| Objective:To explore the distribution regularity of traditional Chinese medicine(TCM)syndromes in patients with idiopathic membranous nephropathy and its correlation with renal pathology.To lucubrate the pathogenesis of idiopathic membranous nephropathy,and the dialectical system of TCM syndrome.In order to optimize the treatment scheme of idiopathic membrane nephropathy,and provide the basis for the treatment of integrated TCM and efficacy evaluation.Methods:According to inclusion and exclusion criteria,collected data of 153 cases idiopathic membranous nephropathy patients from September 2015 to September 2020 in outpatient and inpatient Nephrology Department of the First Teaching Hospital of Tian Jin university of Traditional Chinese Medicine and outpatient treatment.Discriminated and analyzed their TCM case data,according to the patient’s general condition,TCM diagnostic information and pathology reports and clinical and biochemical indicators.To explore the distribution regularity of TCM syndromes,depends on Chi-square test,one-way analysis of variance and rank sum test in medical statistics.When P<0.05,here was obvius statistical significance.Results:1.Among the 153 patients with idiopathic membranous nephropathy,there are 96 males and57 females,the ratio of male to female is about 1.69:1;The average age is 51.02±11.82 years old.The middle-aged(45-59 years old)has a total of 85 cases,accounting for 55.56%.The most of course of disease is from 0 to 3 months and about 75 cases(49.02%).2.Spleen-kidney qi deficiency is the most common syndromes in the main syndromes of TCM,accounting for 45.10%(69 cases).The rest is spleen-kidney Yang deficiency,lung-kidney qi deficiency,qi-yin deficiency,and liver-kidney Yin deficiency in order from high to low.In the secondary syndromes of TCM,the most common syndrome is water-dampness,accounting for 46.41%(71 cases),followed by damp-heat syndrome,blood-stasis syndrome and dampness-turbidity syndrome.There is no statistical significance in the distribution of TCM syndromes(P>0.05).3.In TCM syndromes,the male and female proportion of Qi-Yin deficiency syndromes is the same,and the other TCM syndromes are mostly male;Spleen-kidney qi deficiency syndrome is the maximum in both men and women of the main syndromes,while water-dampness syndrome was more common in both men and women of the secondary syndromes.There is no statistical significance between TCM syndrome type and gender distribution(P>0.05).4.In TCM syndromes,the order of the main syndromes is qi-Yin deficiency,liver-kidney Yin deficiency syndrome,lung-kidney deficiency syndrome,spleen-kidney Yang deficiency syndrome,spleen-kidney deficiency syndrome from young to old,the highest was52.29±11.70 years old,the main syndromes between the age distribution of no statistical significance(P>0.05);The average age of the secondary syndromes increased gradually in the order of dampness-heat syndrome,water-dampness syndrome,dampness-turbidity syndrome,and blood-stasis syndrome,and the highest age was 52.48±10.14 years old.There is no statistical significance in the distribution of the secondary syndromes among ages(P>0.05).5.In the main syndromes,the average course of disease of lung-kidney qi deficiency syndrome and liver-kidney Yin deficiency syndrome is the longest,both are 6 months;in the secondary syndromes,the average course of disease of dampness-turbidity syndrome and blood-stasis syndrome is longer,which is 4 months;there is no statistical significance between TCM syndromes and the distribution of disease course(P>0.05).6.There are 92 cases(60.13%)that accompany hypertension of 153 cases,and systolic blood pressure is averaged of 138.63±16.38 mm Hg,diastolic blood pressure is averaged of86.53±14.67 mm Hg,of which spleen-kidney deficiency syndrome accompanied hypertension is the most of the main syndrome,the water-wet and damp-heat syndrome combined with hypertension are more of the secondary syndrome,the TCM syndrome types in the distribution of hypertension has no statistical significance(P>0.05);The patients with hyperuricemia accounted for 19.6%(30 cases)of the 153 patients,and the mean blood uric acid was 369.71±98.13μmol/L.Among them,the syndrome of spleen-kidney qi deficiency is the most in the main syndrome,and the syndrome of water-dampness is the most in secondary syndrome.There is no statistical significance in the distribution of TCM syndrome combined with hyperuricemia(P>0.05).7.CKD1 stage accounted for the largest proportion in 153 patients,accounting for 57.5%(88cases).CKD1 was the main stage in the main syndrome.CKD1 was the main stage of water-dampness syndrome,dampness-heat syndrome and blood-stasis syndrome,CKD3 and above was the most common stage of dampness-turbidity syndrome.The secondary syndrome of TCM syndrome has statistical significance in the distribution of kidney CKD stage(P<0.05).8.In the secondary syndrome of TCM syndrome,the LDL in the blood-stasis syndrome group Is significantly higher than that in the damp-heat syndrome group(P<0.05),but there is no statistical significance in the comparison between the other groups.In the secondary syndrome of TCM syndrome test,the triglyceride in the damp-heat syndrome group is significantly higher than that in the water-dampness syndrome group(P<0.05),but there is no statistical significance among the other groups.In the secondary syndrome of TCM syndrome tests,the serum creatinine in the dampness and turbidity syndrome group is higher than that in the damp-heat syndrome group,the water-dampness syndrome group and the blood-stasis syndrome group,with statistical significance(P<0.05),while there is no statistical significance among the other groups.9.In 153 cases of patients,pathological stage to Ⅱ accounted for most,65.4%(100 cases).In addition to the liver-kidney Yin deficiency syndrome in the main syndrome stage Ⅰ and Ⅱproportion is the same,the rest of the group are mainly on Ⅱ period,the secondary syndromes are also mainly on Ⅱ period,in the distribution of TCM syndrome types in the renal pathological staging on no statistical significance(P>0.05);Among TCM syndromes,no glomerular sclerosis is the most common,accounting for 49.67%(76 cases),spherical sclerosis accounted for 48.37%(74 cases),segtional sclerosis accounted for 1.96%(3 cases),and TCM syndromes have statistical significance in the distribution of glomerular sclerosis(P<0.05).The secondary syndrome showed statistical significance in the distribution of immune complex diversity(P<0.05).Conclusions:1.The ratio of male to female in idiopathic membranous nephropathy is 1.69:1.The mean age of renal biopsy is 51.02±11.82 years.The longest course of disease is 9 years,the shortest is 4 days,and the most common was 0-3 months.In kidney CKD stage,CKD1 stage accounted for the largest proportion,and the secondary syndrome showed statistical significance in the distribution of kidney CKD stage(P<0.05).2.Spleen-kidney qi deficiency is the most common syndrome in the TCM,and the others are spleen-kidney Yang deficiency,lung-kidney qi deficiency,qi and Yin deficiency,and liver-kidney Yin deficiency from high to low.In the secondary syndrome,the most common is water-dampness syndrome,followed by dampness-heat syndrome,blood-stasis syndrome and dampness-turbidity syndrome.3.In the secondary syndrome,the LDL in the blood-stasis syndrome group is higher than that in the damp-heat syndrome group(P<0.05).The triglyceride in the damp-heat syndrome group is higher than that in the water-dampness syndrome group(P<0.05).The serum creatinine in the dampness and turbidity syndrome group is higher than that in the damp-heat syndrome group,the water-dampness syndrome group and the blood-stasis syndrome group,with statistical significance(P<0.05).4.In the renal pathological staging Ⅱ period accounted for most,the distribution of TCM syndrome types in the renal pathological staging has no statistical significance(P>0.05).5.Among the types of glomerulosclerosis,no glomerulosclerosis is the most,followed by globular sclerosis.The distribution of glomerulosclerosis in TCM syndrome is statistically significant(P<0.05).The secondary syndrome showed statistical significance in the distribution of immune complex diversity(P<0.05). |
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