摘要
目的探讨血液透析伴血管钙化患者中医特征。方法选取维持性血液透析治疗伴有血管钙化的108例终末期肾病患者,专人进行问卷调查及中医证候辨证。结果108例患者均辨证为虚证,其中102例(94.44%)患者可辨为本虚证合并标实证。本虚证以脾肾阳虚证为主,其次为气阴两虚证、阴阳两虚证、脾肾气虚证、肝肾阴虚证,分别为42例(38.89%)、30例(27.78%)、18例(16.67%)、12例(11.11%)、6例(5.56%);标实证以血瘀证为主,其次为湿热证、湿浊证、水汽证、风动证,分别为42例(38.89%)、33例(30.56%)、20例(18.52%)、4例(3.70%)、3例(2.78%);标实兼证以血瘀证在脾肾阳虚证、气阴两虚证、阴阳两虚证多见,湿热证及湿浊证在脾肾阳虚证、气阴两虚证多见,风动证及水气证仅在气阴两虚证及阴阳两虚证患者中出现。不同年龄、透析龄患者中医证型分布存在差异,比较差异有统计学意义(P<0.05);年龄≥65岁及透析龄≥5年的患者虚证以脾肾阳虚证多见,其次为气阴两虚证,实证则以血瘀证多见,其次为湿浊证,年龄<65岁及透析龄<5年的患者虚证以气阴两虚证多见,其次为脾肾阳虚证,实证以湿热证多见,其次为血瘀证;不同性别及原发疾病患者中医证型分布差异无统计学意义(P>0.05)。结论血液透析伴血管钙化患者多为本虚证合并标实证,本虚证以脾肾阳虚证为主,标实证以血瘀证为主;标实兼证以血瘀证在脾肾阳虚证、气阴两虚证、阴阳两虚证多见,湿热证及湿浊证在脾肾阳虚证、气阴两虚证多见,年龄、透析龄会影响到患者的中医证型分布。
Objective To investigate the characteristics of traditional Chinese medicine syndromes in patients with hemodialysis complicated with vascular calcification.Methods A total of 108 end-stage renal disease patients with vascular calcification treated with maintenance hemodialysis were selected,and a questionnaire survey and traditional Chinese medicine syndrome differentiation were conducted by a dedicated person.Results All 108 patients were diagnosed as deficiency syndrome,102 patients(94.44%)can be identified as the combination of root deficiency syndrome and manifestation excess syndrome.This root deficiency syndrome was mainly characterized by Yang deficiency of spleen and kidney syndrome(42 cases,38.89%).Secondly,there were Qi-Yin deficiency syndrome(30 cases,27.78%),Yin-Yang deficiency syndrome(18 cases,16.67%),Qi deficiency of spleen and kidney syndrome(12 cases,11.11%),and Yin deficiency of liver and kidney syndrome(6 cases,5.56%).The manifestation excess syndrome was mainly characterized by blood stasis syndrome(42 cases,38.89%).Secondly,there were damp-heat syndrome(33 cases,30.56%),damp-turbidity syndrome(20 cases,18.52%),water retention syndrome(4 cases,3.70%)and stirring wind syndrome(3 cases,2.78%).The combined syndrome types of the manifestation excess syndrome:blood stasis syndrome was more common in Yang deficiency of spleen and kidney syndrome,Qi-Yin deficiency syndrome and Yin-Yang deficiency syndrome,while damp-heat syndrome and damp-turbidity syndrome were more common in Yang deficiency of spleen and kidney syndrome and Qi-Yin deficiency syndrome.stirring wind syndrome and water retention syndrome only appeared in patients with Qi-Yin deficiency syndrome and Yin-Yang deficiency syndrome.There were diferences in the distribution of traditional Chinese medicine syndrome types among patients of different ages and dialysis ages,and the dfferences were statistically significant(P<0.05).The patients aged more than 65 years old and with dialysis age more than 5 years with deficiency syndrome were more likely to experience Yang deficiency of spleen and kidney syndrome,followed by Qi-Yin deficiency syndrome,damp-heat syndrome was more common in excess syndrome,followed by damp-turbidity syndrome.The patients aged more than 65 years old and with dialysis age less than 5 years with deficiency syndrome were more likely to experience Qi-Yin deficiency syndrome,followed by Yang deficiency of spleen and kidney syndrome,damp-heat syndrome was more common in excess syndrome,followed by blood stasis syndrome.There was no statistical difference in the distribution of traditional Chinese medicine syndrome types among patients of different genders and primary diseases(P>0.05).Conclusion The patients with hemodialysis complicated with vascular calcification merged with identified as the combination of root deficiency syndrome and manifestation excess syndrome.This root deficiency syndrome was mainly characterized by Yang deficiency of spleen and kidney syndrome.The manifestation excess syndromewas mainly characterized by blood stasis syndrome.Blood stasis syndrome was more common in Yang deficiency of spleen and kidney syndrome,Qi-Yin deficiency syndrome and Yin-Yang deficiency syndrome,while damp-heat syndrome and damp-turbidity syndrome were more common in Yang deficiency of spleen and kidney syndrome and Qi-Yin deficiency syndrome.Age and dialysis age can affect the distribution of traditional Chinese medicine syndrome types in patients.
作者
余斐
李建锋
宋明爱
YU Fei;LI Jianfeng;SONG Ming'ai(First Peoples Hospital of Nanyang,Nanyang 473000,Henan,China)
出处
《中华中医药学刊》
北大核心
2025年第7期94-97,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家中医药管理局中医药科学技术研究专项(2019ZX796)
河南省医学科技攻关联合共建项目(LHGJ20221042)。
关键词
血液透析
血管钙化
中医证候
特征
hemodialysis
vascular calcification
traditional Chinese medicine syndrome
characteristics
