|
In recent years, malnutrition, inflammation and artery atherosclerosis among causal relationship gradually been recognized Stenvinkel 109 pre-dialysis patients with end-stage renal failure study found, 22% of malnutrition inflammation and atherosclerosis in three cases. Subsequent research suggests the presence of malnutrition, inflammation and atherosclerosis syndrome (MIAs). The MIAs seriously affect the quality of life and prognosis of patients with chronic renal failure. Chinese medicine the CRF malnutrition, CRF inflammation of CRF atherosclerosis in various parts of the research is very active, mainly Chinese medicine treatment of chronic renal failure to obtain better results, it is Integrative Medicine CRF may have better prospects. MIAs of TCM research is still at a preliminary stage, it MIAs Pathogenesis syndrome type to give targeted Chinese medicine treatment is very important. Objective: To summarize the distribution of syndrome law the CKD-MIA syndrome, major syndromes characterized; analyze the the MIAs evidence with clinical malnutrition, inflammation and atherosclerosis correlation; the CKD-MIA syndrome for Chinese medicine The dialectical legislation to provide basic clinical information Herbal Prescription. Methods: A cross-sectional survey of all included cases TCM TCM of wasting certificate and evil empirical score the SGA score dialysis patients MIS ratings; collecting entrance science, history and a variety of clinical data, including: gender, age, height, weight, and calculated body mass index BMI = BW (kg) / height (m2), blood pressure, personal habits, serum creatinine, blood urea nitrogen, serum albumin, prealbumin, transferrin, total cholesterol, triglycerides ester, calcium, phosphorus, parathyroid hormone, hemoglobin, high-sensitivity C-reactive protein, interleukin 6, tumor necrosis factor-α and carotid ultrasound measurements of the carotid artery - in film thickness; records defined previously diagnosed cardiovascular and cerebrovascular and peripheral arterial disease. Hemodialysis patients with pre-dialysis blood. Analysis of the relationship between the various clinical indicators and relations between wasting the certificate and evil Empirical integral. Data correlation analysis using Spearman correlation analysis, the groups were compared using the rank sum test, P lt; 0.05 considered to have significant differences. Results: 1. Chronic kidney disease MIA syndrome patients with clinical symptoms: The most common clinical symptoms of lassitude, backache soft knee, shortness of breath, dark complexion, aversion to cold, numbness, poor appetite and indigestion, chest suffocation dry mouth and throat, head and body weight difficulties. Chronic kidney disease MIA syndrome patients with clinical evidence Syndrome: the most common syndromes wasting permit spleen qi deficiency (43.9%), the most common evil Empirical blood stasis (73.17%) and various wet evil (including wet and dirty, hot and humid, wet, phlegm) MIA syndrome in patients with mild to moderate malnutrition spleen qi deficiency syndrome type more common, more common in patients with severe malnutrition yin and yang deficiency type. There was a positive correlation between wasting card Calculus and evil empirical integral. 3. Relationship between malnutrition, inflammation and atherosclerosis indicators: Hs-CRP and MIS exists a positive correlation Hs-CRP and the the PA presence of negative Hs-CRP CHO, LDL negative correlation, indicating that the micro-inflammatory state caused malnutrition and atherosclerosis hardening of the important reasons. The relationship between malnutrition, inflammation and atherosclerosis indicators and TCM syndrome: 1) evil the empirical integral with the physical and chemical indicators of ALB level was negatively correlated, suggesting that the MIA patients with clinical symptoms evil real with albumin levels may lower heavier. 2) inflammatory cytokines IL-6 and wet turbid damp-heat syndrome is positively related to the wet muddy, damp-heat syndrome and of serum IL-6 levels have some correlation. 3) IMT with damp-heat syndrome, blood stasis, there is a positive correlation damp heat stasis transimpedance gather for blood, may be one of the pathogenesis of CKD in patients with atherosclerotic hardening. The above results suggest the following conclusions: chronic renal failure MIA syndrome type syndrome is characterized by a deficiency mixed, the most common clinical TCM wasting syndrome type spleen qi deficiency, the real evil characteristics wet stasis; After CKD- MIA patients with malnutrition, inflammation and atherosclerosis clinical indicators and TCM positive imaginary evil empirical climate correlation analysis confirms the MIA patients, there are two closely related disease caused by virtual due a virtual cause real and due to the real machine changes. According to the clinical practice for patients with positive imaginary evil empirical climate, righting Exorcism the still MIA treatment of important rule, the and spleen the kidney, Yiqihuoxue, the dampness Xiezhuo may MIA syndrome conquer. The topics included in chronic kidney disease MIA syndrome in 41 patients. Epidemiological cross-sectional study, carried out a preliminary analysis of the use of modern statistical methods MIA syndrome TCM syndrome TCM symptoms, clinical data collection, physical and chemical examination data, various laboratory examinations.
|