【摘要】 目的观察分析糖尿病肾病(DN)的证候演变特点。方法纳入接受基础治疗及中医药干预的DN患者共301例,所有病例在观察起点、3个月后、6个月后分别进行证候调查。使用《糖尿病肾病中医证候调查表》收集患者症状,包括7组证候29个症状、舌象和脉象。3个时点的资料通过因子分析进行辨证分型,采用转移概率分析探讨证候演变规律。结果 301例DN患者3个时点因子分析分别得到8、10、9个证候因子。起点第一公因子证候是类似阳虚的表现,有44.19%患者在3个月时点时仍然是类似阳虚的表现,有18.60%的患者向类似痰湿证转化,在3个月点类似阳虚的证候向6个月时点类似阳虚痰湿的证候转化。其他公因子的证候表现也在不同时点的特点不用,部分延续上一个时点的证候表现,部分有发展为其他证候表现的趋势。结论 DN患者总体证候变化多样,但具有一定规律:阳虚有向阳虚痰湿转化的趋势,阴虚有向气虚阴虚阳虚转化的趋势,气虚痰湿有向气虚痰湿湿浊转化的趋势,血瘀证具有相对的稳定性。更多还原

【Abstract】 Objective To observe the characteristics of TCM syndrome evolution of diabetic nephropathy(DN).Methods Totally 301 cases of DN were included and received basic treatment and TCM intervention. The syndromes of all patients were investigated at three time points,i. e. starting point of observation,three months later and six months later. The symptoms including seven-group syndromes and 29 symptoms,tongues and pulses were collected with DN TCM Syndromes Questionnaire. The syndromes were identified with factor analysis and the syndrome evolution was analyzed with transition probability analysis. Results There were 8,10 and 9 syndrome factors in 301patients at three time points respectively. The first common factor syndrome at the starting point was similar to yang deficiency syndrome. At the 1st time point,44. 19% of the patients were still similar to yang deficiency syndrome and18. 60% of the patients transformed to phlegm-damp syndrome. The patients with yang deficiency syndrome at the 1st time point transformed to yang-deficiency phlegm-damp syndrome at the 2nd time point. The syndromes of other common factors were different at different time points as well,partially continuing the previous syndromes or transforming to other syndromes. Conclusion Although DN patients are with various syndromes,there is certain regularity.Yang deficiency syndrome has a tendency to transform to yang-deficiency phlegm-damp syndrome. Yin deficiency syndrome has a tendency to transform to qi-deficiency yin-deficiency yang-deficiency syndrome. Qi deficiency syndrome has a tendency to transform to qi-deficiency phlegm-damp damp-turbidity syndrome. Blood stasis syndrome is relatively stable.更多还原