Relationship Between TCM Syndrome Type Of IgA Nephropathy And Clinical And Pathological Study

Objective:To explore the correlation between TCM syndrome types and clinical and pathological features of 60 cases of primary IgA nephropathy.Methods:A retrospective survey was conducted on patients diagnosed as primary IgA nephropathy by renal biopsy at the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from June 2014 to December 2017.Collected 60 cases of IgA nephropathy deficiency syndrome in four Chinese medical examinations,laboratory indicators,and pathological data,and divided them into four syndromes: lung spleen qi deficiency syndrome,Qi-yin deficiency syndrome,liver-kidney yin deficiency syndrome,and spleen-kidney yang deficiency syndrome.Using statistical methods to explore the correlation between medical evidence and clinical and pathological features.Results:(1)Among the 60 patients with IgA nephropathy,the deficiency of Qi-yin deficiency accounted for 41.67% of TCM syndromes,followed by liver-kidney yin deficiency syndrome,lung and spleen qi deficiency syndrome,spleen-kidney yang deficiency syndrome,accounting for 28.33%,16.67%,and 13.33% respectively.The pathological Lee's grade was most commonly seen in grade III,accounting for 61.67%,followed by grades IV,II,and V,which accounted for 16.67%,11.67%,and 10% respectively,and no grade I patients.(2)Relationship between TCM syndrome type and clinic: 24 h urinary protein quantification,serum creatinine,and cystatin C levels are the symptoms of lung and spleen qi deficiency <Qi-yin deficiency syndrome <liver-kidney yin deficiency syndrome <spleen-kidney yang deficiency syndrome,serum Albumin is the opposite;serum IgA,urinary occult blood qualitative and TCM syndrome no significant correlation.Patients with spleen-kidney yang deficiency had higher rates of proteinuria or elevated serum creatinine than the other three types.(3)Relationship between TCM syndrome type and pathology: With the development of TCM syndrome type,lung spleen qi deficiency syndrome,deficiency of Qi and Yin,deficiency of liver and kidney yin deficiency syndrome,and development of spleen and kidney yang deficiency syndrome,the pathological Lee's grade gradually increases,and the pathological injury gradually increases.Lung-spleen-qi deficiency syndrome and Qi-yin deficiency syndrome were relatively mild,with grade II-III being more common,and liver-kidney yin deficiency syndrome being more common in grade III.The pathological changes of the spleen-kidney yang deficiency syndrome were more severe,mainly in IV,V level.There was a significant correlation between TCM syndrome type and pathological Lee's grade(P<0.01).There is no obvious correlation between the pattern of TCM syndromes and the form of immune deposits.(4)Clinical and pathological relationship: 24-hour urinary protein quantification,serum creatinine,cystatin C levels were positively correlated with Lee's grade,and the occurrence of severe proteinuria or elevated serum creatinine was more common in grades IV and V.Serum Albumin levels were lower in Lee's IV and V than in Lee's II and III.There was no significant correlation between serum IgA,urine occult blood properties,immunodeposition forms,and Lee's grade.Conclusion: 60 cases of IgA nephropathy patients with deficiency syndrome and clinical,pathology there is a certain correlation.(1)Among the 60 patients with IgAN,the deficiency of Qi-yin deficiency was the most common in the TCM syndrome type of deficiency syndrome,and the Lee's grade was the most common in grade III.(2)The clinical changes of lung and spleen-qi deficiency syndrome are mild,mostly distributed in grades II and III,the condition is still mild.And the spleen-kidney yang deficiency syndrome is severely altered clinically,and is mostly distributed in grades IV and V,The condition is severe.Deficiency of spleen and kidney yang is more prone to severe proteinuria and elevated serum creatinine.(3)In the 60 cases of IgAN patients,the immunodeposition forms of the TCM syndromes of this deficiency syndrome were mostly IgA+Ig M+C3,and there was no IgA alone.