216例慢性肾炎患者黏膜炎症、诱因、体质与中医证型分析

目的:分析慢性肾炎患者黏膜炎症、诱因、体质与中医证型之间的关系,为慢性肾炎的防治提供思路与方法。方法:参考中华中医药学会肾病分会2006年《慢性肾炎的诊断、辨证分析及疗效评定》标准及标准化的中医体质量表,对216例慢性肾炎患者进行中医辨证和体质分型,并收集黏膜炎症及炎症诱因资料进行总结分析。结果:216例慢性肾炎患者体质以兼夹质30.1%、阳虚质17.6%、气虚质13.4%、阴虚质11.1%为主要类型;中医证型以脾肾气虚31.9%、气阴两虚22.2%、脾肾阳虚21.8%为常见证型;反复呼吸道炎症在黏膜炎症中最常见(69.9%);脾肾气虚型体质主要为平和质和气虚质(P<0.01),气阴两虚型主要为气虚质兼阴虚质(P<0.01),脾肾阳虚型主要为阳虚质(P<0.01),肝肾阴虚型患者主要为阴虚质(P<0.01),阴阳两虚型主要为阳虚质兼阴虚质(P<0.01),湿热证主要见于湿热质(P<0.01),血瘀证主要见于阳虚质(P<0.01);反复呼吸道炎症在气虚质及阳虚质中多见(P<0.001),慢性皮肤炎症在气虚质兼阴虚质及湿热质中多见(P<0.05),慢性胃炎与长期大便不成形在阳虚质及气虚质多见(P<0.05);气虚质、阳虚质患者易感受六淫之邪而发病(P<0.01);气虚质、阳虚质及阴虚质患者易受饮食因素影响(P<0.05);睡眠不佳在气虚质、阳虚质中多见(P<0.05);劳逸因素在气虚质中多见(P<0.05)。结论:慢性肾炎患者黏膜炎症、诱因、体质与中医证型四者之间密切相关,从优化体质入手,改变生活方式,消除黏膜炎症,结合中医辨证施治及现代医学方法多靶点防治慢性肾炎,应该是一种较好的思路与方法。

Analysis of Mucosal Inflammation and Their Predisposing Factors, the Constitution and Chinese Medicine Syndrome Types in 216 Chronic Glomerulonephritis Patients

To analyze the relationship among mucosal inflammation and their predisposing factors, the constitu tion and the Chinese Medicine Syndrome Types of chronic glomerulonephritis patients in order to explore new ways for controlling this disease. Methods： According to the criterion made by the Nephrology Branch of China Association of Chinese Medicine in 2006 and the questionnaire of Standardized Constitution in Chinese Medicine, the syndrome type and the constitution type of 216 patients were differentiated, and the related mucosal inflammation and prettisposing factors were collected. Results：The major constitution type of the 216 chronic glomerulonephritis patients were accompanied with matter （30.1%）, Yang - deficiency （ 17.6% ）, Qi - deficiency （13.4%） and Yin -deficiency （11.1%） ;the Chinese Medicine Syndrome Types were Pi -Shen qi -deficiency type （31.9%）, qi - yin deficiency type （22.2%）, Pi - shen yang deficiency type （21.8%）. Repeated respiratory inflammation was the most common mucosal inflammation （69.9%）. The major constitution of Pi - Shen qi - deficiency type patients were Yin - Yang harmony and Qi deficiency （P 〈0.01 ） ; qi - yin deficiency type patients were mainly Qi - deficiency accompanied with Yin - deficiency （P 〈0.01 ） ; Pi - shen yang deficiency type patients were mainly Yang - deficiency （ P 〈 0.01 ） ; Gan - Shen yin - deficiency type patients were mainly Yin - deficiency （ P 〈 0.01 ） ; yin - yang deficiency patients were Yin - deficiency accompanied with Yang - deficiency （ P 〈 0.01 ） ; damp- heat syndrome type patients were damp- heat; blood -stasis type patients were Yang -defieiency（P 〈0.01 ）. Re peated respiratory inflammation was common in Qi -deficiency and Yang- deficiency patients （P 〈0.001 ）. Chronic skin inflamma tion was more common in Qi - deficiency accompanied with Yin - deficiency and damp - heat patients （ P 〈 0.05 ）. Chronic gastritis and long- term defecate deformed was common in Yang- deficiency and Qi- deficiency patients（P 〈 0.05 ） ;Patients with Qi -defi- ciency or Yang- deficiency were more susceptible to the six evils （P 〈0.01 ） while patients with Qi -deficiency, Yang -deficiencyor Yin - deficiency were more susceptible to dietary factors （P 〈 0.05）. Poor sleep was more common in patients with Qi - deficiency or Yang - deficiency （ P 〈 0.05 ）. Tired factor was more common in patients with Qi - deficiency （ P 〈 O. 05）. Conclusion： Our study suggested that there are strong relationships among mucosal inflammation and their predisposing factors, constitution and the Chinese Medicine Syndrome Types in chronic glomerulonephritis patients. It is thus possible to control the disease by optimizing the constitu tion, changing the life style, eliminating the mucosal inflammation bv intearated Traditional Chinese Medicine and modem medicine.