【目的】 探讨Ⅱ型心肾综合征（简称 2 型 CRS）患者中医证素与危险因素的相关性。【方法】 通过回顾性分析 116 例 2 型 CRS患者的住院病历资料，统计患者中医证素分布，并分析相关证素与性别、年龄、吸烟史、饮酒史、冠心病、高血压、糖 尿病以及贫血等危险因素的相关性。【结果】（1）证素分布方面：116 例 2 型 CRS 患者中，涉及的主要病位证素有心 96 例 （82.76%）、肺 89 例（76.72%）、肾 81 例（69.83%）、脾 71 例（61.21%）、肝 25 例（21.56%）；主要病性证素有气虚 113 例 （97.41%）、血虚 96 例（82.76%）、阳虚 95 例（81.89%）、痰 94 例（81.03%）、阴虚 90 例（77.59%）、湿 61 例（52.59%）、水停 55 例（47.41%）、血瘀47例（40.52%）。（2）年龄分布方面：116例2型CRS患者大部分集中于60岁以上的中老年人，其中，小 于 60 岁 4 例（3.45%），61 ~ 70 岁 10 例（8.62%），71 ~ 80 岁 28 例（24.14%），81 ~ 90 岁 64 例（55.17%），大于 90 岁 10 例 （8.62%）。（3）性别分布方面：男性46例（39.66%），女性70例（60.34%），女性多于男性。（4）中医证素与危险因素相关性方面： Logistics回归分析结果显示，2型CRS患者的血虚证素与饮酒、高血压和贫血呈正相关（P＜0.05或P＜0.01）；阳虚证素与贫 血呈正相关（P＜0.05）；阴虚证素与吸烟、糖尿病呈正相关（P＜0.05）；湿证素与吸烟、贫血呈正相关（P＜0.01）；水停证素 与性别、蛋白异常呈正相关（P＜0.05或 P＜0.01）；血瘀证素与高血压呈正相关（P＜0.05）。【结论】 2型 CRS的病位在心，涉 及五脏，与肺、肾关系密切，总的病机特点是本虚标实，以气虚、阳虚为本，以痰、血瘀为标。在2型CRS患者中，男性更 容易出现水停证，吸烟者更容易出现阴虚和湿证，饮酒者更容易出现血虚，患有高血压病者更容易出现血虚及血瘀，患有 糖尿病者更容易出现阴虚，贫血者更容易出现血虚、阳虚、湿证，蛋白异常者更容易出现水停证。

Objective To investigate the correlation between traditional Chinese medicine （TCM） syndrome elements and risk factors in patients with type Ⅱ cardio-renal syndrome （CRS）. Methods A retrospective analysis was conducted on the medical records of 116 patients with type Ⅱ CRS. The distribution of TCM syndrome elements was analyzed， and the correlation between the syndrome elements and risk factors of gender， age， smoking history， alcohol consumption history， coronary heart disease， hypertension， diabetes， and anemia were evaluated. Results （1） The analysis of syndrome elements of 116 patients with type Ⅱ CRS showed that the main disease-location elements were heart （96 cases，82.76%），lung （89 cases，76.72%），kidney （81 cases， 69.83%），spleen （71 cases，61.21%），and liver （25 cases，21.56%）；the main disease-nature elements were qi deficiency （113 cases， 97.41%）， blood deficiency （96 cases， 82.76%）， yang deficiency （95 cases， 81.89%），phlegm （94 cases，81.03%），yin deficiency （90 cases，77.59%），dampness （61 cases，52.59%）， water retention （55 cases，47.41%），and blood stasis （47 cases，40.52%）.（2） The analysis of age groups of 116 patients with type Ⅱ CRS showed that the majority of the patients were middle-aged and elderly individuals over 60 years old，and the age groups covered ＜ 60 years old （4 cases，3.45%），61-70 years old （10 cases， 8.62%），71-80 years old （28 cases，24.14%），81-90 years old （64 cases，55.17%），and > 90 years old （10 cases，8.62%）.（3） The analysis of gender of 116 patients with type Ⅱ CRS showed that 46 cases （39.66%） were male， and 70 cases （60.34%） were female， the female outnumbering the male. （4） The exploration of correlation between TCM syndrome elements and risk factors with Logistic regression analysis showed that blood deficiency was positively correlated with alcohol consumption，hypertension，and anemia （P＜0.05 or P＜0.01）， yang deficiency was positively correlated with anemia （P＜0.05），yin deficiency was positively correlated with smoking and diabetes （P＜0.05）， dampness was positively correlated with smoking and anemia （P＜0.01）， water retention was positively correlated with gender and protein abnormalities （P＜0.05 or P＜0.01），and blood stasis was positively correlated with hypertension （P＜0.05）. Conclusion The illness of type Ⅱ CRS is located in the heart，involving the five organs，and is closely related to the lungs and kidneys. The general pathogenesis of type Ⅱ CRS is characterized by being deficiency of qi and yang in the root cause， and having the symptom manifestations of phlegm and blood stasis. In type Ⅱ CRS patients，men are more likely to suffer water retention， smokers are more likely to suffer yin deficiency and dampness，drinkers are more likely to suffer blood deficiency， individuals with hypertension are more likely to suffer blood deficiency and blood stasis，individuals with diabetes are more likely to suffer yin deficiency，individuals with anemia are more likely to suffer blood deficiency，yang deficiency and dampness，and individuals with protein abnormalities are more likely to suffer water retention.

R259.416

广东省中医药局科研项目（编号：2023A414020037）