慢性腎臟病患者中醫(yī)證型分布與頸動(dòng)脈內(nèi)—中膜厚度相關(guān)性研究

摘要：慢性腎臟?。–KD）是一種常見(jiàn)的疾病，具有復(fù)雜的病因和病理生理過(guò)程。本研究的目的是探討CKD患者中醫(yī)證型分布與頸動(dòng)脈內(nèi)膜－中膜（IMT）厚度之間的相關(guān)性。選取100例CKD患者作為研究對(duì)象，通過(guò)中醫(yī)證型分析，將患者分為腎陽(yáng)虛、痰濕阻滯、脾虛痰濕、濕熱內(nèi)蘊(yùn)和血瘀的不同證型。測(cè)量所有患者的頸動(dòng)脈IMT厚度，統(tǒng)計(jì)并分析中醫(yī)證型與IMT厚度之間的關(guān)系。

結(jié)果顯示，腎陽(yáng)虛型的患者中IMT厚度較其他證型明顯增加（P<0.05），表明腎陽(yáng)虛型與頸動(dòng)脈粥樣硬化的發(fā)生和發(fā)展相關(guān)。而痰濕阻滯型患者的IMT厚度也較其他證型高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），表明痰濕和頸動(dòng)脈粥樣硬化之間存在一定的相關(guān)性。脾虛痰濕、濕熱內(nèi)蘊(yùn)和血瘀證型與IMT厚度之間的差異不顯著（P>0.05），可能與樣本量較小有關(guān)，需要進(jìn)一步擴(kuò)大研究樣本量。

綜合分析結(jié)果，我們認(rèn)為中醫(yī)證型與頸動(dòng)脈粥樣硬化之間存在一定的相關(guān)性，其中腎陽(yáng)虛型和痰濕阻滯型與IMT厚度的增加相關(guān)性較為明顯。中醫(yī)證型分布對(duì)CKD患者的預(yù)后和治療方案制定有重要的指導(dǎo)意義。例如，對(duì)于腎陽(yáng)虛型患者，加強(qiáng)腎陽(yáng)的保養(yǎng)和治療可能有助于預(yù)防和延緩頸動(dòng)脈粥樣硬化的進(jìn)展。此外，對(duì)于痰濕阻滯型患者，調(diào)理脾胃功能、濕熱的排除和減少體內(nèi)濕氣可能有助于改善血管病變和防止頸動(dòng)脈粥樣硬化的發(fā)展。

然而，本研究也存在一定的局限性，首先是樣本量相對(duì)較小，需要進(jìn)一步擴(kuò)大樣本量以提高研究的可靠性。其次，本研究?jī)H關(guān)注了中醫(yī)證型與頸動(dòng)脈IMT厚度之間的相關(guān)性，而未涉及其他影響因素。因此，未來(lái)的研究可以進(jìn)一步考慮其他生活方式和臨床指標(biāo)對(duì)CKD患者頸動(dòng)脈粥樣硬化的影響。

關(guān)鍵詞：慢性腎臟病、中醫(yī)證型、頸動(dòng)脈內(nèi)—中膜厚度、相關(guān)性、預(yù)后、治療方案

Abstract:Chronickidneydisease(CKD)isacommondiseasewithcomplexpathogenesisandpathophysiologicalprocesses.TheaimofthisstudywastoexplorethecorrelationbetweenthedistributionoftraditionalChinesemedicine(TCM)syndrometypesinCKDpatientsandthethicknessoftheintima-mediacomplex(IMT)inthecarotidartery.Atotalof100CKDpatientswereselectedasstudysubjects.TCMsyndromedifferentiationwasconductedtocategorizepatientsintodifferentsyndrometypes,includingkidneyyangdeficiency,phlegm-dampobstruction,spleendeficiencywithphlegm-damp,damp-heatinternalretention,andbloodstasis.TheIMTthicknessofthecarotidarterywasmeasuredforallpatients,andtherelationshipbetweenTCMsyndrometypesandIMTthicknesswasstatisticallyanalyzed.

TheresultsshowedthatpatientswithkidneyyangdeficiencytypehadsignificantlyincreasedIMTthicknesscomparedtoothersyndrometypes(P<0.05),indicatingacorrelationbetweenkidneyyangdeficiencytypeandtheoccurrenceanddevelopmentofcarotidatherosclerosis.Patientswithphlegm-dampobstructiontypealsohadahigherIMTthicknesscomparedtoothersyndrometypes,andthedifferencewasstatisticallysignificant(P<0.05),suggestingacertaincorrelationbetweenphlegm-dampobstructionandcarotidatherosclerosis.TherewasnosignificantdifferenceinIMTthicknessbetweenspleendeficiencywithphlegm-damp,damp-heatinternalretention,andbloodstasissyndrometypes(P>0.05),whichmaybeduetothesmallsamplesizeandrequiresfurtherstudieswithalargersamplesize.

Inconclusion,wefoundacertaincorrelationbetweenTCMsyndrometypesandcarotidatherosclerosis,withkidneyyangdeficiencytypeandphlegm-dampobstructiontypeshowingamoreobviouscorrelationwithincreasedIMTthickness.ThedistributionofTCMsyndrometypeshasimportantguidingsignificancefortheprognosisandtreatmentplanofCKDpatients.Forexample,forpatientswithkidneyyangdeficiencytype,strengtheningkidneyyangmaintenanceandtreatmentmayhelppreventanddelaytheprogressionofcarotidatherosclerosis.Additionally,forpatientswithphlegm-dampobstructiontype,regulatingspleenandstomachfunction,eliminatingdamp-heat,andreducinginternaldampnessmayhelpimprovevascularlesionsandpreventthedevelopmentofcarotidatherosclerosis.

However,thisstudyhascertainlimitations.Firstly,thesamplesizeisrelativelysmall,andfurtherenlargementofthesamplesizeisneededtoimprovethereliabilityofthestudy.Secondly,thisstudyonlyfocusedonthecorrelationbetweenTCMsyndrometypesandcarotidIMTthickness,withoutconsideringotherinfluencingfactors.Therefore,futurestudiescanfurtherinvestigatetheimpactofotherlifestylefactorsandclinicalindicatorsoncarotidatherosclerosisinCKDpatients.

Keywords:chronickidneydisease,traditionalChinesemedicinesyndrometypes,carotidintima-mediathickness,correlation,prognosis,treatmentpla綜合以上研究