糖尿病肾病患者生物节律紊乱的中医证型及影响因素研究
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摘要
目的:观察糖尿病肾病患者生物节律紊乱的中医证型及影响因素。方法:随机选择2014年7月～2017年7月伴随生物节律紊乱的未透析前DN患者86例,随访患者1年,将患者是否转为透析期作为分组标准,分成透析组27例,未透析组患者59例,每隔3个月对患者进行PSQI评分和中医症候评分,观察两组患者评分变化情况,观察生物节律紊乱与糖尿病肾病患者中医证型变化的相关性。结果:两组患者来诊时和随访3个月后PSQI评分均无明显差异(P>0. 05),随访6个月、9个月、12个月透析组患者PSQI评分明显高于未透析组,且具有统计学差异(P<0. 05);两组患者来诊时、随访3个月、随访6个月的中医症候评分均无统计学差异(P>0. 05),随访9个月、12个月透析组患者中医症候评分明显高于未透析组,且具有统计学差异(P<0. 05);以患者症候评分为因变量,以患者PSQI评分为自变量,对患者进行回归分析,结果发现患者症候评分与PSQI评分两者呈正相关,具有统计学意义。结论:糖尿病肾病患者病情进展与患者生物节律紊乱呈正相关,患者生物节律紊乱越严重,糖尿病肾病进展越快。
Objective: To observe the TCM syndrome type and influencing factors of diabetic nephropathy patients with biological rhythm disorder. Methods: Randomly selected from July 2014 to July 2017 with the biological rhythm before dialysis in86 patients with DN,patients were followed up for 1years,would be turned into dialysis patients as grouping criteria,divided into dialysis group 27 cases,59cases of patients with non dialysis group,every 3months for patients with PSQI score and TCM syndrome,observing the two groups of patients were observed,observation of the relationship between circadian rhythm disorders and diabetic nephropathy in patients with TCM syndrome type change. Results: There were no significant difference between the groups of patients to the diagnosis and follow-up of 3months after the PSQI score(P>0. 05),follow-up of 6months,9months,12 months of dialysis patients PSQI score was significantly higher than that in non dialysis group,and had statistically significant difference(P< 0. 05). There were no statistically significant differences between the two groups to visit and followed up for3 months and 6months of follow-up symptom score(P> 0. 05),were followed up for 9months and 12 months of dialysis patients TCM syndrome was significantly higher than that in non dialysis group,and had statistically significant difference(P<0. 05). In patients with symptom score as the dependent variable,in patients with a PSQI score for patients as the independent variables.By regression analysis,found that patients with symptom score and PSQI score both were positively correlated with statistical significance. Conclusion: The progression of diabetic nephropathy is positively correlated with the disturbance of circadian rhythm.The more serious the disorder of biological rhythm is,the faster the progression of diabetic nephropathy is.
Objective: To observe the TCM syndrome type and influencing factors of diabetic nephropathy patients with biological rhythm disorder. Methods: Randomly selected from July 2014 to July 2017 with the biological rhythm before dialysis in86 patients with DN,patients were followed up for 1years,would be turned into dialysis patients as grouping criteria,divided into dialysis group 27 cases,59cases of patients with non dialysis group,every 3months for patients with PSQI score and TCM syndrome,observing the two groups of patients were observed,observation of the relationship between circadian rhythm disorders and diabetic nephropathy in patients with TCM syndrome type change. Results: There were no significant difference between the groups of patients to the diagnosis and follow-up of 3months after the PSQI score(P>0. 05),follow-up of 6months,9months,12 months of dialysis patients PSQI score was significantly higher than that in non dialysis group,and had statistically significant difference(P< 0. 05). There were no statistically significant differences between the two groups to visit and followed up for3 months and 6months of follow-up symptom score(P> 0. 05),were followed up for 9months and 12 months of dialysis patients TCM syndrome was significantly higher than that in non dialysis group,and had statistically significant difference(P<0. 05). In patients with symptom score as the dependent variable,in patients with a PSQI score for patients as the independent variables.By regression analysis,found that patients with symptom score and PSQI score both were positively correlated with statistical significance. Conclusion: The progression of diabetic nephropathy is positively correlated with the disturbance of circadian rhythm.The more serious the disorder of biological rhythm is,the faster the progression of diabetic nephropathy is.
引文
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[2]陈国光.腹膜透析治疗终末期糖尿病肾病的综合评价[J].中国药物与临床,2016,16(7):1022~1023
[3]程洁,黄钟声,刘艳明,等. 2型糖尿病肾病相关代谢指标临床分析[J].山西医药杂志,2015,44(8):915~917
[4] Jiangmin. The efficacy of active vitamin D in the early treatment of diabetic nephropathy[J]. Zhejiang Medicine,2015,37(3):239~241
[5] Wang Xing,Tian Liming,Li Chunxiang,et al. Research progress on TCM pathogenesis of diabetic nephropathy[J]. Chinese Medicine Emergency,2015,24(12):2172~2174
[6] Xiong Yanwen,Jin Zhou Hui,Hu Yanhua,et al. The latest research on the name and pathogenesis of diabetic nephropathy and etiology and pathogenesis of[J]. World Traditional Chinese Medicine,2015,10(A02):943~944
[7]俞翔,陈敏.中医药治疗糖尿病肾病的研究进展[J].现代中西医结合杂志,2016,25(25):2847~2850
[8]王兴华,童奎骅.三黄肾病方治疗早期糖尿病肾病的临床研究[J].中国中西医结合肾病杂志,2015,16(7):612~614
[9]朱风琴,赵晓光.中西医结合治疗糖尿病肾病52例疗效观察[J].中国继续医学教育,2016,8(22):197~198
[10]陈霞波,龚文波,苏琼,等.宁波市部分社区糖尿病肾病的中医辨证分型横断面调查[J].中国中西医结合肾病杂志,2014,15(3):223~225
[11]王凤丽,陈志强,王月华,等.糖尿病肾病Ⅲ?Ⅳ期患者中医证型与相关实验室指标典型相关分析[J].中医杂志,2012,53(9):767~771
[12]彭国平,胡锡元,梁淼,等.肾脏血流动力学与糖尿病肾病中医辨证分型的相关性[J].中医杂志,2012,53(16):1394~1396
[13]耿文佳,毛炜,刘旭生,等.糖尿病肾病中医证型与CRP指标关系探讨[J].中国中西医结合肾病杂志,2011,12(1):31~33
[14]吴金玉,黄仁发,史伟,等.糖尿病肾病中医证型分布特征及其与血清纤维化因子的关系[J].广西医学,2012,34(11):1435~1437
[15]宋启明,陈其华,丁兰,等.糖尿病肾病中医证型与胱抑素C?β2微球蛋白的相关性研究[J].湖北中医杂志,2012,34(11):22~23
[16] Liu ZH. Ne phrology in China[J]. Nature Re vie w s Ne phrology,2013,9(9):523~528
[17]陈刚毅,温淑婷,林育,等.基于中医学理论探讨“起居无节”的致病机制[J].新中医,2014,46(9):9~10
[18]陈刚毅,温淑婷,林育,等.生物节律紊乱影响糖尿病肾病大鼠“气阴亏虚”病机的初步探讨[J].天津中医药大学学报,2015,34(2):91~94
[19]中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中华糖尿病杂志,2014,6(11):792~801
[20] CJ Mcm ullan,GC Curhan,J P Form an. As s ociation of s hort s le e p duration and rapid de cline in re nal function[J]. Kidney International,2016,89(6):1324~1330
[21] Darukhanavala A,Booth J N,Brom le y L,et al. Changes in insulinse cretion and action in adults with fam ilial risk for type 2 diabe tes who curtail their sleep[J]. Diabetes Care,2011,34(10):2259~2264
[22]刘峰.高血压病合并糖尿病患者中医体质分布的研究[J].中国处方药,2014,12(10):108~109