单中心成人泌尿系结石与中医体质相关性研究

目的?探讨成人泌尿系结石与中医体质的相关性，为防治尿石症提供新的方向和策略。方法?收集南京中医药大学附属医院/江苏省中医院泌尿外科2018年6月至2019年12月的成年泌尿系结石住院患者998例，统计其性别、年龄、身高、体质量、发病部位、是否复发等基本信息及结石成分分析结果，并对其进行中医体质类型辨识，采用统计学方法，分析成人泌尿系结石与中医体质类型的相关性。结果?成人泌尿系结石患者各体质类型与其BMI、性别、年龄、发病部位显著相关（P<0.01）。成人泌尿系结石患者最常见的中医体质分型是痰湿质、湿热质、阳虚质、阴虚质，其中男性患者以湿热质、痰湿质为主，女性患者则以阳虚质、痰湿质为主。998例成人泌尿系结石患者共发现23种结石成分组成，其中单一结石成分334例，2种复合结石成分462例，3种复合结石成分194例，4种复合结石成分8例，临床上结石成分多以混合形式出现。一水草酸钙、二水草酸钙、碳酸磷灰石为最常见的结石成分。患病人群以中年人为主，其体质多为痰湿质、阳虚质；青年结石患者体质多为湿热质；老年结石患者体质多为阴虚质。结石患者的主要发病部位在上尿路。气虚质较湿热质、痰湿质、阴虚质成年患者更易患感染性结石（P<0.003）。湿热质患者较其他体质患者结石复发率更高，平和质患者结石不易复发（P<0.003）。结论?成人泌尿系结石与中医体质之间具有明确的相关性。从中医体质学的角度出发，为临床防治成人泌尿系结石提供新的方法。 

Study on the Correlation Between Single-Center Adult Urinary Calculi and Traditional Chinese Medicine Constitution

OBJECTIVE?To explore the correlation between adult urinary calculi and traditional Chinese medicine (TCM) constitution， and to provide new directions and strategies for the prevention and treatment of urolithiasis. METHODS?A total of 998 adult patients with urinary calculus in Jiangsu Province Hospital of Chinese Medicine from June 2018 to December 2019 were recruited. The basic information such as sex， age， height， body weight， location of disease， recurrence， analyzed the results of calculus composition and identified the TCM constitution types were collected. The statistical methods were applied to analyze the correlation between adult urinary calculus and TCM constitution types. RESULTS?Adult urinary calculus patients' TCM constitution types were significantly correlated with their BMI， gender， age and location (P<0.01). The most common types of TCM constitutions in adult patients with urinary calculus were phlegm-dampness， dampness-heat， yang deficiency and yin deficiency， among which male patients were mainly dampness-heat and phlegm-dampness while female patients were mainly yang deficiency and phlegm-dampness. A total of 998 adult patients with urinary calculus were found to be composed of 23 kinds of calculus composition， including 334 of single ones， 462 of two compound ones， 194 of three composition compound ones， 8 of four composition compound ones. The mixed form was more common in clinics. The affected patients were mainly middle-aged people， and their constitutions were mostly phlegm-dampness and yang deficiency. The young patients with urinary calculus were mostly dampness-heat and the elderly patients yin deficiency. The main focus located in the upper urinary tract. Calcium oxalate monohydrate， calcium oxalate dihydrate， and carbonate apatite were the most common calculus components. Qi deficiency was more likely to cause infectious calculi in adult patients than the type of dampness-heat， phlegm-dampness and yin deficiency (P<0.003). Patients with dampness-heat had a higher recurrence rate of calculus than patients with other constitutions. Mild constitution patients were not so likely to relapse (P<0.003). CONCLUSION?There is a clear correlation between adult urinary calculus and TCM constitution. From the perspective of Chinese medicine constitution， it provides new methods for clinical prevention and treatment of adult urinary calculus.