摘要
[目的]分析终末期肾病伴不宁腿综合征(URLS)患者体质分布特点及与不宁腿综合征严重程度的相关性,为针对性临床治疗提供参考依据。[方法]通过门诊调查问卷面对面采集165例URLS患者体质数据及RLS相关评分,匹兹堡睡眠质量指数(PSQI)、Karnofsky功能状态量表(KPS)评分,采用频数分析、Spearman相关分析、因子分析、聚类分析及有序逻辑回归分析等统计分析方法,分析单一体质分布规律、体质兼夹情况、体质与性别关系及体质与疾病严重程度的相关关系。[结果]排名前4的偏颇体质(“是”和“倾向是”)为阴虚质、痰湿质、阳虚质和血瘀质;在各偏颇体质中,单一体质占比小,兼夹体质占比大;痰湿质相对不易与其他偏颇体质形成兼夹,阳虚-血瘀、气虚-阴虚、湿热-气郁、气虚-特禀、阳虚-阴虚-血瘀、气虚-阳虚-阴虚-血瘀(均不区分主次)是较典型的URLS人群体质兼夹组合类型;9种体质得分中,阴虚质、阳虚质、血瘀质、气虚质与RLS疾病严重程度正相关,平和质与RLS严重程度负相关;气虚质、血瘀质与PSQI正相关,平和质与PSQI负相关;血瘀质、气虚质、阳虚质与年龄正相关,平和质与年龄负相关。PSQI、年龄与RLS严重程度正相关,KPS评分、透析龄与RLS严重程度相关性结果差异无统计学意义(P>0.05)。多因素有序逻辑回归分析中,阳虚质、阴虚质、阳虚-阴虚(不区分主次)与URLS严重程度显著正相关(P<0.01)。[结论]URLS患者最常见的体质类型为阴虚质、痰湿质、阳虚质和血瘀质,大部分兼夹多种体质,痰湿质相对不易与其他偏颇体质形成兼夹,阳虚-血瘀、气虚-阴虚、湿热-气郁、气虚-特禀、阳虚-阴虚-血瘀、气虚-阳虚-阴虚-血瘀(均不区分主次)是较典型的URLS人群体质兼夹组合类型。阳虚质、阴虚质、阳虚-阴虚(不区分主次)与URLS严重程度显著正相关,初诊时应重点关注阳虚-阴虚(不区分主次)型体质患者。
[Objective]To analyze the constitutional characteristics of patients with end⁃stage renal disease(ESRD)accompanied by restless legs syndrome(URLS)and its correlation with disease severity of RLS,providing a reference for targeted clinical treatment.[Methods]A total of 165 URLS patients’constitutional data and related RLS scores,including Pittsburgh sleep quality index(PSQI)scores and Karnofsky performance status(KPS)scores,were collected through face⁃to⁃face outpatient questionnaires.Statistical analysis methods such as frequency analysis,Spearman correlation analysis,factor analysis,cluster analysis and ordinal logistic regression analysis were employed to analyze the distribution pattern of single constitution,combined constitutions,the relationship between constitution and gender,and the correlation between constitution and disease severity.[Results]The top four imbalanced constitutions(“yes”and“tend to be”)were yin deficiency,phlegm⁃dampness,yang deficiency,and blood stasis.Among these imbalanced constitutions,the proportion of single constitution was small,while the proportion of combined constitutions was large.Phlegm⁃dampness constitution was relatively less likely to combine with other imbalanced constitutions.Yang deficiency⁃blood stasis,qi deficiency⁃yin deficiency,damp⁃heat⁃qi stagnation,qi deficiency⁃special diathesis,yang deficiency⁃yin deficiency⁃blood stasis,and qi deficiency⁃yang deficiency⁃yin deficiency⁃blood stasis(without hierarchical distinction)were typical combined constitution types in the URLS population.Among the scores of the nine constitutions,yin deficiency,yang deficiency,blood stasis,and qi deficiency were positively correlated with RLS disease severity,while the balanced constitution score was negatively correlated with RLS severity.Qi deficiency and blood stasis constitutions were positively correlated with PSQI scores,while the balanced constitution was negatively correlated with PSQI scores.Blood stasis,qi deficiency,and yang deficiency constitutions were positively correlated with age,while the balanced constitution was negatively correlated with age.PSQI scores and age were positively correlated with RLS severity.The correlations between KPS scores,dialysis vintage,and RLS severity showed no statistically significant difference(P>0.05).Multivariate ordinal logistic regression analysis revealed that yang deficiency constitution,yin deficiency constitution,and yang deficiency⁃yin deficiency combination(without hierarchical distinction)were significantly positively associated with the severity of URLS(P<0.01).[Conclusion]The most common constitutional types in ESRD patients with RLS were yin deficiency,phlegm⁃dampness,yang deficiency,and blood stasis,with the majority of patients exhibiting multiple constitutions.Phlegm⁃dampness constitution was relatively less likely to combine with other imbalanced constitutions.Yang deficiency⁃blood stasis,qi deficiency⁃yin deficiency,damp⁃heat⁃qi stagnation,qi deficiency⁃special diathesis,yang deficiency⁃yin deficiency⁃blood stasis,and qi deficiency⁃yang deficiency⁃yin deficiency⁃blood stasis(without hierarchical distinction)were typical combined constitution types in this patient population.Yang deficiency constitution,yin deficiency constitution,and yang deficiency⁃yin deficiency combination(without hierarchical distinction)were significantly positively associated with the severity of URLS.Attention should be paid to patients with yang deficiency⁃yin deficiency(without hierarchical distinction)constitution during the initial diagnosis.
作者
徐楚瀚
李粒萌
于涛
黄莹雪
李华南
常文秀
谭涛
XU Chuhan;LI Limeng;YU Tao;HUANG Yingxue;LI Huanan;CHANG Wenxiu;TAN Tao(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;National Clinical Research Center for Chinese Medicine,Tianjin 300381,China;Department of Nephrology,Tianjin First Central Hospital,Tianjin 300192,China;Level 3 Laboratory of Biological Effects of Tuina Manipulation of National Administration of Traditional Chinese Medicine,Tianjin 300381,China;Tianjin Institute of TCM Tuina of Tianjin Municipal Health Commission,Tianjin 300381,China)
出处
《天津中医药》
2026年第4期461-470,共10页
Tianjin Journal of Traditional Chinese Medicine
基金
天津市卫生健康委员会中医中西医结合科研课题(2023118)
第七批全国老中医药专家学术经验继承工作项目(202276)
天津市名中医工作室(TJMZY2405)。
关键词
终末期肾病
不宁腿综合征
体质
PSQI
因子分析
聚类分析
有序逻辑回归分析
uremic restless legs syndrome
constitution
disease severity
PSQI
factor analysis
cluster analysis
ordinal logistic regression analysis
