| 摘要: |
| [目的] 探讨维持性血液透析（MHD）合并肌少症患者的中医证候特点及其相关影响因素。[方法] 选取2023年3月—2024年9月广州中医药大学附属中山中医院MHD患者199例，分为肌少症组和非肌少症组，收集其临床资料及中医四诊信息并统计分析其中医证候特点及相关影响因素。[结果] MHD患者中肌少症患病率为30.2%。中医证型方面，两组患者基本证型均以脾肾气虚证为主；肌少症组中湿浊证比例更高（P<0.05），非肌少症组中瘀血证比例更高（P<0.05）。证候积分分析显示，肌少症组脾肾气虚证、脾肾阳虚证及瘀血证积分均高于非肌少症组（P<0.05）。Logistic回归分析结果提示：高龄、男性、缺乏运动是肌少症发生的危险因素，而较高身体质量指数（BMI）和握力以及瘀血证是保护因素。[结论] MHD合并肌少症患者多以脾肾气虚为本，湿浊内阻为标。临床上，高龄、男性、缺乏运动等因素可能增加MHD患者发生肌少症风险。 |
| 关键词: 维持性血液透析 肌少症 中医证候 Logistic回归 |
| DOI：10.11656/j.issn.1672-1519.2026.09.04 |
| 分类号:R459.5 |
| 基金项目:国家中医优势专科-中山市中医院肾病科（〔2024〕2号）；国家中医药传承发展示范试点项目-中山市中医院中医药科研立项（YN2024A007）；国家中医药传承发展示范试点项目-中山市中医院潘胡丹教授高水平团队；广州中医药大学附属中山中医院研究生及规培医师科研创新项目（2022KCY08）。 |
|
| Study of traditional Chinese medicine syndromes in patients with maintenance hemodialysis combined with sarcopenia and analysis of related influencing factors |
|
LIU Ruxin, LIN Shuai, LIU Li, XU Juan, LIU Linna, PANG Jie, HUANG Lin, HUANG Qingxiu, LI Yanlin
|
|
Department of Nephrology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan 528400, China
|
| Abstract: |
| [Objective] To investigate the characteristics of traditional Chinese medicine（TCM）syndrome patterns and their associated influencing factors in maintenance hemodialysis（MHD）patients complicated with sarcopenia. [Methods] In this single-center cross- sectional study，199 MHD patients were enrolled. Based on the 2019 Asian Working Group for Sarcopenia（AWGS）diagnostic criteria， patients were divided into a sarcopenia group and a non-sarcopenia group. Clinical data and TCM four diagnostic data were collected， and TCM syndrome patterns and identify associated risk factors were used to be statistical analysis. [Results] The prevalence rate of sarcopenia in this MHD cohort was 30.2%. Compared to the non-sarcopenia group，patients in the sarcopenia group were older，had a higher comorbidity index and prevalence of cerebral infarction，while exhibiting significantly lower body mass index（BMI），a lower proportion engaging in regular exercise，and reduced handgrip strength（P<0.05）. Regarding TCM syndrome patterns，the primary pattern in both groups was spleen-kidney qi deficiency syndrome. The sarcopenia group had a significantly higher proportion of damp- turbidity syndrome（P<0.05），while the non-sarcopenia group had a higher proportion of blood stasis syndrome（P<0.05）. Analysis of syndrome scores revealed that scores for spleen-kidney qi deficiency syndrome，spleen-kidney yang deficiency syndrome，and blood stasis syndrome were all significantly higher in the sarcopenia group compared to the non- sarcopenia group（P<0.05）. Multivariate Logistic regression analysis indicated that advanced age，male gender and lack of exercise were risk factors for sarcopenia，while higher BMI，stronger handgrip strength and blood stasis syndrome were protective factors. [Conclusion] MHD patients with sarcopenia predominantly present with spleen-kidney qi deficiency as the primary pattern and internal obstruction by damp-turbidity as the secondary manifestation. Clinically，factors such as advanced age，male gender，and lack of exercise may increase the risk of sarcopenia in MHD patients. |
| Key words: maintenance hemodialysis sarcopenia traditional Chinese medicine syndrome Logistic regression |
