125例慢性原發(fā)性腎小球腎炎中醫(yī)證候與實(shí)驗(yàn)室檢查的相關(guān)性分析
發(fā)布時(shí)間：2018-12-18 05:37
【摘要】：目的:收集整理125例慢性原發(fā)性腎小球腎炎(Chronic primary glomerulonephritis CPGN)病例,采用回顧性分析方法,觀察中醫(yī)證候分布規(guī)律,并比較其與臨床實(shí)驗(yàn)室檢查指標(biāo)之間的相關(guān)性,將中醫(yī)宏觀思維與西醫(yī)微觀思維相結(jié)合,使中醫(yī)辨證論治更加客觀、規(guī)范。材料與方法:選取2014年10月至2015年11月就診于遼寧中醫(yī)藥大學(xué)附屬醫(yī)院腎內(nèi)科,病例資料完整的125例CPGN患者作為研究對(duì)象,將其按中醫(yī)辨證分為本證和標(biāo)證,應(yīng)用SPSS17.0統(tǒng)計(jì)軟件分析125例CPGN患者的中醫(yī)證候與性別、年齡、病程等因素及臨床實(shí)驗(yàn)室指標(biāo)是否存在相關(guān)性。結(jié)果:1.125例CPGN患者性別分布以女性多見(jiàn);年齡多為38-57歲。2.病程較短,多在1年以?xún)?nèi),多數(shù)不超過(guò)5年。3.中醫(yī)癥狀出現(xiàn)頻率前五的是腰酸痛、膝軟乏力、尿色淡黃、尿中有泡沫、畏寒肢冷。4.中醫(yī)舌脈出現(xiàn)頻率前五的是舌質(zhì)暗、脈沉、舌質(zhì)淡、脈細(xì)、苔黃。5.CPGN證候以本虛標(biāo)實(shí)為主,本證以腎氣虛證多見(jiàn),標(biāo)證以濕熱+瘀血證多見(jiàn)。6.CKD分期以CKD1期多見(jiàn),CKD1-3期以腎氣虛證多見(jiàn)。7.不同中醫(yī)證候患者的PRO嚴(yán)重程度及24小時(shí)尿蛋白定量無(wú)明顯差異。8.不同中醫(yī)證候患者的鏡檢紅細(xì)胞個(gè)數(shù)無(wú)明顯差異,但兩兩比較,腎氣虛證組與腎陰虛證組之間在鏡檢紅細(xì)胞個(gè)數(shù)總體分布上存在差異(P0.05)。9.本證血清白蛋白正常組與異常組存在差異(P0.01);本證總膽固醇正常組與異常組存在差異(P0.05)。10.腎氣虛證組血肌酐高于非腎氣虛證組;瘀血證組尿素氮高于非瘀血證組。濕熱證組血紅細(xì)胞高于非濕熱證組。(血肌酐、尿素氮、血紅細(xì)胞均在正常值范圍內(nèi)增高)。結(jié)論:1.腎氣虛是CPGN的主要發(fā)病基礎(chǔ);濕熱、瘀血是疾病發(fā)展的重要病理因素。2.腎陰虛證組鏡檢紅細(xì)胞個(gè)數(shù)多于腎氣虛證組3.腎陽(yáng)虛證、陰陽(yáng)兩虛證有血清白蛋白低于正常值的現(xiàn)象,但樣本數(shù)較少,需進(jìn)一步研究4.腎陰虛證、陰陽(yáng)兩虛證有總膽固醇高于正常值的現(xiàn)象,但樣本數(shù)較少,需進(jìn)一步研究。
[Abstract]:Objective: to investigate the distribution of TCM syndromes in 125 cases of chronic primary glomerulonephritis (Chronic primary glomerulonephritis CPGN) by retrospective analysis, and to compare the correlation between TCM syndromes and clinical laboratory examination. The combination of macro-thinking of TCM and micro-thinking of western medicine makes TCM dialectical treatment more objective and standardized. Materials and methods: 125 patients with CPGN were selected from October 2014 to November 2015 in Department of Nephrology, affiliated Hospital of Liaoning University of traditional Chinese Medicine. The correlation of TCM syndromes with sex, age, course of disease and clinical laboratory indexes in 125 patients with CPGN was analyzed by SPSS17.0 software. Results: the sex distribution of 1.125 patients with CPGN was mostly female, the age was 38-57 years old. The course of disease is relatively short, many in 1 year, most do not exceed 5 years 3. 3. TCM symptoms appear in the first five lumbar pain, knee weakness, yellowish urine color, urine foam, cold limbs. 4. 4. In Chinese medicine, the first five types of tongue appear in frequency are dark tongue, deep vein, light tongue, fine vein and yellow fur. 5.CPGN syndrome is characterized by deficiency of kidney qi, deficiency of kidney qi and blood stasis of dampness and heat. 6.CKD stage is more common in CKD1 stage. Kidney qi deficiency syndrome was more common in CKD1-3 stage. 7. 7%. There was no significant difference in PRO severity and 24 hour urinary protein quantification among patients with different TCM syndromes. There was no significant difference in the number of erythrocytes in different TCM syndromes, but there was significant difference in the total distribution of erythrocyte number between kidney qi deficiency syndrome group and kidney yin deficiency syndrome group (P0.05). There was difference between normal group and abnormal group (P0.01), and between normal group and abnormal group (P0.05). The blood creatinine of kidney qi deficiency group was higher than that of non-kidney qi deficiency group, and the urea nitrogen of blood stasis syndrome group was higher than that of non-blood stasis syndrome group. The red blood cell of damp-heat syndrome group was higher than that of non-damp-heat syndrome group. The levels of serum creatinine, urea nitrogen and erythrocyte were all increased within the normal range. Conclusion: 1. Deficiency of kidney qi is the main pathogenesis of CPGN, dampness and heat and blood stasis are important pathological factors in the development of CPGN. 2. The number of erythrocytes examined by microscope in the group of deficiency of kidney yin was more than that in the group of deficiency of kidney qi. There is a phenomenon that the serum albumin is lower than the normal value in kidney yang deficiency syndrome and yin and yang deficiency syndrome, but the sample number is less, so it is necessary to further study 4. 5%. Kidney yin deficiency syndrome, yin and yang deficiency syndrome have the phenomenon that total cholesterol is higher than normal value, but the sample number is less, need further study.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R277.5
，
本文編號(hào)：2385431
[Abstract]:Objective: to investigate the distribution of TCM syndromes in 125 cases of chronic primary glomerulonephritis (Chronic primary glomerulonephritis CPGN) by retrospective analysis, and to compare the correlation between TCM syndromes and clinical laboratory examination. The combination of macro-thinking of TCM and micro-thinking of western medicine makes TCM dialectical treatment more objective and standardized. Materials and methods: 125 patients with CPGN were selected from October 2014 to November 2015 in Department of Nephrology, affiliated Hospital of Liaoning University of traditional Chinese Medicine. The correlation of TCM syndromes with sex, age, course of disease and clinical laboratory indexes in 125 patients with CPGN was analyzed by SPSS17.0 software. Results: the sex distribution of 1.125 patients with CPGN was mostly female, the age was 38-57 years old. The course of disease is relatively short, many in 1 year, most do not exceed 5 years 3. 3. TCM symptoms appear in the first five lumbar pain, knee weakness, yellowish urine color, urine foam, cold limbs. 4. 4. In Chinese medicine, the first five types of tongue appear in frequency are dark tongue, deep vein, light tongue, fine vein and yellow fur. 5.CPGN syndrome is characterized by deficiency of kidney qi, deficiency of kidney qi and blood stasis of dampness and heat. 6.CKD stage is more common in CKD1 stage. Kidney qi deficiency syndrome was more common in CKD1-3 stage. 7. 7%. There was no significant difference in PRO severity and 24 hour urinary protein quantification among patients with different TCM syndromes. There was no significant difference in the number of erythrocytes in different TCM syndromes, but there was significant difference in the total distribution of erythrocyte number between kidney qi deficiency syndrome group and kidney yin deficiency syndrome group (P0.05). There was difference between normal group and abnormal group (P0.01), and between normal group and abnormal group (P0.05). The blood creatinine of kidney qi deficiency group was higher than that of non-kidney qi deficiency group, and the urea nitrogen of blood stasis syndrome group was higher than that of non-blood stasis syndrome group. The red blood cell of damp-heat syndrome group was higher than that of non-damp-heat syndrome group. The levels of serum creatinine, urea nitrogen and erythrocyte were all increased within the normal range. Conclusion: 1. Deficiency of kidney qi is the main pathogenesis of CPGN, dampness and heat and blood stasis are important pathological factors in the development of CPGN. 2. The number of erythrocytes examined by microscope in the group of deficiency of kidney yin was more than that in the group of deficiency of kidney qi. There is a phenomenon that the serum albumin is lower than the normal value in kidney yang deficiency syndrome and yin and yang deficiency syndrome, but the sample number is less, so it is necessary to further study 4. 5%. Kidney yin deficiency syndrome, yin and yang deficiency syndrome have the phenomenon that total cholesterol is higher than normal value, but the sample number is less, need further study.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R277.5
，
本文編號(hào)：2385431
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