Analysis of Traditional Chinese Medical Syndromes and Syndrome Patterns in Diabetic Nephropathy / 广州中医药大学学报

ABSTRACT

Objective To investigate the characteristics of traditional Chinese medical syndromes and syndrome patterns in diabetic nephropathy (DN) from delta regions of pearl river. Methods A cross-section and retrospective trial was carried out in 292 DN inpatients from four hospitals(the First Affiliated Hospital of Guangzhou University of TCM, Foshan Hospital of TCM, Shenzhen Hospital of TCM, and Zhongshan Hospital of TCM) from January, 2003 to December, 2005. Demographic information, past history, symptoms and laboratory parameters of the patients were collected.Results Of the enrolled 292 patients, there were 14 in the clinical stage Ⅱ, 42 in stage Ⅲ, 210 in stage Ⅳ, and 26 in stage Ⅴ. The manifestations of TCM syndrome were dominated as lassitude and weakness (69.9%), loss of energy (54.1%), dry mouth (49.3%), aching waist (42%), dry mouth and throat (38%), numbness of extremities (69.9%), dry eyes (33.2%) and dry stool (31.5%), but the signs of frequent sighing, night sweating and tidal fever were less found. For the deficiency syndrome patterns, there existed deficiency of kidney (37.7%), spleen (27.7%), heart (8.9%), liver (3.8%) and lung (2.1%) when differentiating the syndromes according the five zang-organs; there was deficiency of yin (32.5%), Qi (19.5%), blood (9.6%) and yang (8.2%) when differentiating the syndromes according to Qi, blood, yin and yang; there were complex deficiency syndromes such as deficiency of Qi and yin (40.4%), deficiency of spleen and kidney Qi (26.4%), deficiency of lung and kidney Qi(4.8%) and deficiency of yin and yang (3.8%). For the excess syndrome patterns, there were blood stasis syndrome (49.7%), damp-heat syndrome (33.2%), water-dampness syndrome (25%), and Qi stagnation syndrome (7.5%). Conclusion The syndrome patterns of DN present the following characteristics leading deficiency syndromes being kidney deficiency and spleen deficiency when differentiating the syndromes according the five zang-organs, being yin deficiency and Qi deficiency when differentiating the syndromes according to Qi, blood, yin and yang, and complex deficiency syndromes being Qi-yin deficiency and spleen-kidney Qi deficiency. The leading excess syndromes are blood stasis syndrome and damp-heat syndrome. The manifestations of DN are characterized by the concurrence of deficiency and excess, cold and heat. The pathogenesis of DN is classified into deficiency in the root and excess in the branch. The deficiency syndrome mainly involves Qi and yin, and is located in spleen and kidney. The excess syndrome is characterized by blood stasis and damp-heat, and by water-dampness and dampness-turbidity in the late stage of DN. In one word, the pathogenesis of DN is characterized by deficiency of Qi and yin, and blood-stasis blocking kidney collaterals.