Reserach Of TCM Syndrome Characteristics And Renal Pathology In IgA Type Of Hepatitis B Virus Associated Glomerulonephritis

Objective:To explore the TCM syndrome characteristics and renal pathological changes in IgA Type of Hepatitis B virus associated Glomerulonephritis, to provide a theoretical basis for clinical diagnosis and guiding treatment of IgA Type of Hepatitis B virus associated Glomerulonephritis.Methods:According to the appropriate inclusion and exclusion criteria, each 60 cases of renal biopsy pathology diagnosis confirmed HBV-IgAN and pIgAN were collected from December 1, 2009 to August 31,2014, Fuzhou General Hospital of Nanjing Military Region, outpatient and inpatient. Two groups of patients conduct traditional Chinese medicine before and after renal biopsy 3 days.Then collected general information.At last compared the data for statistical analysis of two groups.Results:1.General comparison:(1) Renal function:The difference between two groups was not statistically significant (P>0.05). (2) Laboratory parameters:HBV-IgA group of ALB, complement C3 level were lower than IgAN group,while 24h urine protein,TC,ALT higher than IgAN group, the difference was statistically significant (P<0.05). (3)Clinical manifesta-tions:HBV-IgAN groups with chronic nephritis syndrome (60%), nephrotic syndrome (23.4 %), asymptomatic proteinuria (8.3%), isolated hematuria (5%), acute nephritic syndrome (3.3 %). IgAN groups with chronic nephritis syndrome (53.5%), isolated hematuria (26.7%), neph-ritic syndrome (13.3%), acute nephritic syndrome (5%), asymptom aticproteinuria (1.7%). The difference between two groups was statistically significant (P<0.05).2. Renal pathology comparion:(1) Lee grading:HBV-IgAN group was more common with Lee Ⅲ～Ⅳ, pIgAN group to Lee Ⅱ～Ⅲ more common. But the distribution of the two groups was no statistically significant (P>0.05). (2) Oxford typing:HBV-IgAN combined with renal tubular atrophy and interstitial fibrosis (T1/T2) ratio is higher than IgAN group, the difference was statistically significant (P＜0.05). (3) Renal impairment integral:HBV-IgAN group of mesangial prolifer-ation degree integral, renal tubular interstitial integral, interstitial inflammatory cell infiltra-tion, interstitial fibrosis integral, renal tubular atrophy integral were significantly higher than that of IgAN groups, the difference was statistically significant (P＜0.05).3.TCM comparion:(1) Main card:HBV-IgAN group with the highest proportion of spleen and kidney deficiency syndrome(38.4%), followed by liver and kidney Yin deficiency syndrome(35%), qi and Yin deficiency syndrome(20%), spleen and kidney Yang deficiency syndrome(6.6%). And plgAN group with qi and Yin deficiency syndrome(41.6%), followed by the spleen and kidney defic-iency syndrome(28.4%), liver and kidney Yin deficiency syndrome(20%), spleen and kidney Yang deficiency(10%). Two groups was significant (P＜0.05). (2) Permits:HBV-IgAN groups were with the highest proportion of damp heat syndrome(48.3%), followed by blood stasis syndrome(18.4%), wet cards(16.7%), some have not merged and certificates(13.3%) and damp turbidity(3.3%). While pIg AN groups were more common to blood stasis syndrome’ (31.7%), followed by damp heat syndrome(26.7%), not merged and certificates(20%),wet cards(13.3%)and dampness syndrome(8.3%). Two groups was significant (P<0.05).4.The follow-up comparion:At the end of two follow-up, the sum of the rate of complete and partial remission, like. HBV-IgAN group into end-stage renal disease (ESRD) is higher than the proportion of IgAN groups, pIgAN group no relieve (13.3%) is higher than the proportion of HBV-IgAN group (6.7%), but the difference was not statistically significant (P> 0.05).Conclusion:1. Kidney pathological aspects, HBV-IgAN compared with pIgAN, the degree of renal tubule interstitial lesions was heavier.2. TCM syndrome aspect, there have difference between HBV-IgAN and IgAN, HBV-IgAN group based on spleen and kidney qi deficiency, damp and heat accumulation as the standard, always hot and humid throughout the illness, but pIgAN group based on Qi Yin deficiency, blood stasis as the standard, blood stasis throughout.3. HBV-IgAN short-term follow-up and prognosis equal with pIgAN, but the long-term prognosis is unclear.