The Correlative Analysis Of TCM Syndrome Type And Immune Function In Pediatric Patients With Henoch-Schonlein Purpura Nephritis

Objective:Throughout the clinical research,we try to study the TCM syndrome type in pediatric patients with HSPN,sort the normal and outlier,explore the correlation between the TCM syndrome types and immune parameters and determine whether there is variance between immune parameters in the different TCM syndrome types.The final purpose is to enrich the content of syndrome differentiation and treatment in TCM and provide the objective basis for the treatment of pediatric patients with HSPN using TCM.Methods:We take the pediatric inpatient with HSPN from Shanxi Pediatric Hospital from July 2015 to June 2016 as study cases,develop investigation table and collect cases.Then we use statistical description to analyze the patients' general information(including gender,age,duration and place of residence),TCM syndrome types and its distribution with renal pathological character,cellular immune function(including T cell,Th cell,Ts cell,NK cell,CIK cell,B cell)and humoral immune function(including IgG,IgA,IgM,C3,C4).Third,we successively use Kruskal-Wallis H test to analyze the correlation between different TCM syndrome types in T cell,Th cell,Ts cell,NK cell,CIK cell,B cell,IgG,IgA,IgM,C3,C4 and course.If the difference is statistically significant,we further conduct pairwise comparison.Finally,we use Multi-Class Logistic Regression method to analyze the correlation between the TCM syndrome types and immune parameters.Results:1.Of 92 pediatric patients with HSPN,most are boys,and the male to female ratio is almost1.36:1.The mean age is 9.48±2.429.There is 1 patient in the period of infancy(1.09%),23 patients in the period of preschool age(25%),58 patients in the period of school age(63.04%),10 patients in the period of puberty(10.87%).The percentage of patients in the period of school age is more than 50%.2.There is statistically significant variance between the different TCM syndrome type and course in pediatric patients with HSPN.Further pairwise comparison shows that the main significant variance is respectively in blood-heat with blood stasis syndrome with Yin deficiency with blood stasis syndrome,Qi and Yin deficiency with blood stasis syndrome.3.The TCM syndrome type in pediatric patients with HSPN comprises 2 cases of wind-heat with blood stasis syndrome(2.17%),27 cases of blood-heat with blood stasis syndrome(29.35%),17 cases of Yin deficiency with blood stasis syndrome(18.48%),32 cases of Qi and Yin deficiency with blood stasis(34.78%),5 cases of spleen and kidney deficiency syndrome(5.43%),5 cases of dampness and blood stasis phlegm syndrome(5.43%)and 4 cases of liver depression and spleen vacuity syndrome(4.35%).The total cases of blood-heat with blood stasis syndrome,Yin deficiency with blood stasis syndrome and Qi and Yin deficiency with blood stasis syndrome are 76,accounting for82.61% of 92 pediatric patients with HSPN.4.There is statistically significant variance between the different TCM syndrome types in the level of T cell,Th cell,Ts cell and B cell in pediatric patients with HSPN.Further pairwise comparisons show that the main significant variance is between blood-heat with blood stasis syndrome and dampness and blood stasis phlegm syndrome respectively with Yin deficiency with blood stasis syndrome and Qi and Yin deficiency with blood syndrome stasis in the level of T cell;Qi and Yin deficiency with blood stasis syndrome respectively with dampness and blood stasis phlegm syndrome,Yin deficiency with blood stasis syndrome and blood-heat with blood stasis syndrome in the level of Th cell;Yin deficiency with blood stasis syndrome respectively with dampness and blood stasis phlegm syndrome and blood-heat with blood stasis syndrome in the level of Ts cell;blood-heat with blood stasis syndrome respectively with Yin deficiency with blood stasis syndrome and Qi and Yin deficiency with blood stasis in the level of B cell.We can not confirm that there is statistically significant variance between the different TCM syndrome types and the level of NK cell.We can not confirm that there is statistically significant variance between the different TCM syndrome types and the level of CIK cell.5.We can not confirm that there is statistically significant variance between the different TCM syndrome types and the level of IgG.We can not confirm that there is statistically significant variance between the different TCM syndrome types and the level of IgA.We can not confirm that there is statistically significant variance between the different TCM syndrome types and the level of IgM.We can not confirm that there is statistically significant variance between the different TCM syndrome types and the level of C3.We can not confirm that there is statistically significant variance between the different TCM syndrome types and the level of C4.6.The outcome of Multi-Class Logistic Regression between the TCM syndrome type and immune parameters shows T cell and Th cell are statistically significant,others arenot.The reduced probability of blood-heat with blood stasis syndrome is 0.515 times the level of T cell of the Qi and Yin deficiency with blood stasis syndrome.The reduced probability of Yin deficiency with blood stasis syndrome is 0.541 times the level of Th cell of the Qi and Yin deficiency with blood stasis syndrome.Conclusion:1.The incidence age is concentrated on school age in pediatric patients with HSPN.2.The TCM syndrome type is associated with course in pediatric patients with HSPN.3.The most common TCM syndrome types are Qi and Yin deficiency with blood stasis syndrome,blood-heat with blood stasis syndrome and Yin deficiency with blood stasis syndrome in pediatric patients with HSPN.4.The TCM syndrome type is associated with immune function in pediatric patients with HSPN,which is mainly related to the level of T cell,Th cell,Ts cell and B cell in cellular immune function,especially in blood-heat with blood stasis syndrome,Yin deficiency with blood stasis syndrome,Qi and Yin deficiency with blood stasis syndrome and dampness and blood stasis phlegm syndrome,others are not significant.5.The main factors affecting the TCM syndrome type in pediatric patients with HSPN are the level of T cell and Th cell.