不同中医证型慢性肾脏病G5D 期维持性血液透析伴甲状旁腺切除术患者相关指标的差异研究
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R692

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中山市医疗卫生重点项目(2020B3005)


Study on Differences of Relevant Indexes in Patients with G5D Stage of Chronic Kidney Disease with Different Traditional Chinese Medicine Syndrome Types Who Underwent Maintenance Hemodialysis with Parathyroidectomy
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    摘要:

    目的:观察不同中医证型慢性肾脏病(CKD) G5D 期维持性血液透析(MHD) 伴甲状旁腺切除 术(PTX) 患者一般资料、实验室指标的差异。方法:收集不同中医证型患者的一般资料(性别、年龄、透析 龄、原发病、开始透析年龄、全段甲状旁腺激素(iPTH) 升高至行PTX 治疗的间隔时间) 及实验室指标[术 前和术后1 个月血红蛋白(Hb)、iPTH、血钙(Ca)、血磷(P)]。结果:不同中医证型患者年龄及开始透析 年龄整体比较,差异均有统计学意义(P<0.05)。其中,肾阳亏虚证患者年龄大于脾阳虚衰证及湿热蕴结证患 者,肝肾阴虚证患者年龄大于湿热蕴结证患者,肝肾阴虚证及肾阳亏虚证患者开始透析年龄均大于湿热蕴结证 患者,差异均有统计学意义(P<0.05)。不同中医证型患者性别及iPTH 升高至行PTX 治疗的间隔时间、透析 龄整体比较,差异均无统计学意义(P>0.05)。高血压病、肾小球肾炎、肾性贫血及其他基础疾病在不同中医 证型患者中占比比较,差异均无统计学意义(P>0.05)。术前,不同中医证型患者Hb、iPTH 水平整体比较, 差异均有统计学意义(P<0.05)。其中,湿热蕴结证患者Hb 水平低于脾阳虚衰证患者,湿热蕴结证与肾阳亏 虚证患者iPTH 水平均高于脾阳虚衰证和肝肾阴虚证,差异均有统计学意义(P<0.05)。不同中医证型患者血 P 及血Ca 水平整体比较,差异均无统计学意义(P>0.05)。术后1 个月,不同中医证型患者Hb 水平整体比 较,差异有统计学意义(P<0.05)。其中,湿热蕴结证患者Hb 水平低于脾阳虚衰证患者,差异有统计学意 义(P<0.05)。不同中医证型患者血P、血Ca、iPTH 水平整体比较,差异均无统计学意义(P>0.05)。结 论:MHD 伴PTX 术后患者中医证型以脾阳虚衰证为主。不同中医证型患者的年龄、开始透析年龄、术前及术 后1 个月Hb、iPTH 水平存在显著差异。

    Abstract:

    Abstract: Objective: To observe the differences of general data and laboratory indexes in patients with G5D stage of chronic kidney disease (CKD) with different traditional Chinese medicine(TCM) syndrome types who underwent maintenance hemodialysis (MHD) and parathyroidectomy (PTX). Methods: The general data of patients with different TCM syndorme types were collected, including gender, age, dialysis duration,primary affection,age of starting dialysis,interval between intact parathyroid hormone (iPTH) elevation and PTX, and the laboratory indexes, including hemoglobin (Hb), iPTH, blood calcium (Ca) and blood phosphorus (P). Results: Comparing the age and age of starting dialysis of patients with different TCM syndrome types showed significance in the differences (P<0.05). Specifically,the patients with syndrome of kidney yang depletion were older than those with syndrome of spleen yang deficiency and syndrome of accumulated damp-heat,patients with liver-kidney yin deficiency syndrome were older than those with syndrome of accumulated damp- heat, and patients with syndrome of kidney yang depletion and liver-kidney yin deficiency syndrome firstly received dialysis at an older age than those with syndrome of accumulated damp- heat, differences being significant (P<0.05). There was no significant difference being found in the overall comparisons of gender, interval among iPTH and PTX treatment and dialysis duration among patients with different TCM syndrome types (P>0.05). There was no significant difference being found in the comparisons of proportions of hypertension,glomerular nephropathy,renal anemia and other basic diseases among patients with different TCM syndrome types (P>0.05). Before surgery, the comparisons of levels of Hb and iPTH among patients with different TCM syndrome types (P<0.05). The Hb levels of patients with syndrome of accumulated damp- heat were lower than those of patients with syndrome of spleen yang deficiency,and the iPTH levels of patients with syndrome of accumulated dampheat and syndrome of kidney yang depletion were higher than those of patients with syndrome of spleen yang deficiency and liver- kidney yin deficiency syndrome, differences being significant (P<0.05). There was no significant difference being found in the overall comparisons of levels of blood P and blood Ca among patients with different TCM syndrome types (P>0.05). One month after surgery,the overall comparison of Hb level among patients with different TCM syndrome types showed significance in the difference (P< 0.05). The Hb levels of patients with syndrome of accumulated damp- heat were lower than those of patients with syndrome of spleen yang deficiency, differences being significant (P<0.05). There was no significant difference being found in the overall comparisons of levels of blood P,blood Ca and iPTH among patients with different TCM syndrome types (P>0.05). Conclusion: The main TCM syndrome type of patients after receiving MHD and PTX is the syndrome of spleen yang deficiency. There were significant differences in the age, age of starting dialysis, levels of Hb and iPTH of patients with different TCM syndrome types one month before and after surgery.

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甘沛敏,刘琳娜.不同中医证型慢性肾脏病G5D 期维持性血液透析伴甲状旁腺切除术患者相关指标的差异研究[J].新中医,2023,55(24):80-85

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  • 在线发布日期: 2023-12-30
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