Study The Correlation Between TCM Syndromes And Clinic,Pathology And Prognosis Of IgA Nephrology With Secondary Segmental Glomerulosclerosis

Objective To investigate the characteristics of TCM syndromes of IgA nephrology with secondary segmental glomerulosclerosis,and to understand the correlation between TCM syndromes and clinic,pathology and prognosis.Methods A total of 104 patients who were diagnosed IgA nephrology with secondary segmental glomerulosclerosis by renal biopsy from January 2008 to December 2008 in Hangzhou Traditional Chinese Medical Hospital were summarized.We finished the follow-up study to all patients,and recorded their clinic symptoms and laboratory tests,and re read the pathological results;According to the clinic symptoms and laboratory tests,we divided all patients into Shenxu,Blood-Stasis or Wind-dampness syndromes of TCM.The patients were divided into Wind-dampness group and non Wind-dampness group according to whether with Wind-dampness syndromes,and the same methods were token to Blood-stasis group and non Blood-Stasis group.Then,analyze the correlation between TCM syndromes and clinic,pathology and prognosis.The cumulative renal survival rate of the patients was calculated by using the Meier-Kaplan method.Results 104 cases include male 51 and female 53,the median renal biopsy age was 35 years old,the median duration was 12.2 months,62.5 months median follow-up,28 cases with shenxu syndrome,shenxu and Blood-Stasis syndrome in 31 cases,21 cases of Wind-dampness and shenxu,syndrome of Blood-Stasis and shenxu Wind-dampness 24 cases.Among them,45 cases(43.3%)in Wind-dampness group while 59 cases in non Wind-dampness group(56.7%),and 55 cases in Blood-Stasis group(52.9%)while 49 cases(47.1%)in non Blood-Stasis group.Compared with non Wind-dampness syndrome patients,serum creatinine,blood urea nitrogen,serum uric acid,24h urine protein levels in Wind-dampness syndrome were increased,while the serum albumin and glomerular filtration rate in Wind-dampness syndrome were decreased,which showed significant differences with non Wind-dampness group(P<0.05).Lee grading and T1/T2 of Oxford classification were heavier than non Wind-dampness syndrome(P<0.05)in patients with Wind-dampness syndrome.In patients with Wind-dampness syndrome,the glomerular score,tubular interstitial score of Katafuchi standard and the score of Andreoli standard higher than those of non Wind-dampness syndrome(P<0.05).Compared non Blood-Stasis syndrome,blood creatinine,blood uric acid,urine microscopic red cells in patients with Blood-Stasis group increased significantly,and glomerular filtration rate and hemoglobin were decreased.There were significant differences between them(P<0.05).Lee grading and El or T1/T2 of Oxford classification were heavier than non Blood-Stasis syndrome(P<0.05)in patients with Blood-Stasis syndrome.In patients with Blood-Stasis syndrome,the tubular interstitial score of Katafuchi standard and the score of Andreoli standard higher than those of non Blood-Stasis syndrome(P<0.05).At the end of follow-up,there were 6 cases(5.8%)getting to the ending event,including 1 cases of shenxu group,1 cases of shenxu and Blood-Stasis group,1 cases of shenxu syndrome,3 cases of shenxu and Blood-Stasis syndrome.The renal survival rate of Wind-dampness group was significantly lower than that of non Wind-dampness group(P<0.05).Conclusion 1.Shenxu syndrome,Blood-Stasis syndrome,and rheumatism syndrome are the main TCM Syndromes of IgA nephrology with segmental glomerulosclerosis;2.Whether Wind-dampness syndrome or Blood-Stasis syndrome has a correlation with clinic laboratory data and pathology.The prognosis of Wind-dampness diseases is bad,and it is proved that Wind-dampness disease is the pathogenesis of IgA nephrology with segmental glomerulosclerosis.Micro syndrome differentiation can supplement the content of TCM syndrome differentiation,and serve the clinic practice.