Study On The Relationship Between Oxford Pathological Classification And TCM Syndrome Types In Patients With Primary IgA Nephropathy

Objective:To explore the distribution of TCM syndrome types in patients with primary IgA nephropathy admitted to Shandong provincial hospital in recent years,and to explore the correlation between Oxford pathological classification and TCM syndrome types.Methods:To analyze 98 patients with primary IgA nephropathy diagnosed by renal biopsy from November 2019 to December 2020 in Shandong Provincial Hospital.To explore the correlation between the distribution of TCM syndrome types and Oxford’s pathological type,98 patients were collected with diagnostic information and pathological data and classified according to TCM syndrome differentiation.Results:1.Among 98 patients with IgA nephropathy,the ratio of male to female was 1: 1.04;the young(18 years old ≤44 years old)had the largest number of cases;The course of disease was less than one month.Proteinuria is the most common accompanying symptom at onset.Mental fatigue is the most frequent TCM syndrome,with 59 people,accounting for60.2% of the total number.2.Oxford classification of renal pathology was 22 types in 98 patients,and M1E1S1T0C0 was the most common type in 11 patients.There were 53 cases of mesangial cell hyperplasia(M1)(54.1%),59 cases of capillary hyperplasia(E1)(60.2%),88 cases of segmental sclerosis or adhesion(S1)(89.8%),35 cases of tubular atrophy or interstitial fibrosis(T1/T2)(35.7%),of which 31 cases were T1(31.6%)and 4 cases were T2(4.1%).There were 38 cases(38.9%)of crescents(C1/C2),37 cases(37.8%)of C1 and 1 case(1.0%)of C2.3.Among the 98 patients with IgA nephropathy,the deficiency of qi and yin is the most common syndrome in intrinsic deficiency syndrome,and the stagnation of kidney and collaterals is the most common syndrome in standard demonstration.There were 37(37.8%)patients with deficiency of both qi and Yin,32(32.7%)patients with deficiency of lung-spleen-qi,29(29.6%)patients with deficiency of liver-kidney-yin,41(41.8%)patients with stagnation of collaterals and blood stasis,36(36.7%)patients with damp-heat in lower jiao and 21(21.4%)patients with disturbance of internal wind-dampness.4.There was significant difference in the incidence of pathological M type between different deficiency syndrome and different standard syndrome(p<0.01).The distribution of pathological M1 showed the trend of lung-spleen-qi deficiency syndrome < qi-yin deficiency syndrome <liver-kidney yin deficiency syndrome;The distribution of pathological M1 in the syndrome of standard syndrome showed the trend of lower jiao damp-heat syndrome<rheumatic disturbance syndrome<Shen Luo Yu Bi syndrome.There was a significant difference in the incidence of pathological C between the two syndrome types(p<0.01).The distribution of pathological C1/C2 showed the trend of lower jiao damp-heat syndrome<Shen Luo Yu Bi syndrome< rheumatic disturbance syndrome.There was correlation between pathological M and deficiency of lung-spleen-qi,deficiency of liver-kidney-yin,damp-heat of lower jiao and stagnation of kidney-collateral(p<0.05).There was significant correlation between pathological C and internal disturbance syndrome of rheumatism(p<0.01).Conclusion:There is certain correlation between Oxford’s pathological type and TCM syndrome type in patients with IgA nephropathy.There is a tendency of pathological M1 in liver-kidney yin deficiency syndrome and kidney-collateral stasis syndrome,which indicates that the increase rate of mesangial cells is high and the pathological damage is serious in patients with liver-kidney yin deficiency syndrome and kidney-collateral stasis stasis syndrome.The high incidence of pathological C1/C2 in rheumatic disturbance syndrome suggests that the patients with rheumatic disturbance syndrome have more crescents when undergoing renal biopsy.