| BackgroundIdiopathic membranous nephropathy(IMN)is one of the most common cause for unexplained adult nephrotic syndrome and the most common kidney disease which is difficult to cure. The disease inâ… andâ…ˇstage is mostly seen in clinic. The pathogenesis has not been explained clearly. The prognosis is different and the effective treatment disputable. Treatment by Traditional Chinese Medicine is effective in controlling the progress, remitting the symptoms and preventing the complicat ions. But there is no uniform standard of diagnosis and treatment based on an overall analysis of the illness and the patient's condition. In the past 30 years,a large quantities of scholars have been discussing the relationship between Chinese Medical Syndrome and IMN clinical and pathological characteristic with the wide development of renal biopsy. However, the quantities of the special reacerch and the examples is still small.ObjectiveReference will be provided to improve the treatment of Traditional Chinese Medicine and to infer the prognosis by the retrospective research to the relationship between Chinese Medical Syndrome and IMN inâ… andâ…ˇstage clinical and pathological characteristic.MethodsThere are two parts of this article.The first part is literature review. The first review Idiopathic membranous nephropathy's Study of Modern Medicine included the rencent and present study of the epidemiology, pathogenesis, renal pathology, treatment and prognosis by modern medicine. The second review Idiopathic membranous nephropathy's Study of Traditional Chinese Medicine included the study of the designaion in the category of Chinese medicine, pathogenesis, diagnosis and treatment based on an overall analysis of the illness and the patient's condition, treatment by traditional Chinese and western medicine, the relation of differential of symptoms and signs and renal pathology and experiment by traditional Chinese medicine.The second part is the clinical reaserch. The medical records of the 71 IMN patients inâ… andâ…ˇstage who were all diagnosed by renal biopsy were reviewed and analysed according to the The Guide Principle of Clinical Study of New Traditional Chinese Drugs of Chronic Nephritis to explore the relationship between Chinese Medical Syndrome and IMN clinical and pathological characteristic.Resul tsOf the 71 IMN patients inâ… andâ…ˇstage, the type of deficiency of both Qi and Yin is the commonest syndrome, which is accounted for 43.66%(31 cases), the second common syndrome is the type of deficiency of both spleen-Qi and kidney-Qi. which is accounted for 25.35%(18 cases). The cases of the type of deficiency of both lung-Qi and spleen-Qi, the type of deficiency of both spleen-yang and kidney-yang and the type of deficiency of both liver-Yin and kidney-Yin are fewer. The mostly seen superficial excess type is water retention, which is accounted for 35.21%(25 cases), the following types are damp-heat (28.17%), blood-stasis(23.94%) and damp-turbid (12.68%). There is no statistics diffencense through all the types in gender, age and the course of disease (P> 0.05). The relationship of the deficiency types and the superficial excess types have not been finded by statistics. There is no statistics diffencense through all the types in clinical manifestations and compl icat ions (P> 0.05). The cases in stage CK.D3 and above mostly belong to the type of damp-turbid (P> 0.05). The level in diastolic pressure of the type of damp-turbid is obiviously higher than the other three superficial excess types(P<0.05),which is obiviously higher than the type of water retention and damp-heat(P<0.01). The hemoglobin content of the type of deficiency of both liver-Yin and kidney-Yin is less than the type of deficiency of both spleen-Qi and kidney-Qi (P< 0.05). The level in diastol ic pressure of the type of damp-turbid is obiviously higher than the type of water retention and the type of blood-stasis (P<0.05), which is obiviously higher than the type of damp-heat (P< 0.01). The level of f ibr inogen content of the type of blood-stasis is higher than the type of damp-turbid and damp-heat (P<0.05). The level of total cholesterol content of the type of water retention is higher than the type of damp-heat (P< 0.05). The level of low densi ty 1ipoprotien content of the type of damp-turbid is higher than the type of damp-heat (P< 0.05). There is no statistics diffencense through all the types in pathological stage (P> 0.05). The tubulointerstitial injury of the type of deficiency of Yin is more serious than the type of deficiency of Qi and the the type of deficiency of Yang through the pathological scores (P< 0.05).ConclusionsThe type of deficiency of both Qi and Yin is the mostly seen syndrome, which is followed by the type of deficiency of both spleen-Qi and kidney-Qi. Of superficial excess types, water retention and damp-heat occur mostly. There should be some relationship between Chinese Medical Syndrome and IMN clinical and pathological characteristic. |
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