维持性血液透析伴不宁腿综合征患者危险因素和中医证素特点相关性研究

Research on risk factors and correlation of Chinese medical evidence features in patients on maintenance haemodialysis with restless legs syndrome

关键词:  不宁腿综合征  维持性血液透析  中医证素  危险因素

Key words:  restless legs syndrome  maintenance hemodialysis  traditional Chinese medicine syndrome elements  risk factor

摘要:

[目的] 研究维持性血液透析（MHD）患者并发不宁腿综合征（RLS）的危险因素及与中医证素特点相关性研究。[方法] 选取2021年9月—2022年10月于天津市第一中心医院血液净化中心治疗的MHD患者305例，根据是否发生RLS分为阳性组和阴性组，其中RLS阳性组患者72例，RLS阴性组患者233例，通过Logistic回归分析MHD并发RLS患者的危险因素及与中医证素特点的关系。[结果] 多因素Logistic回归分析显示Hb＜110 g/L、PTH≥350 pg/mL、原发糖尿病肾病是MHD患者并发RLS的危险因素（P＜0.05）。病性证素中最常见的是血虚45例（62.50%）、阴虚42例（58.33%）、湿40例（55.56%）、动风38例（52.78%），病位证素最常见的是肾50例（69.44%）、肝44例（61.11%）、经络41例（56.94%）、脾36例（50.00%），中医证素与危险因素回归分析中，年龄是血虚、湿、痰的危险因素，原发肾小球疾病是气虚、血瘀的危险因素。[结论] 糖尿病肾病、贫血、高PTH水平是MHD并发RLS的独立危险因素。MHD 并发RLS中医证素常见肾、血虚、肝、阴虚等，危险因素相关性分析中，年龄与血虚、湿、痰证素呈正相关，慢性肾小球肾炎与气虚、血瘀呈正相关。

Abstract:

[Objective] To investigate the risk factors and traditional Chinese medicine（TCM） evidence features of maintenance haemodialysis（MHD） patients with complications of restless legs syndrome（RLS）. [Methods] From September 2021 to October 2022，the 305 patients with MHD treated at the blood purification center of Tianjin First Central Hospital were selected and divided into positive and negative groups according to the occurrence of restless legs syndrome，including 72 patients in the RLS positive group and 233 patients in the RLS negative group. The risk factors of patients with MHD complicated with RLS and the relationship with the characteristics of Chinese medical evidence were analyzed by Logistic regression. [Results] Multi-factor Logistic regression analysis showed that Hb＜110 g/L，PTH≥350 pg/mL，and primary diabetic nephropathy were risk factors for complications of RLS in patients with MHD（P＜0.05）. The most common pathogenic evidence elements were blood deficiency 45（62.50%），yin deficiency 42（58.33%），dampness 40（55.56%） and moving wind 38（52.78%），while the most common pathogenic evidence elements were kidney 50（69.44%），liver 44（61.11%），meridian 41（56.94%） and spleen 36（50.00%）. In the regression analysis of evidence elements and risk factors，age was a risk factor for blood deficiency，dampness and phlegm，and primary glomerular disease was a risk factor for qi deficiency and blood stasis. [Conclusion] Diabetic nephropathy，anemia，and high PTH levels were independent risk factors for MHD complicated by RLS. MHD complicated RLS is complicated by common elements of TCM such as kidney，blood deficiency，liver，and yin deficiency，and the age is positively correlated with blood deficiency，dampness，and phlegm syndrome，and chronic glomerulonephritis is positively correlated with qi deficiency and blood stasis.