Study On The Relationship Of Clinical Features, Pathological Types And Their Correlation To TCM Syndromes In288Cases Of IgA Nephropathy

Objective:288adult patients diagnosed as IgA nephropathy (IgA nephropathy, hereinafter referred to as IgAN)according to renal punctrue pathology were divided into two groups--symptomatic disease IgAN group and physical examination found group.Compare and analyze their clinical symptoms,TCM syndrome type and pathology classification of the characteristics. Explore the relationship between the TCM syndrome type and renal pathology clinical index and pathological features. Provide basis for the objectivatione of TCM symptom differentiation of IgAN, In order to guide the prevention and treatment of IgAN.Methods:Retrospective study (From January2003to August2010) was done on288cases of primary IgAN adult patients daignozed by renal punctrue pathology from Nephrology ward and TCM ward in our hospital. To make analysis of the relationship beween their clinical symptoms,TCM syndrome type and pathology classification.The patients who had clinical symptom on their first visit were grouped into symptom group (group A),an the one who had no clinical symptom but detected by physical examination were grouped into physical examination found group (group B). Compared with two groups of general conditions,laboratory index, pathology classification and immunopathology.Study the correlation between TCM syndrome type and objective index.Results:1、288cases of IgAN were collected, including group A of146cases, groupB of142cases. In group A,the value of weight, BMI, blood Hb, blood IgG,IgA are lower than that of group B(P <0.05). The value of age,height,blood pressure, urine occult blood、CHOL、BUN、CREA、GFR、 URIC、IgM、C3、C4、urine protein classification、CKD classification had no significant difference between the two groups(P>0.05).2、Among288cases of patients,The pathology classification was mainly of Lee SMK Ⅲ,followed by Ⅳ、Ⅰ、Ⅱ、Ⅴ. There are no significant difference between the two groups(P>0.05). Katafuchi R rating had no statistical difference between the two groups(P>0.05). Renal histopathologic Immunofluorescence Antibody,and the complement deposit was mainly of IgA+IgM+IgG+C3, totaly125cases, make up a portion of43.40%.There are no significant difference of Immunofluorescence Antibody and the complement deposit between the two groups(P>0.05).3、Among288cases of patients,TCM syndrome type was mainly of Qi yin deficiency syndrome, totaly80cases, make up a portion of27.78%.Followed by Yin deficiency syndrome of kidney and liver、Qi deficiency syndrome of spleen and liver、Damp-heat Sydrome、wind-heat syndrome. There are no significant difference of TCM syndrome types(P>0.05).Conclusion:1、288cases of IgAN were collected, the value of weight, BMI, blood Hb, blood IgG,IgA are lower than that of group B(P<0.05).The value of age,height,blood pressure,urine occult blood、CHOL、BUN、CREA、GFR、URIC、IgM、C3、C4、urine protein classification、 CKD classification had no significant difference between the two groups(P>0.05).2、Among288adults IgAN patients, the pathology classification was mainly of Lee SMK Ⅲ.Renal histopathologic Immunofluorescence Antibody and the complement deposit was mainly of IgA+IgM+IgG+C3,more than IgA. There are no significant difference between the two groups.3、TCM syndrome type was mainly of Qi yin deficiency syndrome,followed by Yin deficiency syndrome of kidney and liver、Qi deficiency syndrome of spleen and liver、Damp-heat Syndrome、wind-heat syndrome. The pathology classification of Yin deficiency syndrome of kidney and liver、Qi deficiency syndrome of spleen and liver、Damp-heat Syndrome was more seriously than that of wind-heat syndrome.The pathology classification of Qi yin deficiency syndrome was more seriously than that of Damp-heat Syndrome. Proving that there was a degree of correlation with the TCM syndrome type and pathology classification. It suggested that we should attach great importance to the therapy of qi-replenishing, yin-nourishing, heat clearing and diuresis promoting.