280例海南地区狼疮性肾炎中医证候分布特征研究

Distribution Characteristics of Traditional Chinese Medicine (TCM) Syndromes of 280 Cases of Lupus Nephritis in Hainan

目的:探讨海南地区狼疮性肾炎(lupus nephritis, LN)患者的临床特征及中医证型分布特征。方法:采用IBM SPSS Statistics 26.0软件对比分析280例狼疮性肾炎患者(LN组)和246例非狼疮性肾炎的系统性红斑狼疮患者(非LN组)的性别、年龄、临床特征及中医证型分布。结果:LN组患者和非LN组患者在年龄、性别方面差异无统计学意义(P > 0.05);临床症状方面:LN组中尿少、浮肿、舌质齿痕、舌苔滑等频率明显高于非LN组,而畏寒肢冷、盗汗、舌红的频率低于非LN组,差异有统计学意义(P < 0.05);中医证型方面:LN组中医证型以脾肾阳虚证为主;非LN组的中医证型以阴虚内热证为主,两组中医证型总体分布差异有统计学意义(P < 0.05),与非LN组同证型比较,LN组在脾肾阳虚证、风湿热痹证构成比上差异有统计学意义(P < 0.05)。logistic回归结果显示:LN组和非LN组在胸闷、尿少、浮肿、舌苔黄、舌淡白方面有差异。结论:海南地区LN患者中医证型分布主要以脾肾阳虚证为主,其次为阴虚内热证;LN患者的独立危险因素为浮肿、尿少、胸闷、舌苔黄、舌淡白。

Objective: To investigate the clinical characteristics and TCM syndrome distribution of patients with lupus nephritis (LN) in Hainan. Methods: IBM SPSS statistics 26.0 software was used to compare and analyze the gender, age, clinical characteristics and TCM syndrome distribution of 280 patients with lupus nephritis (LN group) and 246 patients with systemic lupus erythematosus without lupus nephritis (non ln group). Results: There was no significant difference in age and gender between ln group and non ln group (P > 0.05);In terms of clinical symptoms, the frequencies of oliguria, edema, tooth mark of tongue and slippery tongue coating in LN group were significantly higher than those in non ln group, while the frequencies of chilly limbs, night sweat and red tongue were lower than those in non ln group (P < 0.05). TCM syndrome types: the TCM syndrome types of LN group were mainly spleen and kidney yang deficiency syndrome;The TCM syndrome type of non ln group was mainly Yin deficiency and internal heat syndrome. There was significant difference in the overall distribution of TCM syndrome types between the two groups (P < 0.05). Compared with the same syndrome type of non ln group, LN group had significant difference in the constituent ratio of spleen kidney yang deficiency syndrome and rheumatic heat arthralgia syndrome (P < 0.05). Logistic regression showed that there were differences in chest tightness, oliguria, edema, yellow tongue coating and pale tongue between ln group and non ln group. Conclusion: The distribution of TCM syndrome types of LN patients in Hainan is mainly spleen and kidney yang deficiency syndrome, followed by Yin deficiency and internal heat syndrome;The independent risk factors of LN patients were edema, oliguria, chest tightness, yellow tongue coating and pale tongue.