Study On IgA Nephropathy Based On TCM Syndrome,clinical And Pathological Characteristics

Objective: To study the correlation between Oxford classification of IgA nephropathy(IgAN)and clinical indicators,Traditional Chinese Medicine(TCM)syndrome types,and the related factors of traditional Chinese and Western medicine in IgAN with malignant hypertension,so as to provide scientific basis for the diagnosis and treatment of IgAN with integrated traditional Chinese and Western medicine.Methods: 1.The clinical,pathological and traditional Chinese medicine four diagnostic data of patients with primary IgAN diagnosed by renal biopsy in the first medical center of the General Hospital of the Chinese people’s Liberation Army from March 2021 to December 2021 were collected.To analyze the correlation between Oxford classification,clinical indexes and TCM syndrome types.2.Patients with primary IgAN and malignant hypertension diagnos ed by renal biopsy in the first medical center of the General Hospital of the Chinese people’s Liberation Army from December 2013 to September2021 were included,and patients with primary IgAN and no malignant hypertension diagnosed by renal biopsy in the same period were randomly selected according to 1:5.The clinical,pathological and TCM four diagnostic data of patients were collected,and the TCM and Western medicine related factors of IgAN with malignant hypertension were analyzed.Results: 1.In the first part,a total of 153 patients were included.Qi Yin deficiency syndrome was the most common main syndrome in traditional Chinese medicine,and damp heat and blood stasis were the most common concurrent syndromes.The correlation analysis of pathological indexes showed that S lesion(OR=2.726,P=0.014),T lesion(OR=2.270,P=0.024)and C lesion(OR=2.609,P=0.019)were positively correlated with M lesion.S lesion(OR=4.724,P=0.015)was positively correlated with E lesion.M lesion(OR=2.851,P=0.007)and E lesion(OR=4.087,P=0.030)were positively correlated with S lesion.The correlation analysis between TCM syndrome types and pathological indexes showed that spleen kidney yang deficiency syndrome(OR=7.775,P=0.009),blood stasis syndrome(OR=2.85 4,P=0.011)and M lesion(OR=2.378,P=0.015)were positive correlation factors of T lesion.Spleen kidney yang deficiency syndrome(OR=4.211,P=0.007)and M lesion(OR=3.250,P=0.003)were positive correlation factors of C lesion.2.In the second part,102 patients were included,including 17 IgAN patients with malignant hypertension and 85 IgAN patients without malignant hypertension.There was a positive correlation between renal tubular atrophy / interstitial fibrosis and blood stasis syndrome in IgAN with malignant hypertension patients(P=0.040).Headache(OR=7.895,P=0.010),blurred vision(OR=5.499,P=0.028),dry mouth and happy drink(OR=10.079,P=0.002)and onychomycosis(OR=18.312,P=0.007)were positively related to IgAN with malignant hypertension.Conclusion: S lesion,T lesion and C lesion were positively correlated with M lesion.Spleen kidney yang deficiency syndrome and blood stasis syndrome were positively correlated with T lesion,and spleen kidney yang deficiency syndrome was positively correlated with C lesion.Blood stasis syndrome was a TCM syndrome characteristic of IgAN patients with malignant hypertension.