维持性腹膜透析患者中医证型与C-反应蛋白关系探讨

目的：探讨维持性腹膜透析患者中医证型与C-反应蛋白（CRP）之间的关系,为微炎证状态的治疗提供新的思路。方法：参考中华中医药学会肾病分会2006年《慢性肾衰竭的诊断、辨证分析及疗效评定》标准制定“维持性腹膜透析患者中医证型分布临床症状调查表”,对151例维持性腹膜透析患者进行中医辨证分型,本虚证分为脾肾气虚、肝肾阴虚、脾肾阳虚、气阴两虚、阴阳俱虚5型,标实证分为无兼证、湿浊证、湿热证、热毒证、血瘀证5型,并收集患者的CRP结果,通过方差分析进行比较。结果：本虚证各组间平均值均高于正常参考值,但组间比较差异无统计学意义（P〉0.05）;标实证方面组间总差异有统计学意义（P〈0.05）,组间两两比较主要表现为湿热证组的CRP水平显著高于其他各组（P〈0.05）,并且把临床上有明显感染征象的患者剔除后再做统计,结果仍显示湿热证组与其他各证型间差异有统计学意义（P〈0.01）。结论：维持性腹膜透析患者湿热证型与CRP结果有较好的相关性,能为临床辨证施治提供参考,为治疗微炎证状态提供新的思路。

Relationship between Traditional Chinese Medicine Syndromes and C Reactive Protein in Patients with Peritoneal Dialysis

Objective：To discuss the relationship between traditional Chinese medicine syndromes and the CRP levels in peritoneal dialysis patients.Methods：A questionnaire based on the criterion made by the Nephropathy Branch of China Association of Chinese Medicine in 2006 was used on 151 peritoneal dialysis patients for groups division according to their Chinese medicine syndromes.The asthenia syndromes include spleen and kidney Qi deficiency,liver and kidney Yin deficiency,spleen and kidney Yang deficiency,both Qi and Yin deficiency,both Yin and Yang deficiency.The excess syndromes consist of none syndrome,turbid damp syndrome,damp-heat syndrome,heat-toxicity syndrome and blood stasis syndrome.Then the Analysis of Variance was used to compare the differences of CRP among all the syndromes.Results：The mean values of all the asthenia syndromes were above the normal level,but there were no significant differences among the different asthenia syndromes（P0.05）.In the excess syndromes,the CRP levels in patients with damp-heat syndrome was significantly higher than that in any other syndromes （P0.05）.It was still significantly higher （P0.01） when the patients with obvious signs of infection were excluded.Conclusion：There is certain correlation between the damp-heat syndrome and the CRP,which may provide us with reference and new idea in clinical practice.