 cases(40.83%),followed by deficiency of spleen and kidney Yang in 34 cases(28.33%),deficiency of Yin-Yang in 17 cases(14.17%),deficiency of Qi-Yin in 12 cases(10.00%),deficiency of liver and kidney Yin in 8 cases(6.67%).In patients with spleen-kidney Qi deficiency syndrome,Hb and TRF were higher than those of other syndrome types,hs-CRP levels were lower than those of other syndrome types,BUN was lower than those of Qi-Yin deficiency syndrome,spleen-kidney Yang deficiency syndrome and Yin-Yang deficiency syndrome,and PAB was higher than those of Qi-Yin deficiency syndrome,spleen-kidney Yang deficiency syndrome and Yin-Yang deficiency syndrome.Kt/v was higher than Qi-Yin deficiency syndrome and Yin-Yang deficiency syndrome,the difference was statistically significant(P<0.05).There were significant differences in Hb,BUN,PAB,TRF,hs-CRP and Kt/v among other syndromes(P<0.05).Conclusion:The syndrome type of TCM in PD patients is mainly the deficiency of Qi in spleen and kidney,and the micro inflammatory state is closely related to the syndrome type of TCM.The patients with deficiency of Yin and Yang syndrome have the most inflammatory reaction,which can provide important guidance for TCM treatment.