Objective

2

To explore the distribution characteristics of traditional Chinese medicine （TCM） syndromes and syndrome elements in diabetic kidney diseases （DKD）.

Methods

2

The clinical studies and surveys related to TCM syndromes in patients with DKD were searched for in CNKI， VIP， Wanfang Databases， CBM， Web of Science， Pubmed， and Embase from the inception dates to June 30th， 2022. Microsoft Excel 2019 was used to extract the information of TCM syndromes and syndrome elements in DKD at different stages for establishing a database， and descriptive analysis was performed of TCM syndromes and syndrome elements.

Results

2

A total of 97 articles were enrolled， including 18 001 patients with DKD at Ⅱ-V stages. Among of them， 419 patients were at stage Ⅱ， 8702 patients at stage Ⅲ， 6207 patients at stage Ⅳ， and 2673 patients at stage V. There were 34 TCM syndrome types and 24 syndrome elements （6 disease location elements and 18 disease nature elements）. The 12 common TCM syndrome types of DKD with a composition ratio ≥3% were blood stasis syndrome （5017 times），

qi

-

yin

deficiency syndrome （4466 times），

qi

deficiency syndrome （3057 times），

yin

deficiency syndrome （2680 times），

yang

deficiency syndrome （2216 times）， phlegm dampness syndrome （2019 times）， spleen-kidney

qi

deficiency syndrome （2003 times）， damp heat syndrome （2001 times），

yin

-

yang

deficiency syndrome （1985 times）， damp turbidity syndrome （1832 times），

yin

deficiency and dry heat syndrome （1261 times）， and blood deficiency syndrome （1025 times）. The main syndrome type of DKD at stage Ⅱ was yin deficiency and dry heat syndrome （50.10%）， while that was

qi

-

yin

deficiency syndrome at stage Ⅲ （19.59%）， and blood stasis syndrome at stage Ⅳ and V （14.78% and 15.23%）. In terms of syndrome elements， the disease location was mainly kidney and liver at stage Ⅱ， while that was kidney and spleen at stage Ⅲ-V；

yin

deficiency， heat and dryness were the main nature at stage Ⅱ， while

yin

deficiency，

qi

deficiency， and blood stasis were the main nature at stage Ⅲ，

yin

deficiency，

qi

deficiency and dampness at stage Ⅳ， and

yang

deficiency，

yin

deficiency and dampness at stage V.

Conclusion

2

The TCM syndromes of DKD is deficienc-excess complex. The core of the root deficiency is

yin

deficiency， combined with

qi

deficiency and

yang

deficiency， while the branch excess is mainly characterized by blood stasis， heat and dampness. The evolution of pathogenesis in DKD is from

yin

deficiency and dryness-heat， to

qi

-

yin

deficiency and then blood stasis.