300例2型糖尿病肾病患者分期与中医辨证分型的相关性研究

目的:通过分析2型糖尿病肾病临床分期与中医证型的相关性,为临床治疗提供指导。方法:采用Ridit及Kappa检验比较2型糖尿病肾病临床分期与中医证型之间的关系。结果:300例患者中,阴虚燥热证占临床前期糖尿病肾病的78.18%;气阴两虚证占早期糖尿病肾病得77.60%;阴阳两虚证占临床期糖尿病肾病得72.22%;阳衰瘀阻证占终末期糖尿病肾病得83.33%,经Ridit检验,组间差异有显著性意义(P<0.05);但Kappa检验发现临床前期与阴虚燥热证强相关,Kappa=0.957;早期临床与气阴两虚证中度相关,Kappa=0.406;临床期与阴阳两虚证、终末期与阳衰瘀阻证相关性差,Kappa均<0.400。阴虚燥热证在临床前期最常见且与之强相关。结论:2型糖尿病肾病临床分期与中医证型有一定的相关性。

Study on Relationship Between Clinical Stage and TCM Syndrome Types in 300 Cases of Type 2 Diabetic Nephropathy Patients

Objective:By analyzing the relationship between clinical stage and traditional Chinese medicine(TCM) syndrome types in type 2 diabetic nephropathy patients(pts),it is to provide guidance for clinical treatment.Methods:Ridit and Kappa tests were used to study the relationship between clinical stage and TCM syndrome types in type 2 diabetic nephropathy pts.Results:Among the 300 cases,Yin deficiency and dryness-heat syndrome accounted for 78.18% in pre-clinical diabetic nephropathy,qi and Yin deficiency syndrome accounted for 77.60% in early-stage,both Yin and Yang deficiency syndrome accounted for 72.22% in clinical-stage,Yang deficiency and blood stasis syndrome accounted for 83.33% in end-stage.By Ridit analysis,the difference between the groups was significant(P<0.05).But from the result of Kappa test,pre-clinical stage strongly compared with Yin deficiency and dryness-heat syndrome,Kappa=0.957;early-clinical stage moderate compared with Qi and Yin deficiency syndrome,Kappa=0.406;clinical stage compared with both Yin and Yang deficiency syndrome and end-stage poor with Yang deficiency and blood stasis syndrome,all Kappa<0.400.Yin deficiency and dryness-heat syndrome was the most common syndromes in pre-clinical diabetic nephropathy and strongly associated with it.Conclusion:The clinical stage has some relationship with TCM syndrome types in pts with type 2 diabetic nephropathy.