Japan-based Prognostic Risk Model To Explore Different Prognostic Features IgA Nephropathy TCM Syndrome

Immunoglobulin A Nephropathy (IgAN) is the most common form of glomerulonephritis, and a substantial number of patients succumb to end-stage renal disease (ESRD).Previous study showed that IgAN accounts for20-50%of the primary glomerulonephritis.ObjectiveThrough literature review and clinical cases observation, based on the Japanese scoring system, we try analyzing the character of TCM syndromes in different risk levels, exploring the progression of TCM syndrome, to provide some evidence of prevention and treatment of IgA nephropathy of TCM.Methods105Patients, all be diagnose as IgA nephropathy according to pathological examination, were from Guang’anmen Hospital, China Academy of Chinese Medical Science from January2012to March2014.We collected the general data, clinical features, auxiliary examination, TCM symptoms, then calculated the score of Japanese system.In addition, we determined the TCM syndrome of every patient.Results1Basic materials105patients were collected in this research, male54cases (51.4%) and female51cases (48.6%).The average age is37.7±10.8, and the number<30years old is30(23%).2Whether has a complication86(82%) patients without complication,19(18%) patients with complication, the main incentive is upper respiratory tract infection, the rest includ gynecological inflammation, urinary tract infection, pregnancy and tired.3Estimated glomerular filtration rateWe used two kinds of formulas to calculate the eGFR, MDRD and the Japanese.The result showed that, the eGFR value calculated by Japan formula is small, assigning the majority of patients to a higher CKD level.4. TCM syndrome11people belong to the Waiganfengre,6belong to the Xiajiaoshire,10belong to the Feipiqixu,38belong to the Qiyinliangxu,24belong to the Ganshenyinxu,17belong to the Pishenyanxu.5Accompanied symptoms33people have no accompanied symptom,48people have one, and24people have two.There are96accompanied symptoms in total. 6Prognostic scoring and risk predictionJapan prognostic scores conform to the normal distribution, the maximum is113, the minimum is0, and the average score is55.1±18.97.There are29people have0-5%estimated10-year risk of ESRD,34have5-20%risk,26have20-50%risk and16have50-100%risk.7TCM syndrome compared with prognostic scoreWe test the difference of each group by analysis of variance, P=0.37, the result showed there is no significant statistical difference among the groups.But the result shows that, the score of Feipiqixu is different from pishenyangxu’s.8TCM syndrome compared with risk stratificationWe test the difference of each group by Chi square test, P=0.33, the result showed there is no significant statistical difference among the groups.But the result shows that, Feipiqixu in1groups is obviously more distribution.9Accompanied symptoms compared with risk stratificationAnalysis the difference of total integral number and risk stratification, P=0.126, the result showed there is no significant statistical difference among the groups.The results of multiple comparisons shows that, there is obviously different between0accompanied symptom and2accompanied symptoms.Conclusion1Qiyinliangxu has the largest proportion of TCM syndromes, secondly for Ganshenyinxu, Pishenyangxu.Shire has the largest proportion of accompanied symptoms, secondly for Xueyu, Shuishi and Tanshi.2Feipiqixu and Waiganfengre have the lowest prognostic score, secondly for Qiyinliangxu, Ganshenyinxu and Pishenyangxu.Xiajiaoshire has the highest score.It shows the development of disease from outside to inside, and the development from Shangjiao, Zhongjiao to Xiajiao.3The more accompanied symptoms, the higher prognostic score.