Case86Chinese Medicine Symptoms Of Primary Nephrotic Syndrome Between Various Clinica Pathology Stages

Object iveTo explore the relation between the types of TCM syndrome, renal pathologic types and serous biochemical indexes about Primary Nephrotic Syndrome (PNS)Method1.86patients with PNS that confirmed through renal biopsy during March,2011-March,2012in Nephrology dept. were enrolled as the research objects.2. To divide the86patients into4types by Differentiation Standard of TCM: nsuff icient Qi of both the lung and the kidney (group A); nsufficient Yang of both the spleen and the kidney(group B) Deficient Yin of the liver and the kidney (group C), deficiency of both Qi and Yin (group D).3. To classify the pathologic materials of the objects by pathologic types, then to carry out qualitative assessment to glomerular diseases,tubulointerstitial diseases and nephropathy.4. To collect the serous biochemical indexes of te86patients that contain Scr, UA, BUN, IgA, IgM, IgG, complement C3and C4.5.To analyze the distribution characteristics about epidemiologic feature, TCM syndrome and renal pathologic types of the86patients.6.To discuss the relativity between the types of TCM syndrome and renal pathologic types, integral in Glomerular lesions, integral in nephric tubule, integral in nephropathy, serous biochemical indexes about the objects.Results1. Among the86candidates, male in54.7percent (47cases) and female in45.3percent(39cases),M-F is1.2:l;the candidates were aged18to 45years old, with an average(35.12±11.354)years of age. Aged19to45have a high incidence to suffer this ill.2. Divided by types of TCM syndrome, insufficient Yang of both the spleen and the kidney in53percent(46cases);both deficient Yin of the liver and the kidney and deficiency of both Qi and Yin in12percent (10cases). Classi f ied by pathologic types, MCD in21percent(18cases);MsPGN in30percent(26cases);MPGN in23percent(20cases);MN in19percent(16cases);FSGS in7percent(6).3. Serous biochemical indexes about renal function in4groups:By the comparing the contents of Scr and BUN in4groups was not statistically significant (P>0.05);By the comparing the level of serous UA in4group the differences were of statistical significance (P>0.05) in group A and B, the contents in group B is higher than group A, there was not statistically significant in group A, group C and D(P>0.05), there was not statistically significant in group B, group C and D(P>0.05).4. By the comparing the contents of IgA、IgM、IgG、complement C4in4groups, there was not statistically significant in4groups (P>0.05).By the comparing the contents of complement C3in4groups, there was not stati stically significant between group C and group A and B(P>0.05), the differences were of statistical significance between group D and group A, group B,group C(P <0.05), there was statistical significance between group A and group B(P <0.05), the level of complement C3in4groups:group A>group D>group C>group B.5. By the comparing of4groups with glomerular lesions:(1)It has no statistical significance about the hyperplasia of mesangial cells in4groups (P>0.05);(2)There was not statistical significance in4groups with broadened Mesangial matrix(P>0.05);(3)The differences were of statistical significance in4groups with glomerulosclerosis(P<0.05), the degree of harmful:group C>group B>group D>group A;(4)There was not statistical significance in4groups with stenosing or injured capillary loops or lesion (P>0.05);(5)The differences were of statistical significance in4groups with thickened basement membrane(P<0.05), the degree of harmful:group B>group C>group D>group A;(6)There was not statistical significance in4groups with adhesion of glomerular capsule(P>0.05);(7)The differences were of statistical significance in4groups about integral in Glomerular lesions (P <0.05), the degree of harmful:group B>group Ogroup D>group A.6. By the comparing of4groups with tubulointerstitial diseases:(1)It has no statistical significance about ectasia of renal tubule in4groups (P>0.05);(2)There was not statistical significance in4groups with atrophy of renal tubule(P>0.05);(3)There was not statistical significance in4groups with vacuolation of renal tubular epithelial cell (P>0.05);(4)There was not statistical significance in4groups with sputrescence of renal tubular epithelial cell (P>0.05);(5)There was not statistical significance in4groups with renal interstitial f ibrosis (P>0.05);(6) The differences were of statistical significance in4groups with inflammatory cells infiltration in renal tubulointerstitial (P<0.05), the degree of harmful rgroup B>group Ogroup D>group A;(7)The differences were of statistical significance in4groups about integral in tubulointerstitial diseases (P<0.05), the degree of harmful:group B>group Ogroup D>group A.7. By the comparing of integral in renal diseases in4groups, the differences were of statistical significance in4groups (P<0.05),the degree of harmful:group B>group C>group D>group A.Conclusion(1) Insufficient Yang of both the spleen and the kidney has the most proportion in4types, almost in53percent.(2)The level of UA in group B is higher than group A, it points out that the degree of lesion about renal function in patients who with insufficient Yang of both the spleen and the kidney is worse than who with insufficient Qi of both the lung and the kidney.(3)The level of complement C3in4groups:group A>group D>group C>group B, the result showed that patient with insufficient Yang of both the spleen and the kidney has an unfavourable prognosis in all of4groups.(4)The degree of lesion in kidney:group B>group C>group D>group A.