Chronic Primary Glomerular Diseases, Proteinuria Tcm Syndromes Research

Proteinuria is one of the significant indexes for nephropathy diagnosis and therapeutic efficiency, which is related to course and prognosis of nephropathy. Presently compared with modern medicine, Traditional Chinese Medicine (TCM) has big advantage in reducing proteinuria, recurrence and side-effects.Research targets:this research tries to explore TCM syndrome characteristic of proteinuria in patients with chronic primary glomerular diseases, which is micro-symptom, under the guideline of TCM theory. And then the main syndrome types are known. Then we will analyze relations of the main syndrome types with clinical deseases and experimental indexes which are good for guiding differential treatment of proteinuria, especially aimed at people who have no symptoms except proteinuria.This paper includes two parts. The first part is the literature review and the second is clinical research. The former is mainly divided into two parts: the research summary of modern medicine on proteinuria which contains proteinuria conception, pathogenesis and check methods of experiment, having effect on other parts of body, diagnosis and treatments. The later part introduces how TCM understands etiology and pathogenesis of proteinuria in patients with chronic primary glomerular diseases which can not be seen by naked eyes, different views of doctors, the research conditions of TCM syndromes of chronic primary nephropathy which is main characteristic of proteinutia, and correlational study of differential treatment and clincical experimental check.Research methods:the clinical research surveys 138 patients who suffer from chronic primary glomerular diseases which are main characteristic of proteinuria. These patients are devided into three groups:the amount of 24h proteinuria in group A is below 1g, group B being between 1g and 3.5g, group C being more than or equal to 3.5g. Collect clinical data, including general data and experimental data. Abide by differentiation guideline based on the diagnostic standards of the chronic nephritis in 2002. Statistical software is SAS8.2, with P<0.05 as statistically significant.Research results:original deficiency and superficial excess is the main character of proteinuria. We come to conclusions that Qi deficiency of both kidney and spleen is the main syndrome in group A, both Qi and Yin deficiency is the main syndrome in group B, and Yang deficiency of both kidney and spleen is the main syndrome in group C. Of superficial excess types, damp-heat and water retention occur at high frequency rates in every group. Damp-heat easily merges into three main types of origin deficiency in three groups. Water retention easily merges into Yang deficiency of both kidney and spleen in group C.Of experimental indexes, contrary to high cholesterol and D-dimmer, serum calcium, albumin and IgG decrease obviously in patients who are Yang deficiency of both kidney and spleen in group C, compared with other groups. In group C serum calcium and IgG decrease much more obviously in patients who are Yang deficiency of both kidney and spleen than who are not. This conclusion is favor for diagnosis of Yang deficiency of both kidney and spleen. Albumin is higher in patients who aren't both Qi and Yin deficiency in group B than patients who are, which is favor for diagnosis of both Qi and Yin deficiency types of middle amount of proteinuria from the side-way. Triglyceride and LDL are higher in patients who are Yang deficiency of both kidney and spleen in group C and Qi and Yin deficiency in group B than patients who are Qi deficiency of both kidney and spleen in group A. OnlyYang deficiency of both kidney and spleen in group C and Qi deficiency of both kidney and spleen in group A are significantly different.Conclusions:, original deficiency and superficial excess is the main character of proteinuria in patients with chronic primary glomerular diseases. Of original deficiency types, Qi deficiency of both kidney and spleen is the main syndrome type in patients of mild proteinuria. Both Qi and Yin deficiency is the main syndrome type in patients of middle amount of proteinuria, and Yang deficiency of both kidney and spleen is the main syndrome type in patients of large amount of proteinuria. Of superficial excess types, damp-heat type is most closely related with proteinuria, and water retention type is the second. Water retention easily merges into Yang deficiency of both kidney and spleen in patients of large amount of proteinuria. Serum calcium, IgG and albumin decrease, and cholesterol and D-dimmer are high in patients of large amount of proteinuria who are Yang deficiency of both kidney and spleen. Serum calcium and IgG are lower in patients of large amount of proteinuria who are Yang deficiency of both kidney and spleen than who are not. Albumin is lower in patients of middle amount of proteinuria who aren't Qi and Yin deficiency than who are. Triglyceride and LDL are higher than normer in patients of large amount of proteinuria who are Yang deficiency of both kidney and spleen and patients of middle amount of proteinuria who are Qi and Yin deficiency, and only the former differs from Qi deficiency of both kidney and spleen of mild proteinuria.