增长性单纯性肾囊肿中医虚证证型分布规律及临床特征相关性研究

Study on Correlation Between Syndrome Type Distribution of Traditional Chinese Medicine Deficiency Syndrome and Clinical Characteristics of Growing Simple Renal Cysts

目的:探讨增长性单纯性肾囊肿(SRC)中医虚证证型分布与临床特征的相关性。方法:回顾性选择451例增长性SRC患者作为研究对象,根据中医分型将患者分为脾肾气虚证组(113例)、肝肾阴虚证组(44例)、气阴两虚证组(235例)、脾肾阳虚证组(59例)。比较各组性别、年龄、收缩压、舒张压、血肌酐、肾小球滤过率(eGFR)、血尿酸、总胆固醇、甘油三酯、血红蛋白等临床指标,采用无序多分类Logistic回归分析不同虚证与临床资料的相关性。结果:增长性SRC中医虚证证型以气阴两虚证为主。肝肾阴虚证、气阴两虚证、脾肾阳虚证组年龄大于脾肾气虚证组(P<0.05),且肝肾阴虚证、气阴两虚证组年龄小于脾肾阳虚证组(P<0.05)。脾肾阳虚证组血肌酐、血尿酸水平高于脾肾气虚证组、肝肾阴虚证组(P<0.05),舒张压、血尿酸水平高于气阴两虚证组(P<0.05),总胆固醇水平高于脾肾气虚证组(P<0.05)。脾肾阳虚证组eGFR水平低于脾肾气虚证组、肝肾阴虚证组、气阴两虚证(P<0.05),且脾肾气虚证组eGFR水平高于气阴两虚证组(P<0.05)。无序多分类Logistic回归结果显示,以脾肾气虚证组为对照组,年龄与肝肾阴虚证相关(P<0.05);年龄、收缩压与气阴两虚证相关(P<0.05);年龄、收缩压、血肌酐、血尿酸与脾肾阳虚证相关(P<0.05)。结论:增长性SRC的主要证型为气阴两虚证,不同中医虚证证型与年龄、收缩压、血肌酐和血尿酸等临床指标密切相关。

Objective:To investigate the correlation between syndrome type distribution of traditional Chinese medicine(TCM)deficiency syndrome and clinical characteristics of growing simple renal cysts(SRC).Methods:A total of 451 cases of patients with growing SRC were retrospectively selected as research objects,and were divided into the spleen-kidney qi deficiency syndrome group(113 cases),the liver-kidney yin deficiency syndrome group(44 cases),the deficiency of both qi and yin syndrome group(235 cases),and the spleen-kidney yang deficiency syndrome group(59 cases)according to different TCM syndrome types.Clinical indicators such as gender,age,systolic blood pressure,diastolic blood pressure,serum creatinine,glomerular filtration rate(eGFR),blood uric acid,total cholesterol,triglyceride and hemoglobin were compared among all groups.Disordered multiple Logistic regression was used to analyze the correlation between different deficiency syndromes and clinical data.Results:The main TCM deficiency syndrome type of growing SRC was deficiency of both qi and yin syndrome.The age of patients in the liverkidney yin deficiency syndrome group,the deficiency of both qi and yin syndrome group,and the spleenkidney yang deficiency syndrome group was higher than that in the spleen-kidney qi deficiency syndrome group(P<0.05),and the age in the liver-kidney yin deficiency syndrome group and the deficiency of both qi and yin syndrome group was lower than that in the spleen-kidney yang deficiency syndrome group(P<0.05).The levels of serum creatinine and blood uric acid in the spleen-kidney yang deficiency syndrome group were higher than those in the spleen-kidney qi deficiency syndrome group and the liver-kidney yin deficiency syndrome group(P<0.05);diastolic blood pressure and blood uric acid level were higher than those in the deficiency of both qi and yin syndrome group(P<0.05),and the total cholesterol level was higher than that in the spleen-kidney qi deficiency syndrome group(P<0.05).The eGFR level in the spleenkidney yang deficiency syndrome group was lower than those in the other three groups(P<0.05),and the eGFR level in the spleen-kidney qi deficiency syndrome group was higher than that in the deficiency of both qi and yin syndrome group(P<0.05).The results of disordered multiple Logistic regression showed that the age was related to liver-kidney yin deficiency syndrome while taking the spleen-kidney qi deficiency syndrome group as the control group.(P<0.05);age and systolic blood pressure were correlated with the deficiency of both qi and yin syndrome(P<0.05);age,systolic blood pressure,serum creatinine and blood uric acid were correlated with spleen-kidney yang deficiency syndrome(P<0.05).Conclusion:The main syndrome type of growing SRC is deficiency of both qi and yin syndrome,and different TCM deficiency syndrome types are closely related to clinical indicators such as age,systolic blood pressure,serum creatinine and blood uric acid.