| ObjectiveTo survey the clinical diagnoses.and pathological types,and their correlation to TCM syndromes in the patients with renal biopsy in Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine for 13 years,analyse the composing characteristics and changing tendency of kidney diseases.MethodFrom January 2004 to December 2016,histological diagnosis of renal diseases was made in 364 patients in Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine.Their demographic data,clinical and pathological data were analyzed retrospectively.Pathological diagnoses were determined according to the modified WHO criteria for renal pathology of 1995 and the "renal biopsy pathological diagnosis standard guidance" made at the 2001 national renal biopsy pathological diagnosis seminar,combined with clinical data and laboratory tests.TCM syndromes were made according 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.Using the SPSS 19.0 software to analyse the distribution of the clinical diagnoses,pathological types and TCM syndromes,and explore their internal relationships.Results1.PGD accounted for 75.3%of the total renal patients biopsied,and SGD for 20.3%.In PGD cases IgAN,MN and MCD accounted for 38.7%,32.8%and 12.4%respectively.The most frequent types of SGD were LN(29.7%)and HBVGN(20.3%).2.IgAN was the most frequent pathologic type(50.0%)of PGD in the data from 2004 to 2010,followed by MN(18.0%).In the data from 2011 to 2016,MN became the most frequent type(41.4%),followed by IgAN(32.2%).3.In this group,the clinical diagnosis of nephritis syndrome(52.5%)was most frequent,followed by nephrotic syndrome(40.6%).Nephritis syndrome was the main manifestation in IgAN,MsPGN,LN and HSPN,while nephrotic syndrome was the main manifestation in MN,MCD,FSGS,HBVGN and DN.4.The root deficiency and incidental excess syndrome had a highest occurrence both in PGD and SGD cases(72.6%and 78.4%respectively).In PGD,The spleen-kidney Qi deficiency syndrome,Qi-Yin deficiency syndrome and spleen-kidney Yang deficiency syndrome were the most common root deficiency syndromes(48.9%,17.5%and 16.1%respectively),while the damp-heat syndrome(40.1%)and water-damp syndrome(29.2%)in incidental excess syndromes were the most common.In SGD,The spleen-kidney Qi deficiency syndrome and Qi-Yin deficiency syndrome were the most common root deficiency syndromes(45.9%and 29.7%respectively),while the damp-heat syndrome,water-damp syndrome and blood stasis syndrome were the most common incidental excess syndromes(37.8%,29.7%and 28.4%respectively).5.Compared with CKD1 and CKD2 period,the proportion of spleen-kidney Qi deficiency syndrome in CKD3 period decreased and the proportion of damp-muddy syndrome increased.And the proportion of spleen-kidney Yang deficiency syndrome in CKD3 period was higher than that in CKD2 period.(P<0.05)6.In IgAN patients,spleen-kidney Qi deficiency syndrome and Qi-Yin deficiency syndrome were the most common root deficiency syndromes(44.0%and 24.0%respectively),while spleen-kidney Qi deficiency syndrome and spleen-kidney Yang deficiency syndrome were the most common in MN patients(52.3%and 19.3%respectively).As for the incidental excess syndromes,the damp-heat syndrome were frequently seen in IgAN patients(40.0%),while the damp-heat syndrome and water-damp syndrome were the most in MN(45.5%and 37.5%respectively).In the patients with CKD1 period,the proportion of water-damp syndrome in IgAN group was significantly lower than that in MN group(P<0.01),while the proportion of blood stasis syndrome was higher than the MN group's(P<0.05).Conclusion1.PGD is the most common renal disease occurred in patients with renal biopsy.IgAN decreased significantly while MN increased in recent years.LN is the most frequent type of SGD.2.As for the TCM syndrome,the root deficiency and incidental excess syndrome has the highest occurrence both in PGD and SGD cases.The spleen and kidney Qi deficiency syndrome and damp-heat syndrome are the most frequent syndromes.3.There is a certain correlation between TCM syndrome and renal pathology.With the progress of the disease,the spleen-kidney Qi deficiency syndrome decrease,while the spleen-kidney Yang deficiency syndrome and damp-muddy syndrome increase.And in the IgAN and MN groups,there are significant differences in the distribution of TCM syndromes. |
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