Study On The Relationship Between TCM Syndrome Differentiatian And Clinical Pathology In Pations With IgA Nephropathy

ObjectiveTo investigate the disposition of TCM syndrome pattern, clinical classification and immunopathogenesis;the focal point is the study on the relationship between TCM syndrome differentiation and clinical pathology,for revealing the internal material foundation and objective rule,as the directions of syndrome differentiation;presuming clinical and pathological changes by TCM syndrome differentiation and also combining three categories of index(TCM syndrome,clinical index and pathological index) to judge prognosis.MethodBy haplo-centre epidemiological investigation and retrospective study,96 patients' TCM syndrome and clinical pathology data was collected,their syndrome pattern was different tiated together.Database was established in table to analyze the relationship between TCM syndrome and clinical pathology by statistical software.ResultThree deficient syndrome was the major syndrome(82.3%) rather than other two sthenia syndrome(17.7%).Pi(Fei)-Shen qi deficiency was the major part among five types,hsymptomatic abnormal urinalysis was the most common clinical type followed by mass proteinuria.Pathologically,sangial proliferation and focal segmental /glomerular glomerulosclerosis were the most frequent types,hccoding to the occurred frequency of symptom and physical sign,Qi-asthenia andyindeficiencywere the principal syndrome manifestation among deficiency syndrome,the sick entrails were lung,spleen,liver and kidney,wind-heat and damp-heat syndrome were the common manifestation among sthenia syndrome.The wind-heat syndrome showd mildest clinical and pathological changes in clinical types,proteinuria,total Katafuchi scores,glomerular scores,tubulo-interstitial scores, WHO classification and basic pathological types,which could show this syndrome had better prognosis than other four syndrome; damp-heat syndrome showed server clinical and pathological changes as the other sthenia syndrome,which showed no significant difference with three deficient syndrome;Three deficient syndrome showed no significant difference in clinical types,blood pression, blood serum creatinine,blood urea nitrogen and WHO classification.The characteristic of wind-heat syndrome in clinical and pathological changes was as follows:recurrent gross hematuria and mass proteinuriawere the major clinical subtypes;it showed lower proteinuria than damp-heat syndrome,both Qi-Yin deficient syndrome and Yin deficient syndrome and also showed wildest changes in total Katafuchi scores,glomerular,tubulo-interstitial scores and interstitial fibrosis scores;most of them belonged to gradeI to III by WHO classification;meanwhile,FMsPGN and ML as the wilder pathological subtypes belonged to wind-heat syndrome in total ConclusionThe disposition of TCM syndrome pattern with IgA nephropathy shows TCM pathogenesis esence——asthenia in origin and sthenia in superficiality.Qi-asthenia and yin deficiency is the principal syndrome among athenia syndrome,Ink entrails are lung,spleen, liver and kidney,wind-heat and damp-heat syndrome is the common manifestation among sthenia syndrome.The study on the relationship between TCM syndrome differentiatian and clinical pathology proves that TCM syndrome is correlated with clinical and pathological Index especially prognosis index,Wind-heat syndrome is a fine macro index reflecting prognosis;Meanwhile,for clinical and pathological changes refletting TCM syndrome and TCM syndrome presuming clinical and pathological changes,wind-heat syndrome shows referential significance,but not existing in other four syndrome.Therefor, we need more penetrating study and other study method for inter-promotion between TCM syndrome and clinical pathology and to direct clinical practice.