慢性肾脏疾病合并高尿酸血症的中医证型分析

目的:研究慢性肾脏疾病合并高尿酸血症患者中医证型的分布规律及中医证型与主要临床因素的关系。方法:回顾性分析188例慢性肾脏疾病3～4期合并高尿酸血症患者的中医证候学及实验室检查资料。结果:188例患者中,脾肾阳虚证86例(45.8%),阴阳两虚证42例(22.3%),脾肾气虚证26例(13.8%),脾肾气阴两虚证22例(11.7%),肝肾阴虚证12例(6.4%)。兼证中湿热证32例(34.0%),血瘀证11例(11.7%),湿浊证6例(6.3%),水气证3例(3.2%),风动证1例(1.1%),无兼证42例(44.7%)。随着年龄的增长,肝肾阴虚证的比例呈下降趋势,脾肾阳虚证的比例呈上升趋势。脾肾阳虚证的高血压、肾功能损害的发生率显著高于其他各证(P<0.01)。脾肾气虚证中肥胖比例最高。病程>5年患者兼证发生率明显高于0～5年的患者(P<0.05)。结论:脾肾阳虚证是慢性肾脏疾病合并高尿酸血症患者最常见的中医证型,中医证型与年龄、病程、肾功能等临床因素密切相关。

Analysis on Chinese Medical Patterns in Patients with both Chronic Kidney Diseases and Hyperuricemia

Objective: To observe the distribution of Chinese medical patterns in patients with chronic kidney diseases and hyperuricemia,and relationship between Chinese medical patterns and clinical factors.Methods: A retrospective analysis was conducted to collect the information of 188 patients with chronic kidney diseases and hyperuricemia,including Chinese medical syndromes and clinical data.Results: Among these 188 patients,spleen-kidney yang deficiency syndrome was in 86 cases(45.8%),yin-yang deficiency syndrome was in 42 cases(22.3%),spleen-kidney qi deficiency syndrome was in 26 cases(13.8%),spleen-kidney qi and yin deficiency syndrome was in 22 cases(11.7%),and liver-kidney yin deficiency syndrome was in 12 cases(6.4%).Accompanied symptom of damp-heat was in 32 cases(34.0%),blood stasis was in 11 cases(11.7%),turbid damp was in 6 cases(6.3%),water accumulation was in 3 cases(3.2%),wind was in 1 case(1.1%),and no accompanied symptom was in 42 cases(44.7%).With the increase of age,there were fewer patients with liver-kidney yin deficiency syndrome,and more patients with spleen-kidney yang deficiency syndrome.The probability of hypertension and renal dysfunction was higher in spleen-kidney yang deficiency syndrome than in other syndromes(P<0.01).The proportion of fat patients was highest in spleen-kidney qi deficiency syndrome than in other syndromes.The incidence of accompanied symptom was higher in patients with the disease more than 5 years than below 5 years(P<0.05).Conclusion: Spleen-kidney yang deficiency syndrome is the most common Chinese medical syndrome in patients with chronic kidney diseases and hyperuricemia.The Chinese medical syndrome is closely related to age,course of disease,kidney function and other clinical factors.