Study On The Correlation Between Pathological Types And Chinese Medicine Syndrome Types Of Asdthenic Splenonephro-yang In Children With Primary Nephrotic Syndrome

Objectives:Clear children’s primary nephrotic syndrome type TCM syndrome of the asdthenic splenonephro-yang and the correlation between the pathological type.Methods:1. Choose the cases of illness:The renal biopsy renal pathology clear the primary nephrotic syndrome, all check24h urine protein quantitative, and plasma cholesterol, plasma albumin index, and TCM syndrome differentiation for asdthenic splenonephro-yang types of60patients hospitalized children, the male34cases,26were women, men and women ratio is about1.3:1; Age distribution in1.0-16.0years old, an average of6.83years, in October2010to February2012renal biopsy clear kidney pathological primary nephrotic syndrome in Nanjing military command in nanjing general hospital in pediatrics.2. TCM syndrome type:refer to the "Chinese medicine pediatrics " by Dr,Wang, divided TCM Syndrome into the following five types:①the lung spleen qi deficiency;②the spleen deficiency, wet trapped;③spleen and kidney Yang;④kidney Yin deficiency;⑤gas Yin deficiency of both. By an experienced doctors of traditional Chinese medicine dialectical type points, during24hours of at renal biopsy preoperative. Because of the spleen and kidney Yang syndrome types is common in the clinical, so choice children with this type in the cases.3. The puncture method:using a second single suction method puncture with18Menghini thin needles by B ultrasound. The children Under the age of5years old without cooperation, using the ketamine anesthesia with muscle note (4-6mg/kg). Checking the blood coagulation time conventionally, prothrombin time and platelet count before the operation. Puncture point is usually at the right kidney or left in the lower pole. Lying on the back for24hours after the operation.4. Pathological examination:60cases of children are already doing in renal biopsy, and their pathological types is chear.19cases are minimal change disease (MCD),26cases are mesangial proliferative glomerulonephritis (MsPGN),4cases are membrano proliferative glomerulonephritis (MPGN),5cases are membranous glomerulonephritis(MN), and6cases are focal and segmental glomerulosclerosis (FSGS). 5. Take the pathological type frequency statistics of60patients with spleen and kidney Yang syndrome types of children, and analysis the distribution, finds out the correlation of both.6.45patients with primary nephrotic syndrome are divided into minimal change disease group (n=19) and mesangial proliferative glomerulonephritis group (n=26).The two groups are performed with independent samples group t test based on normal distribution and homogeneity of variance, or performed with two independent samples nonparametric test based on non-normal Distributions or heterogeneity of variance. Proteinuria, albumin and cholesterol are separately compared.7. Statistical methods:Taking the statistical analysis by SPSS17.0software. Measuring the data for mean±standard deviation (x±s). Taking the normal sexual inspection and variance analysis together for the group data. Using independent t test for the two groups of independent samples, if according with normal distribution and homogeneity of variance. Using the parameters of inspection and testing Wilcoxon rank,if not according with normal distribution and homogeneity of variance. For two separate sample t-test and Wilcoxon rank and test to P<0.05is significant difference.Results:1. Most of the children’s, with primary nephrotic syndrome, urinary protein, plasma albumin and cholesterol are accordding with primary nephrotic syndrome diagnostic criteria.2. IN the60cases of children of spleen and kidney Yang syndrome types with the PNS, there are MCD is19cases (31.7%), MsPGN is26cases (43.3%), MPGN4is cases (6.7%), MN is5cases (8.3%), FSGS is6cases (10.0%).3. There are different in proteinuria between the children with MCD and MsPGN.4. There are different in albumin between the children with MCD and MsPGN.5. There are not different in cholesterol between the children with MCD and MsPGN.Conclusions:1. The pathological types of children of spleen and kidney Yang with PNS are most of the mesangial proliferative glomerulonephritis, accounts for about43.3%proportion, followed by MCD (31.7%), FSGS (10.0%), MN (8.3%), MPGN (6.7%).2. There are different in proteinuria and albumin between the children with MCD and MsPGN.