广西地区100例慢性肾衰竭中医证型分布调查研究

目的:研究广西地区慢性肾衰竭的中医证型的分布特点。方法:采用临床调研的方法,收集广西中医药大学第一附属医院肾病科门诊、病房及血透室的慢性肾衰竭患者100例,进行中医辨证分型,运用医学统计学的方法,研究慢性肾衰竭的中医各证型分布规律。结果:在100例慢性肾衰竭患者中,正虚证型以脾肾阳虚证患者最多(38.0%),其次为脾肾气虚证(26.0%),气阴两虚证和阴阳两虚证患者接近(15.0%),肝肾阴虚证最少(7.0%)。邪实证型以湿热证患者出现频率最多(51.0%),湿浊证及血瘀证次之,分别占43.0%和49.0%,水气证和风动证较少(35%)。在中医各虚证证候与肾功能衰竭各期的关系统计中,脾肾气虚证主要见于肾功能代偿期、失代偿期及衰竭期,在尿毒症期降低(P0.05);脾肾阳虚证中尿毒症期为最多,代偿期、失代偿期和衰竭期均较少(P0.05);气阴两虚证主要见于失代偿期、肾衰竭期和尿毒症期,代偿期较少,差异无统计学意义(P0.05);肝肾阴虚证散在见于肾功能衰竭各期中,无明显差异;阴阳两虚证主要见于肾衰竭期和尿毒症期,尿毒症所占比例较大(P0.05)。在中医正虚与邪实兼夹的分布中,纯虚证未兼挟邪实者以脾肾气虚证为最多;湿浊证在脾肾亏虚证中出现最多,湿热证在气阴两虚证中出现最多,水气证在脾肾阳虚证出现最多,在肝肾阴虚证出现最少,血瘀证主要在脾肾阳虚和脾肾气虚证出现最多,风动证在各虚证中较少见,缺乏统计学意义。慢性肾衰竭不同证型之间的年龄分布差异无统计学意义。结论:慢性肾衰竭的中医证型分布具有一定的规律性,将为今后的临床中医治疗提供依据。

Investigation on Distribution of Traditional Chinese Medicine Syndromes of 100 Cases of Chronic Renal Failure in Guangxi Region

Objective ： To study the distribution characteristics of syndrome types of traditional Chinese medicine of chronic renal failure in Guangxi region. Methods ： By clinical research method, 100 cases of patients with chronic renal failure in the First Affiliated Hospital of Guangxi Medical University outpatient and ward were selected. With the method of medical statistics research of traditional Chinese medicine, chronic renal failure syndrome distribution was analyzed. Results ： In 100 patients with chronic renal failure, deficiency syndrome type was most spleen and kidney Yang deficiency syndrome （ 38.0% ）, followed by spleen and kidney deficiency syndrome （ 26.0% ）, qi and Yin deficiency syndrome and Yin and Yang deficiency syndrome （ 15.0% ）, liver and kidney Yin deficiency syndrome （ 7.0% ）. Evil excess syndrome was most heat-dampness syndrome （ 51.0% ）, dampness syndrome （43.0%） and blood stasis （49.0%）, water and wind sydnrome （ 35% ）. In the deficiency syndrome of traditional Chinese medicine and renal failure relationship, spleen and kidney deficiency syndrome was mainly in compensation period and decompensation period and renal function failure and uremia period （ P〈0.05 ）. Spleen and kidney Yang deficiency syndrome was in uremia period for most, compensation period and decompensation stage and failure stage were less （ P〈0.05 ）. Qi and Yin deficiency syndrome was mainly in decompensated period stage, renal failure and uremia and compensatory phase were less, there was no statistically significant difference （ P〉0.05 ）. Liver and kidney Yin deficiency syndrome in installments in renal failure had no obvious difference. Yin and Yang deficiency syndrome stage were mainly in renal failure and uremia, larger proportion of uremia periods （P〈0.05）. In the traditional Chinese medicine distribution, signle deficiency is most spleen deficiency. Dampness syndrome is most in spleen and kidney deficiency syndrome. Heatdampness syndrome is most in qi and Yin dediciency syndrome. Water syndrome is most in spleen and kidney Yang deficicency and less in liver and kidney Yin deficiency. Blood stasis is most in spleen and kidney Yang deficiency syndrome and spleen and kidney qi deficiency sydnorme. Wind syndrome is less in deficiency syndromes without significance. The age distribustion of chronic renal failure with different syndromes had no significance. Conclusion ： There is a certain distribustion law of chronic renal failure TCM syndromes, providing some reference for the treatment in the future.