Interrelated Study Of Primary Chronic Glomerulonephritis Between Traditional Chinese Medicine Syndromes And Pathological Types

Objectives:To explore the relation between syndrome type of Traditional Chinese Medicine(TCM)and renal pathology.And then learn about the microscopic changes of renal pathology based on TCM syndrome differentiation.Realizing the combination of macro and micro,so that can provide an objective basis for the diagnosis and treatment of kidney diseases with integrated TCM and Western Medicine.Methods:This study employs retrospective investigation.Formulating a unified clinical recordinformation table.Collected clinical data of patients who was treated and performed renal biopsy in the Jiangsu Provincial Hospital of TCM inpatient from April 2013 to October 2017,a total of 330 cases.Analyzing these TCM syndrome types and pathological integration reference to the relevant standards,then process statistical analysis.Results:1.This study included 330 cases of CGN patients,including 167 cases of male patients(in 50.6 percent)and 163 cases of female patients(in 49.4 percent).People who aged from 20 to 50 have a high incidence to suffer this ill.2.The most common fundamental symptom was spleen and kidney deficiency tupe,followed by qi and Yin deficiency type.The most common incidental symptom was windsyndrome,followed by damp heat syndrome.The most common renal pathological type was IgA(in 34 percent),the rest from more to less followed by MN、MsPGN、MCD、FSGS.3.As for the relationship between TCM syndromes and biochemical indicators,the urine protein quantification level was significantly higher in the spleen and kidney yang deficiency than in the liver-kidney yin deficiency syndrome and the spleen-kidney qi deficiency(p<0.05);the urine protein quantification in the wet turbid syndrome was significantly higher than the no syndrome,wind syndrome and damp heat syndrome(p<0.05).The dampness syndrome was also significantly higher than that of the wind syndrome and no syndrome(p<0.05).The wet turbid syndrome and dampness syndromes were significantly lower than the wind syndrome,damp heat syndrome,blood stasis syndrome,no syndrome(p<0.05)in the ALB level.lung and kidney qi deficiency syndrome BUN levels were significantly lower than spleen and kidney qi deficiency syndrome and spleen and kidney yang deficiency,Qi and Yin deficiency syndrome(p<0.05);Wet turbid syndrome was significantly higher in.Scr and BUN than that in wind syndrome,dampness syndrome,damp heat syndrome,blood stasis syndrome,and no syndrome(p<0.05);there was no significant difference in other types and biochemical indexes(p>0.05).4.In terms of the relationship between renal pathology and biochemical indicators,the level of urinary protein in IgAN patients was significantly lower than that in MsPGN,FSGS,MN,and MCD(p<0.05);the urine protein level of MsPGN was also significantly lower than that of MN and MCD(p<0.05).The urinary red blood cell count of IgAN was significantly higher than that of MN(p<0.05).MCD patients had significantly lower levels of Scr and ALB than IgAN,MsPGN,and FSGS(p<0.05),MN patients had significantly lower levels of ALB than IgAN and MsPGN(p<0.05);the rest were not statistically different(p>0.05).5.IgAN =>lung-kidney qi deficiency(sup6.364%,Con42.857%),IgAN->damp heat syndrome(sup 20.909%,Con44.928%),MsPGN ＝>spleen and kidney qi deficiency(sup 50.0%,Conl7.576%),MsPGN ＝>no syndrome(sup17.576%,Con17.241%%,FSGS =>spleen and kidney yang deficiency(sup8.485%,Conl7.857%),FSGS =>wet turbid syndrome(sup9.697%,Con21.875%),MN ＝>liver-kidney yin deficiency syndrome(sup7.273%,Con37.5%),MN =>dampness syndrome(sup12.727%,Con40.746%),MCD=>Spleen and kidney yang deficiency(sup8.485%,Conl 7.857%),MCD;=>dampness syndrome(sup12.727%,Con21.429%).The support and confidence levels of these are higher,suggesting that the correlation between these data sets is more closely related to other combinations.Conclusion:1.In this study,the incidence of CGN is quite similar for men and women,and the age of onset is mainly young and middle-aged.2.Among the TCM syndromes,this syndrome is mainly characterized by spleen and kidney qi deficiency syndrome,and the main syndrome is wind syndrome.The pathological type of kidney is mainly IgA,and the detection rate of MN is gradually increasing.3.Quantification of urinary protein was significantly higher in patients with spleen-kidney yang deficiency than in liver-kidney yin deficiency and spleen-kidney qi deficiency;urinary protein quantification of wet turbid syndrome was significantly higher than that of non-standard syndrome,wind syndrome,and damp-heat syndrome;dampness syndrome was also significantly higher wind syndrome and no syndrome;wet turbid syndrome and dampness syndromes were significantly lower in the ALB level than the wind syndrome,damp heat syndrome,blood stasis syndrome,and no syndrome;lung and kidney qi deficiency syndrome BUN levels were significantly lower than spleen and kidney qi deficiency syndrome and Spleen and kidney yang deficiency,Qi and Yin deficiency.The wet turbid syndrome was significantly higher in Scr and BUN than in wind syndrome,damp heat syndrome,blood stasis syndrome,and no syndrome;it indicated that the spleen and kidney function of spleen and kidney yang deficiency was severely impaired,and the lung function of kidney,kidney and qi deficiency was lighter.There are many proteinurias in wet turbid syndrome and dampness syndrome,which are prone to hypoproteinemia and more likely to have high edema and hypercoagulability.4.The urinary protein in the IgAN and the MsPGN was relatively low,while the IgAN was more clinically characterized by a high urine red blood cell count.The patients with MCD had significantly lower levels of Scr and ALB than IgAN,MsPGN,and FSGS;The patients with MN had significantly lower levels of ALB than IgAN and MsPGN.Suggesting that MCD and MN has more clinical manifestations of clinical features of nephrotic syndrome,while MCD with less impairment of renal function and better prognosis.5.The relationship between the TCM syndrome type and the renal pathological type,IgAN is associated with lung-kidney qi deficiency and damp-heat syndrome;MsPGN is closely related to deficiency of spleen and kidney qi and no syndrome;FSGS is associated with spleen-kidney yang deficiency syndrome and wet turbid syndrome;MN is closely related to liver-kidney yin deficiency syndrome and dampness syndrome;MCD has a certain correlation with spleen-kidney yang deficiency syndrome and dampness syndrome.