Study On The Correlation Between Pathological Types,Clinical Indexes And TCM Syndrome Types Of Renal Biopsy

ObjectivesTo investigate the relationship between renal biopsy in patients with pathological type,clinical indicators and TCM(Traditional Chinese Medical)syndromes,to learn about the microscopic changes of renal pathology and physiology on the basis of TCM syndrome differentiation,and to realize the combination of macro and micro,so that people have a more intuitive and clear understanding of the pathophysiology of TCM Syndromes,and to provide an objective basis for the treatment of kidney diseases with integrated traditional Chinese and Western Medicine.Methods307 cases who were received renal biopsy with general information(name,gender,age,duration),clinical diagnosis,pathological diagnosis,TCM syndrome,blood pressure and related laboratory test results were collected from July 2015 to July 2016 in Guangdong Province Traditional Chinese Medical Hospital nephrology which consists of institute of Nephrology by Dade Road,Fangcun Branch Department of nephrology,University City branch Department of nephrology,Zhuhai branch Branch Department of nephrology,through the retrospective analysis method,and then to construct database using Excel table.Western medicine diagnosis:according to the diagnostic criteria of various renal diseases,combined with clinical manifestations and laboratory test results to determine the clinical diagnosis;and reference to the "kidney biopsy pathological diagnosis standard guidance" standard,which was be heldin the national kidney biopsy pathological diagnosis Seminar by the Chinese Medical Association to determine the pathological diagnosis.TCM syndrome differentiation:referring to the guiding principle of clinical research on new drugs of traditional Chinese medicine on the treatment of chronic nephritis and chronic renal failure with traditional Chinese Medicine,which was edited by Zheng Xiaoyu in 2002.To learn about the clinical diagnosis,pathological type distribution in our hospital that year in renal biopsy patients,the primary and secondary glomerular disease in patients with renal biopsy pathology,laboratory test results,blood pressure and TCM type of correlation analysis by frequency statistics and SPSS statistical software,and then to explore their internal relationships.Result1.In this study,the number of primary glomerular disease was significantly higher than that of secondary glomerular disease and other renal diseases.There was no significant difference in the distribution of gender between TCM Syndromes(P>0.05).Age was associated with deficiency syndrome of TCM(P<0.05).However,there was no significant difference in the sthenia syndrome of TCM(P>0.05).The distribution of TCM syndromes in the course of disease was statistically significan(P<0.05).2.In clinical manifestations,NS was the most common symptoms of PGN and SGN.The clinical manifestations of MN,GML,FSGS and MCD were mainly NS.IgAN is mainly manifested as CNS.MN was the most in the pathological type of PGN,accounting for 38.46%,followed by IgAN(32.13%),GML(11.76%),FSGS(7.24%),MCD(4.98%),MsPGN(3.17%),PSGN/SGN(2.26%).The most of the pathological types of SGN were LN,45.76%,followed by HBVGN(18.64%),HSPN(16.95%),DN(11.86%),LCDD(3.39%),anti GBM glomerulonephritis(1.69%),amyloidosis nephropathy(1.69%).3.Relationship between TCM Syndrome Types and pathological types:In this study,the deficiency of spleen and kidney qi deficiency was dominated in the deficiency syndrome of PGN and SGN.In the sthenia syndrome,PGN was mainly composed of damp heat syndrome,and SGN was mainly composed of dampness and water.Blood stasis accounted for 97.39%.There was no significant difference of PGN pathological type in the distribution of the deficiency syndrome(P>0.05),but they were associated with deficiency syndrome of TCM(P<0.05).There was significant difference of the distribution of SGN pathological type in the deficiency syndrome of TCM(P<0.05),and there was no significant difference in the sthenia syndrome of TCM(P>0.05).4.Relationship between clinical indexes and TCM Syndrome Types:BUN,Scr and blood pressure have statistical significance in the deficiency syndrome of TCM in PGN(P<0.05).TC?HDL-C?LDL-C?TP?ALB?FIB and blood pressure have statistical significance in the sthenia syndrome of TCM in PGN(P<0.05).24h-Upro and TG have statistical significance in all syndrome of TCM in PGN(P<0.05).Immune index and HGB have no statistical significance in all syndrome of TCM in PGN(P>0.05).ALB has statistical significance in the deficiency syndrome of TCM in SGN(P<0.05).Other clinical indexes have no statistical significance in all syndrome of TCM in PGN(P>0.05).5.Relationship between clinical indexes and pathological types:BUN?Scr?24h-Upro?IgG?IgA?C3?TP?ALB?FIB?HGB and blood fat have statistical significance in different pathological types in PGN(P<0.05).UA?IgM?C4 and blood pressure have no statistical significance in different pathological types in PGN(P>0.05).IgG?IgA?C3?C4?TC?HDL-C?LDL-C?SBP?TP?ALB?HGB and renal function have statistical significance in different pathological types in SGN(P<0.05).DBP?IgM?TG and FIB have no statistical significance in different pathological types in SGN(P>0.05).ConclusionAt present,there is a significant increase in the number of renal biopsy in our hospital,and the incidence of primary glomerular disease is more than that of secondary glomerular disease and other renal disease.In clinical manifestations,NS was the most common symptoms of PGN and SGN.MN was the most in the pathological type of PGN,followed by IgAN.The most of the pathological types of SGN were LN,followed by HBVGN.The deficiency of spleen and kidney qi deficiency was dominated in the deficiency syndrome of PGN and SGN.In the sthenia syndrome,PGN was mainly composed of damp heat syndrome,and SGN was mainly composed of dampness and water.Most of the cases included blood stasis syndrome.The result showed that there were significant differences in the sthenia syndrome of PGN pathological types in TCM,and there were differences in the deficiency syndrome of SGN pathological types in TCM.Biochemical indexes and blood pressure were correlated with TCM Syndrome Types and pathological types.