摘要
目的分析早期慢性肾脏病(chronic kidney discase,CKD)患者中医证候分布特点及其与尿蛋白的相关性,为阐明早期CKD患者中医证候辨证规律提供依据。方法采用回顾性调查方法,收集199例早期CKD患者中医证候和尿蛋白等资料,进行中医证候与尿蛋白的多因素的回归分析,其中,尿蛋白包括24 h尿蛋白定量(Upro)、尿白蛋白(UA(?)b)、尿β_2-微球蛋白(Uβ_2-MG)、尿N-乙酰-β-D-氨基葡萄糖苷酶(UNAG)、尿β-半乳糖苷酶(UGAL)等。结果在早期CKD患者中,作为尿蛋白独立相关因素的中医证候包括"腰酸、食少纳呆、小溲黄赤、泛酸、夜尿多、浮肿、泡沫尿、咳嗽、畏寒肢冷"等;UA(?)b升高与脾肾气虚证素"腰酸、食少纳呆"相关;UNAG升高与"浮肿、泡沫尿、夜尿多、咳嗽"相关;UGAL升高与脾肾阳虚证素"腰酸、畏寒肢冷"相关;Uβ_2-MG与"浮肿"相关;脾肾气虚证者UA(?)b、UNAG异常升高,与肝肾阴虚证、肺肾气虚证、脾肾阳虚证者比较,组间差异均有统计学意义(P<0.05)。结论对于早期CKD患者而言,出现尿蛋白的主要脏器与肾、脾有关,其基本病机是脾肾两虚;UA(?)b与脾肾气虚证相关,可以作为其微观证素之一;UNAG也与脾肾气虚证有一定关系;湿热证可能是独立证型。
Objective To analyze the characteristics of TCM syndrome distribution and its correlation with urinary protein in patients with early chronic kidney diseases （CKD） , for the sake of providing a basis for clarifying the rules of TCM syndrome differentiation in CKD. Methods Adopting traditional epidemiological retrospective method, the TCM syndrome and urinary protein related indexes, including 24 h urinary protein （Upro） , urinary al- bumin （UAIb）, urinary β2-microglobulin （Uβ2-MG）, urinary N-acetyl-β-D-glucosaminidase （UNAG）, urinary β-galactosidase （UGAL） , etc, were collected from 199 patients with early CKD, and a multiple factor regression analysis between them was conducted. Results In patients with early stage CKD, the TCM symptoms, as independent factors closely related to urinary protein, were aching loins, poor appetite and indigestion, yellow and brownish urine, regurgitation acid, profuse nocturnal urine, edema, foamy urine, cough, aversion to cold and cold limbs, etc ; the elevation of UAlb with the factors of Pi-Shen qi-deficiency as aching loins, poor appetite and indigestion was correlated; elevation of UNAG with edema, foamy urine, profuse nocturnal urine, cough; UGAL with Pi-Shen yang-deficiency factors as aching loins, aversion to cold and cold limbs; and elevation of Uβ2-MG with e- dema were correlated respectively as well. Levels of UAlb and UNAG in patients of Pi-Shen qi-deficiency type were significantly higher than those in patients of Gan-Shen yin-deficiency type, Fei-Shen qi-deficiency type, and PiShen yang-deficiency type, respectively （all P 〈0.05）. Conclusion For early stage CKD patients, Shen and Pi are the major organs related to the appearance of urinary protein; Pi-Shen deficiency is the basic pathogenesis. Level of UAlb, which is associated with Pi-Shen qi-deficiency type, could be taken as one of microcosmic syndrome factors for the syndrome type; UNAG also be related with that syndrome to certain extent; and heat-damp syndrome might be an independent type.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2008年第9期801-805,共5页
Chinese Journal of Integrated Traditional and Western Medicine
基金
卫生部笹川医学奖学金同学会科研启动基金(No.107)
关键词
慢性肾脏病
中医证候
尿蛋白
回归分析
chronic kidney diseases
traditional Chinese medical syndrome
urinary protein
regression analysis
