多元分析法探讨慢性肾衰竭血液透析患者中医证候特点
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摘要
目的:通过采用多元分析方法探讨慢性肾衰竭血液透析患者的中医证候特点,旨在为透析后患者的中医药治疗提供依据和基础。方法:通过调查问卷的方法,收集终末期肾病维持性血液透析患者临床症状,包括年龄、性别、血液透析病程、原发病、相关实验室检查数据、中医证候等,采用多元统计方法进行分析,探讨慢性肾衰竭血液透析患者中医证候特点。结果:采集了160例于上海中医药大学附属岳阳中西医结合医院维持性血液透析患者调查问卷,通过频数分析、因子分析及聚类分析等统计方法,将维持性血液透析患者中医证候分为:气血两虚证、湿热蕴结证、瘀血阻络证、阴虚风动证。结论:血液透析患者中医证型分布与年龄、血清钾离子水平、血清铁离子水平有关,原发病、透析龄也可能是影响维持性血液透析患者中医证型分布的原因。
Objective:To provide theoretical support and base for the chronical renal failure(CRF)after hemodialysis to turn to TCM treatment by investigating and arguing the characteristics of TCM syndromes of CRF patients with multivariable analysis method. Methods:Gathered the clinical syndrome of maintenance hemodialysis patients(MHP)in the end stage including age gender hemodialysis original disease relative laboratory measure data TCM syndromes and so on by the way of questionnaire and applied multivariable analysis method to investigate and argue the characteristics of TCM syndrome and sign of CRF patients. Results:Collected 160 MHP questionnaires complying with the inclusion criteria from Yueyang combination of Western medicine and TCM hospital subsidiary to Shanghai TCM university. Divided the syndromes of the 160 MHPs into Qi-blood deficiency syndrome, damp-heat accumulation syndrome, blood stasis obstruction syndrome, Yin deficiency and wind movement syndrome. Conclusion:The syndromes of MHP may relate with the age,the level of ion potassium in serum and the level of ion iron in serum,at the same time the original disease hemodialysis time might also have an effect on the maintenance of syndrome and sign of MHP.
Objective:To provide theoretical support and base for the chronical renal failure(CRF)after hemodialysis to turn to TCM treatment by investigating and arguing the characteristics of TCM syndromes of CRF patients with multivariable analysis method. Methods:Gathered the clinical syndrome of maintenance hemodialysis patients(MHP)in the end stage including age gender hemodialysis original disease relative laboratory measure data TCM syndromes and so on by the way of questionnaire and applied multivariable analysis method to investigate and argue the characteristics of TCM syndrome and sign of CRF patients. Results:Collected 160 MHP questionnaires complying with the inclusion criteria from Yueyang combination of Western medicine and TCM hospital subsidiary to Shanghai TCM university. Divided the syndromes of the 160 MHPs into Qi-blood deficiency syndrome, damp-heat accumulation syndrome, blood stasis obstruction syndrome, Yin deficiency and wind movement syndrome. Conclusion:The syndromes of MHP may relate with the age,the level of ion potassium in serum and the level of ion iron in serum,at the same time the original disease hemodialysis time might also have an effect on the maintenance of syndrome and sign of MHP.
引文
[1]刘香红,杨晨,肖敬玲,等.120例终末期肾脏病维持性血液透析患者中医证候规律分析[J].中国中医基础医学杂志,2014,20(2):218-219,227.
[2]董丽洁.终末期肾脏病(ESRD)维持性血液透析患者的中医证候分析[J].中国医院药学杂志,2018,11(6):1-4.
[3]李燕林,赖海标,黄振炎,等.尿毒症规律血液透析阶段的中医证候学特点[J].中国中西医结合急救杂志,2004,34(6):333-335.
[4]马地那,钟剑,曹钋.155例CRF尿毒症期透析患者中医证候的调查研究[J].中国中西医结合肾病杂志,2015,15(7):605-607.
[5]石青松.维持性血液透析患者的中医证候学临床研究[D]:杭州:浙江中医药大学,2014.
[6]张太君,张玲.90例血液透析患者中医证候分布规律分析[J].世界中西医结合杂志,2015,10(2):207-209.
[7]马雷雷,曹钋,赵虎康,等.单中心血液透析患者透析时机回顾性研究[J].中国中西医结合肾病杂志,2016,17(10):892-894.
[8]董睿,郭志勇,谌卫.血液透析及腹膜透析患者生活质量评价及相关因素分析[J].中国中西医结合肾病杂志,2010,11(7):606-610.
[9]常守凤,王俭勤,王文革,等.159例维持性血液透析患者生存分析[J].中国中西医结合肾病杂志,2010,11(8):703-705.
[10]马祖等,郑智华,张涤华,等.血液透析患者生存质量的多中心研究[J].中国血液净化,2004,25(7):38-42,54.
[11]吕文律,滕杰,邹建洲,等.老年维持性血液透析患者生存分析[J].中国血液净化,2012,11(6):298-302.
[12]徐丽平.维持性血液透析患者多因素Cox生存分析[J].中华实用诊断与治疗杂志,2013,27(3):311-312.
[13]闫铁昆,付胜惠,林珊.维持性血液透析患者透析前后血钾状态及其影响因素分析[J].临床荟萃,2009,23(1):30-32.
[14]刘洪梅,梁燕娟,王婷婷,等.维持性血液透析患者透析前后血钾浓度及其影响因素分析[J].广东医学,2016,37(9):1358-1360.
[15]施雪枫,顾勇,丁峰.尿毒症与氧化应激[J].中国中西医结合肾病杂志,2002,3(6):368-371.
[16]卢恕,李秀松,余自成.铁制剂治疗缺铁性贫血的应用和药物经济学评价[J].上海医院药学,1998,9(4):25-31.
[17]薛长江,彭立人.维持性血液透析患者静脉补铁对氧化应激的影响[J].国外医学:移植与血液净化分册,2005,31(6):21-24.
[18]陈颖颖,林春华,陈兰,等.维持性补铁方式对血液透析患者血红蛋白变异度的影响[J].中华全科医学,2018,16(3):419-422.
[2]董丽洁.终末期肾脏病(ESRD)维持性血液透析患者的中医证候分析[J].中国医院药学杂志,2018,11(6):1-4.
[3]李燕林,赖海标,黄振炎,等.尿毒症规律血液透析阶段的中医证候学特点[J].中国中西医结合急救杂志,2004,34(6):333-335.
[4]马地那,钟剑,曹钋.155例CRF尿毒症期透析患者中医证候的调查研究[J].中国中西医结合肾病杂志,2015,15(7):605-607.
[5]石青松.维持性血液透析患者的中医证候学临床研究[D]:杭州:浙江中医药大学,2014.
[6]张太君,张玲.90例血液透析患者中医证候分布规律分析[J].世界中西医结合杂志,2015,10(2):207-209.
[7]马雷雷,曹钋,赵虎康,等.单中心血液透析患者透析时机回顾性研究[J].中国中西医结合肾病杂志,2016,17(10):892-894.
[8]董睿,郭志勇,谌卫.血液透析及腹膜透析患者生活质量评价及相关因素分析[J].中国中西医结合肾病杂志,2010,11(7):606-610.
[9]常守凤,王俭勤,王文革,等.159例维持性血液透析患者生存分析[J].中国中西医结合肾病杂志,2010,11(8):703-705.
[10]马祖等,郑智华,张涤华,等.血液透析患者生存质量的多中心研究[J].中国血液净化,2004,25(7):38-42,54.
[11]吕文律,滕杰,邹建洲,等.老年维持性血液透析患者生存分析[J].中国血液净化,2012,11(6):298-302.
[12]徐丽平.维持性血液透析患者多因素Cox生存分析[J].中华实用诊断与治疗杂志,2013,27(3):311-312.
[13]闫铁昆,付胜惠,林珊.维持性血液透析患者透析前后血钾状态及其影响因素分析[J].临床荟萃,2009,23(1):30-32.
[14]刘洪梅,梁燕娟,王婷婷,等.维持性血液透析患者透析前后血钾浓度及其影响因素分析[J].广东医学,2016,37(9):1358-1360.
[15]施雪枫,顾勇,丁峰.尿毒症与氧化应激[J].中国中西医结合肾病杂志,2002,3(6):368-371.
[16]卢恕,李秀松,余自成.铁制剂治疗缺铁性贫血的应用和药物经济学评价[J].上海医院药学,1998,9(4):25-31.
[17]薛长江,彭立人.维持性血液透析患者静脉补铁对氧化应激的影响[J].国外医学:移植与血液净化分册,2005,31(6):21-24.
[18]陈颖颖,林春华,陈兰,等.维持性补铁方式对血液透析患者血红蛋白变异度的影响[J].中华全科医学,2018,16(3):419-422.