Diagnostic Evaluation Of Three Syndrome Differentiation Criteria For Chronic Nephritis

ObjectiveTo study the professor Renhe Lv and renal collaterals remove lump syndrome differentiation standard(A standard),the implementation of syndrome differentiation of TCM of chronic primary glomerular disease(B),yong-jun wang type IgAN3 treating scheme(C)for chronic nephritis reliability and authenticity of the diagnosis of syndromes,to provide objective basis for clinical application,explore the research methods of diagnostic test without A gold standard in the application of the traditional Chinese medicine dialectical diagnosis of chronic nephritis.MethodsCollected in January 2017-March 2018 in our hospital patients with kidney disease included in the standard of endocrinology clinic,according to A,B,C three kinds of syndrome differentiation scheme collection signs and symptoms of patients and the content of the urine routine,renal function,such as physical and chemical inspection,syndrome differentiation for chronic nephritis patients face to face,with no gold standard diagnostic test evaluation of A,B,C three kinds of reliability and authenticity of the syndrome differentiation scheme.Results1.Use the criteria of A,B and C,and the symptoms with the highest frequency are fatigue and low back pain;2.A standard syndrome type is mainly based on kidney qi deficiency syndrome(58.1%),and the syndrome is the most common in patients with liver depression(55.1%).B standard syndrome differentiation was most common in spleen and kidney Yang deficiency syndrome(49.5%).It was mainly based on humidity and heat syndrome(31.8%)and blood stasis syndrome(29.8%).C standard syndrome differentiation was based on kidney Yin deficiency syndrome(52.2%).3.A,B,and C standards have A correlation with glomerular filtration rate and course of disease,indicating that A standard,B standard and C standard deficiency syndrome can reflect the trend of disease progression.4.The standard of A and C is of moderate' consistency with the diagnosis of Yang deficiency(Kappa=0.61);A standard,B standard and B standard are not consistent with the diagnosis of Yin deficiency;A standard and C standard,A standard and B standard have moderate consistency in the diagnosis of stasis(Kappa=0.583).5.High sensitivity(0.9107)and B standard specificity(0.886)for the diagnosis of Yang deficiency syndrome;A standard sensitivity(0.8784)and specificity(0.8903)were higher for the diagnosis of Yin deficiency syndrome.The diagnosis of blood stasis syndrome was higher than that of standard and C(0.9377 and 0.9356),and the sensitivity of B was higher(0.8557).Conclusion:1.A and B standard for diagnosis of actions of medium consistency,A and C standard for the diagnosis of blood stasis with medium consistency,A,B and C the lack of consistency of Yin deficiency syndrome diagnostic standard.2.Compared with B standard and C standard,A standard has good sensitivity and specificity for the diagnosis of Yang deficiency syndrome and Yin deficiency syndrome without significantly reducing the specificity.A standard and C standard have high specificity for the diagnosis of blood stasis syndrome,and B standard has high sensitivity to the diagnosis of blood stasis syndrome.