Relationship of Cardiac Damage with Traditional Chinese Medicine Syndromes and Clinical Indicators in Patients with Chronic Kidney Disease at Stage 3 / 广州中医药大学学报

ABSTRACT

Objective To explore the relationship of the cardiac damage with traditional Chinese medicine (TCM) syndromes and clinical indicators in patients with chronic kidney disease at stage 3 (CKD3). Methods A cross-sectional study was carried out in 108 CKD3 patients. We collected the clinical data of the included subjects, covering syndrome types, clinical indicators, and echocardiographic indices. And then we analyzed the correlation of syndrome types with echocardiography indices and risk factors of cardiac damage. Results(1) There were 48.1％ of the included subjects having the cardiac structure changes, 19.4％ having myocardial thickening and 82.4％ having left ventricular diastolic dysfunction. Hypertension, hypertension-history lasting time, anemia and phosphorus ion levels were risk factors of myocardial hypertrophy (P < 0.05). Age and free thyroxine levels were risk factors of valvular regurgitation (P < 0.05 or P < 0.01). (2) In the patients with healthy-Qi deficiency syndromes, the heart damage in Yin-Yang deficiency syndrome was more severe than that in spleen-kidney Yang deficiency syndrome and Qi-Yin deficiency syndrome, and the impairment of cardiac function was most severe in Yin-Yang deficiency syndrome(P<0.05). An increasing sequence of incidence of ventricular remodeling was shown in the syndromes of spleen-kidney Qi deficiency, spleen-kidney Yang deficiency , Qi-Yin deficiency , liver-kidney Yin deficiency , Yin-Yang deficiency(P < 0 . 05). (3) Left ventricular mass index (LVMI) in the patients with pathogen-excess complicated syndromes was higher than that in the patients without pathogen-excess complicated syndromes (P<0.05). Of the pathogen-excess complicated syndromes, blood-stasis syndrome had higher incidence of ventricular remodeling than damp-heat syndrome(P<0.01) , but the differences were insignificant among the other syndrome types (P > 0.05). Conclusion The decreased diastolic function and cardiac structure damage are relatively commonly-seen in CKD3 patients, and some of CKD3 patients have myocardial hypertrophy. Anemia, hypertension, hypertension-history lasting time and phosphorus ion level are risk factors of myocardial hypertrophy. Heart damage is more severe in CHD3 patients with Yin-Yang deficiency syndrome than that in spleen-kidney Yang deficiency syndrome and Qi-Yin deficiency syndrome, and the impairment of cardiac function is most severe in Yin-Yang deficiency syndrome. The complication of pathogen-excess can aggravate heart damage. Patients complicated with blood-stasis syndrome have more severe myocardial hypertrophy, and ventricular and atrial enlargement degree.