文献类型：期刊文献

中文题名：不同年龄慢性肾脏病3期患者中医体质与超声骨密度、肾功能的相关性研究

英文题名：Correlation of Traditional Chinese Medicine Constitution with Ultrasound Bone Mineral Density and Renal Function in Patients with Stage 3 Chronic Kidney Disease at Different Age Groups

作者：陈淑园[1];许筠[2];丁文君[3];张茹[2];张丽[1]

第一作者：陈淑园

机构：[1]甘肃中医药大学中西医结合学院,甘肃兰州730000;[2]兰州市第一人民医院老年病科,甘肃兰州730050;[3]甘肃省中医院肾病科,甘肃兰州730050

第一机构：甘肃中医药大学中西医结合学院

年份：2023

卷号：40

期号：8

起止页码：1870

中文期刊名：广州中医药大学学报

外文期刊名：Journal of Guangzhou University of Traditional Chinese Medicine

收录：CSTPCD

基金：甘肃省中医药管理局科研项目(编号:GZK-2019-72);兰州市卫生健康科技发展项目(编号:2019-017);甘肃中医药大学研究生创新创业基金项目(编号:2022CX43)。

语种：中文

中文关键词：慢性肾脏病3期;中医体质;超声骨密度;肾功能;相关性

外文关键词：stage 3 chronic kidney disease;traditional Chinese medicine(TCM)constitution;ultrasound bone mineral density;renal function;correlation

摘要：【目的】探讨不同年龄慢性肾脏病(CKD)3期患者中医体质与超声骨密度、肾功能的相关性。【方法】收集符合纳入、排除标准的350例CKD 3期患者,辨识中医体质,测定超声骨密度(T值)及肾功能指标[估算肾小球滤过率(e GFR)、血肌酐(Scr)、血尿素氮(BUN)、血尿酸(UA)、24 h尿蛋白定量(UTP/24h)],采用双变量相关分析法探析其相关性。【结果】(1)在中老年CKD 3期患者中,女性明显多于男性,且以偏胖人群居多;同时,随年龄增长,骨量减少或骨质疏松患病率呈逐渐升高趋势,肾功能呈逐渐下降趋势,差异均有统计学意义(P<0.05或P<0.01)。(2)体质辨识结果显示:不同年龄组的CKD 3期患者的体质分布存在差异,其中,平和质、气虚质、阳虚质、瘀血质、气郁质在不同年龄组中比较,差异有统计学意义(P<0.05或P<0.01)。(3)各年龄组CKD 3期患者的骨密度T值均与肾功能密切相关,且随年龄增长呈逐渐下降趋势(P<0.05或P<0.01)。(4)中医体质与骨密度T值存在相关性。青年组患者平和质、湿热质与骨密度T值呈正相关;中年组患者阳虚质与骨密度T值呈负相关,瘀血质与骨密度T值呈正相关;老年组患者气虚质、阳虚质、湿热质、瘀血质与骨密度T值呈负相关(P<0.05或P<0.01)。(5)中医体质与肾功能存在相关性。青年组患者平和质与肾功能呈正相关,气虚质与肾功能呈负相关;中年组患者气虚质、阳虚质、湿热质、气郁质与肾功能呈负相关;老年组患者阳虚质、气虚质、瘀血质、湿热质、痰湿质与肾功能呈负相关(P<0.05或P<0.01)。【结论】不同年龄CKD 3期患者中医体质与超声骨密度、肾功能存在一定相关性;通过体质辨识,调理偏颇体质,对临床早期预防并发症及延缓疾病进展具有一定价值。
Objective To explore the correlation of traditional Chinese Medicine(TCM)constitution with ultrasound bone mineral density(BMD)and renal function in patients with stage 3 chronic kidney disease(CKD)at different age groups.Methods A total of 350 stage 3 CKD patients who met the inclusion and exclusion criteria were enrolled into the analysis.The TCM constitution types of the patients were identified,T values of ultrasound BMD were determined,and renal function indicators of estimated glomerular filtration rate(eGFR),serum creatinine(Scr),blood urea nitrogen(BUN),blood uric acid(UA)and 24-hour urine total protein(UTP/24h)were examined.And the correlation of TCM constitution with ultrasound BMD and renal function was explored by bivariate correlation analysis.Results(1)Among the middle-aged and elderly patients with stage 3 CKD,the female was more than the male,and most of the patients were obese;the prevalence of bone loss or osteoporosis tended to increase gradually with the age,and the kidney function tended to decrease gradually,the differences being statistically significant(P<0.05 or P<0.01).(2)The results of TCM constitution identification showed that the distribution of TCM constitution types of stage 3 CKD patients varied in different age groups,and the differences of the balanced constitution,qi deficiency constitution,yang deficiency constitution,blood stasis constitution and qi stagnation constitution were statistically significant(P<0.05 or P<0.01)among various age groups.(3)The T values of BMD in stage 3 CKD patients at various age groups were closely related to the renal function,and the T values of BMD showed a gradual decrease with the increase of the age(P<0.05 or P<0.01).(4)There was a correlation between TCM constitution and T values of BMD.Balanced constitution and damp-heat constitution were positively correlated with T values of BMD in the youth group,yang deficiency constitution was negatively correlated with the T values of BMD and stasis blood constitution was positively correlated with the T values in the middle-aged group,and qi deficiency constitution,yang deficiency constitution,damp-heat constitution and blood stasis constitution were negatively correlated with the T values of BMD in the elderly group(P<0.05 or P<0.01).(5)There was a correlation between TCM constitution and renal function.Balanced constitution was positively correlated with renal function and qi deficiency constitution was negatively correlated with renal function in the youth group,qi deficiency constitution,yang deficiency constitution,damp-heat constitution and qi stagnation constitution were negatively correlated with renal function in the middle-aged group,and the yang deficiency constitution,qi deficiency constitution,blood stasis constitution,damp-heat constitution and phlegm-damp constitution were negatively correlated with renal function in the elderly group(P<0.05 or P<0.01).Conclusion TCM constitution types of stage 3 CKD patients with various age groups are correlated with ultrasound BMD and renal function.The regulation of the biased constitution based on constitution identification is valuable for early clinical prevention of complications and delaying the progression of CKD.