基于“内热致癥”理论探讨SIRI、FAR与2型糖尿病肾脏疾病的相关性*

作者：刘耀珊1,2，刘晴晴1，侯金易1,2，孙金蕊1,2，林诗佳1,2，陈 慧1,2，王 珍1

单位：1.北京中医药大学东直门医院，北京 100700； 2.北京中医药大学，北京 100029

引用：引用：刘耀珊，刘晴晴，侯金易，孙金蕊，林诗佳，陈慧，王珍.基于“内热致癥”理论探讨SIRI、FAR与2型糖尿病肾脏疾病的相关性[J].中医药导报,2025,31(12):143-148.

DOI：10.13862/j.cn43-1446/r.2025.12.023

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摘要：

目的：探讨全身炎症反应指数（SIRI）、纤维蛋白原/白蛋白（FAR）与2型糖尿病肾脏疾病（DKD）内热证的相关性。方法：纳入253例DKD患者，根据内热辨证标准分为内热证、非内热证，并按照分期标准分为早、中、晚期，比较各期内热证组与非内热证组SIRI、FAR及肾功能指标组间差异，进一步分析内热积分与SIRI、FAR的相关性，采用多因素Logistic回归分析各期内热证与SIRI、FAR的相关性。结果：与非内热证组比较，早期内热证组SIRI明显升高，中期内热证组FAR、血清肌酐（Scr）、24 h尿蛋白总量（24 h-UTP）、尿酸（UA）和血尿素氮（BUN）水平明显升高，估算肾小球滤过率（eGFR）降低，晚期内热证组FAR、Scr、BUN明显升高，eGFR降低。早期内热积分与SIRI呈正相关，中期内热积分与FAR呈正相关，晚期内热积分与SIRI、FAR均呈正相关。多因素Logistic回归分析结果提示，SIRI与DKD早期内热证的发生独立相关，FAR与DKD中、晚期内热证的发生独立相关。结论：SIRI和FAR与DKD内热证的发生密切相关，未来有希望成为评估病情及内热证的炎性标志物。SIRI在DKD早期、FAR在DKD中晚期的特异性关联，为“内热致癥”理论提供了客观依据。

关键词：糖尿病肾脏疾病；内热证；内热致癥；炎症；全身炎症反应指数；纤维蛋白原/白蛋白

Abstract：

Objective: To explore the correlation between systemic inflammatory response index (SIRI), fibrinogen-to-albumin ratio (FAR), and internal heat syndrome in type 2 diabetic kidney disease (DKD). Methods: 253 DKD patients were classified into internal heat syndrome and non-internal heat syndrome groups based on TCM criteria, and further staged into early, middle, and late stages. Differences in SIRI, FAR, and renal function indicators were compared between groups. Correlations between internal heat scores and SIRI/FAR were analyzed. Multivariate logistic regression analyzed the association of internal heat syndrome with SIRI/FAR across stages. Results: Compared with the non-internal heat group, SIRI was higher in early-stage internal heat group; FAR, Scr, 24 h-UTP, UA, BUN were higher and eGFR lower in middle-stage; FAR, Scr, BUN were higher and eGFR lower in late-stage. Internal heat scores positively correlated with SIRI in early stage, with FAR in middle stage, and with both in late stage. Logistic regression indicated SIRI independently associated with early-stage internal heat, and FAR with middle- and late-stage internal heat. Conclusion: SIRI and FAR are closely related to internal heat syndrome in DKD and may serve as inflammatory markers for disease and syndrome evaluation. Their stage-specific correlations provide objective support for the "internal heat causing abdominal masses" theory.

Key words：diabetic kidney disease; internal heat syndrome; internal heat causing abdominal masses; inflammation; systemic inflammatory response index; fibrinogen-to-albumin ratio

发布时间：2026-01-30

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