糖尿病肾病分期证候分布特点研究

目的 观察糖尿病肾病(DN)中医证候分布规律,为进一步研究该病的病因病机及证候特点提供依据.方法 将180例DN患者分为Ⅲ,Ⅳ,Ⅴ3期,按照量表的制作方法,制定DN中医证候问卷,对患者进行了分层、横断面调查,对所得数据进行频数统计.结果 Ⅲ期以气虚证、阴虚证表现多见,兼有内热证、血瘀证、痰湿证表现；Ⅳ期在Ⅲ期基础上出现了血虚证、阳虚证表现,还可兼见水湿证、痰湿证、内热证、热结证、血瘀证的表现.Ⅴ期本虚更甚,还可兼有气滞证、郁热证、湿浊证、血瘀证、热结证等多种表现.结论 DN中医证候具有本虚标实的特点,随着病情进展,标实证候趋于多样,血瘀、湿邪贯穿病程始终.

Distribution of staged syndromes of diabetic nephropathy

Objective To observe the distribution rules of TCM syndromes of diabetic nephropathy(DN),and offer the basis for further study on causes,pathogenesis and syndrome characteristics of DN.Methods All 180 patients were divided into stage-Ⅲ,stage-Ⅳ and stage-Ⅴ.A questionnaire of TCM syndromes of DN was made according to scale making methods,and a layered and cross-sectional survey was carried out in the patients.The obtained data were analyzed with frequency statistics.Results In stage-Ⅲ,qi deficiency syndrome and yin deficiency syndrome were common and the manifestations of internal heat syndrome,blood stasis syndrome and phlegm-damp syndrome were also observed.In stage-Ⅳ,there were blood deficiency syndrome and yang deficiency syndrome besides syndromes in stage-Ⅲ and the manifestations of water-damp syndrome,phlegm-damp syndrome,internal heat syndrome,heat accumulation syndrome and blood stasis syndrome were also observed.In stage-Ⅴ,the syndromes of deficiency of the root were more severe and the manifestations of qi stagnation syndrome,depression heat syndrome,damp-turbidity syndrome,blood stasis syndrome and heat accumulation syndrome were also observed.Conclusion The TCM syndromes of DN have the characteristics of deficiency of the root and excess of the tip.Along with disease progress,the syndromes of deficiency of the root trend to multiple,but blood stasis and dampness go throughout the whole course of disease.