糖尿病肾病中医证型与CRP指标关系探讨

目的：探讨糖尿病肾病（diabetic nephropathy,DN）患者中医证型分布特征与炎症指标C反应蛋白（CRP）的关系。方法：将2010年中国人民解放军总医院门诊及住院部糖尿病肾病患者64例分为阴虚燥热、气阴两虚、脾肾气虚（阳）、阴阳两虚4种本证组和兼湿证、兼瘀证、兼痰瘀证3种标证组,并选择50名健康志愿者为正常对照组（NC组）,所有纳入者以速率散射比浊法测定C反应蛋白。结果：与正常健康人50例作对照,糖尿病肾病患者CRP水平（1.73±2.91）mg/dl明显高于NC组（0.54±0.16）mg/dl,差异具有统计学意义（P〈0.05）。DN各本证证型组血清CRP水平的比较显示,随着证型由阴虚燥热、脾肾气（阳）虚、气阴两虚、阴阳两虚的演变,患者血清CRP水平逐渐升高,且阴虚燥热、脾肾气虚、气阴两虚分别与阴阳两虚组比较,结果差异均有统计学意义（P〈0.05）。标证中,痰瘀证与NC组、无兼证组与NC组及痰瘀证与血瘀证组比较,差异均具有统计学意义（P〈0.01）。结论：血CRP水平与中医证型相关,在一定程度上为中医辨证分型提供客观依据。

Relationship between Serum C-reactive Protein and Syndrome of Traditional Chinese Medicine in Diabetic Nephropathy Patients

Objective：To evaluate the relationship between serum C-reactive protein and syndrome of Traditional Chinese Medicine（TCM）in diabetic nephropathy patients.Methods：64 diabetic nephropathy patients were selected from outpatient and inpatient of PLA General Hospital being compared with 50 healthy people in 2010.According to the syndromes of TCM of the patients,deficiency syndromes include Yin deficiency and heat extreme,spleen and kidney Qi deficiency,Qi and Yin deficiency,and both Yin and Yang deficiency.Excess syndromes include damp syndrome,syndrome of blood stasis and syndrome of phlegm stasis.Serum C-reactive protein was measured by speed scattering turbidimetric method.Results：50 cases of healthy people as control,the CRP level of patients with diabetic nephropathy was significantly higher than the control group（P0.05）.As the patients＇ syndromes of TCM from Yin deficiency and heat extreme,spleen and kidney Qi deficiency,Qi and Yin deficiency to both Yin and Yang deficiency,the level of serum C-reactive protein gradually was increased.The level of CRP in Yin and Yang deficiency was significantly the highest of the others（P0.05）.The level of serum CRP in normal control group is the lowest of the three（NC group,phlegm stasis syndrome group and without superficial syndrome group）（P0.01）,and the level of serum CRP in phlegm stasis syndrome group is the lowest of the three（phlegm stasis syndrome group,blood-stasis syndrome group and the NC group）（P0.01）.Conclusion：The level of serum CRP is related with the syndrome of TCM in diabetic nephropathy patients.At a certain extent,that provided an objective basis for TCM syndrome.