关键词: 糖尿病肾病；糖尿病, 2型；中医病机；中医证型

Abstract: Background　Studies about the TCM syndrome type and the laboratory index in diabetic nephropathy（DN） have obtained some results，showing that the two have a certain correlation，which provides a theoretical basis for normalizing and standardizing the TCM diagnosis and treatment system of DN.However，the diagnostic criteria for TCM syndrome of DN still have not been unified and standardized.Objective　To study TCM syndrome types of diabetic nephropathy and their correlation with laboratory indices.Methods　During January 2017 to March 2018，from Department of Nephrology，The First Affiliated Hospital of Guangzhou University of Chinese Medicine，and Department of Endocrinology，Zengcheng TCM Hospital，125 outpatients and inpatients（including 31 with T2DM，31 with stage Ⅲ DN，32 with stage Ⅳ DN，and 31 with stage Ⅴ DN），and other sex- and age-matched 30 healthy physical examinees were enrolled.Number and percentages of incidental and fundamental syndromes in each group were obtained.And urea nitrogen（BUN），serum creatine（Scr），cystatin C（CysC），estimated glomerular filtration rate（eGFR），total cholesterol（TC），triacylglycerol（TG），serum protein（ALB），24-hour urine protein quantity and hemorheological indices were measured in groups with different syndrome types.Results　In terms of primary syndromes，T2DM patients showed yin deficiency and dryness heat syndromes〔32.2%（10/31）〕 and qi-yin deficiency syndrome〔58.1%（18/31）〕，those with stage Ⅲ DN showed spleen and kidney qi deficiency syndromes〔48.4%（15/31）〕，those with stage Ⅳ DN demonstrated yin-yang deficiency syndrome〔46.9%（15/32）〕 and spleen and kidney qi deficiency syndromes〔31.2%（10/32）〕，and those with stage Ⅴ DN presented yin-yang deficiency syndrome〔64.5%（20/31）〕．The incidental syndromes in all T2DM and DN patients mainly were dampness syndrome and blood stasis syndrome.Renal function indices，ALB and 24-hour urine protein quantity differed by stage of DN in DN patients（P<0.05）．DN patients with yin deficiency and dryness heat syndrome had the highest mean levels of BUN，Scr，CysC and 24-hour urine protein quantity，followed by those with qi-yin deficiency syndrome，those with spleen and kidney qi deficiency syndromes，and those with yin-yang deficiency syndrome.DN patients with yin-yang deficiency syndrome demonstrated the highest mean levels of eGFR and ALB，followed by those with spleen and kidney qi deficiency syndromes，those with qi-yin deficiency syndrome，and those with yin deficiency and dryness heat syndromes.Laboratory indices did not vary significantly across those with dampness syndrome，those with phlegm syndrome and those with blood stasis syndrome（P>0.05）．Spearman correlation analysis showed that there was a positive correlation between primary syndrome type and BUN，Scr，CysC，24-hour urine protein quantity，and had a negative correlation with eGFR and serum ALB（P<0.05）．Conclusion　In DN patients，with the progression of the disease，the main manifestations of TCM syndrome type are yin deficiency and dryness heat，qi-yin deficiency，spleen and kidney qi deficiency，yin-yang deficiency.And the levels of BUN，Scr，CysC，eGFR，ALB，and urine protein results may be correlated with TCM syndromes.

Key words: Diabetic nephropathies；Diabetes mellitus, type 2；Pathogenesis（TCM）；TCM syndrome type