Distribution Of TCM Syndrome Elements In IgA Nephropathy Patients With CKD Stage 1-3 And Its Correlation With Pathology

Objective This study is to use Professor Zhu Wenfeng’s syndrome differentiation theory to extract the constituent elements of IgA nephropathy patients with CKD stage 1-3 based on the theory of traditional Chinese medicine The distribution characteristics of the patients with different pathological types,as well as the distribution characteristics of their disease positions and pathologies,provide a theoretical basis for the diagnosis of TCM syndromes of IgA nephropathy patients with CKD stage 1-3.Methods Collected 112 IgA nephropathy patients with CKD stage 1-3 who met the inclusion criteria from January 2021 to October 2021 in the Department of Nephrology,Hangzhou Chinese Medicine Hospital The pathological type and the data of the four diagnosis of traditional Chinese medicine were used to calculate the syndrome score of IgA nephropathy patients with CKD stage 1-3,and SPSS 23.0 software was used for analysis and comparison.Results 1.In this study,a total of 112 IgA nephropathy patients with CKD stage 1-3 were collected,57 males accounted for 50.9%of the samples,55 females accounted for 49.1%,male to female ratio 1.04:1.The patients were between 15-66 years old,and the average age was 40.88±11.72 years old,with 35-44 years old patients being the most,accounting for 31.3%.2.In this study,patients with IgA nephropathy involved more disease sites and disease syndromes.There are 10 syndrome elements in disease location,namely kidney,spleen,liver,lung,skin,surface,heart,large intestine,stomach,and muscles and bones.Liver（57.1%）,lung（25.9%）,skin（11.6%）,table（11.6%）,indicating that the disease location syndrome element is mainly kidney,closely related to spleen and liver,and related to lung,skin and table.There are 14 syndrome elements in total,which are qi deficiency,yin deficiency,yang deficiency,dampness,blood deficiency,qi stagnation,phlegm,qi deficiency,blood stasis,cold,yang hyperactivity,external wind,essence deficiency,and water stagnation.Qi deficiency and yin deficiency accounted for the most（82.1%,78.5%,respectively）,followed by yang deficiency（67.0%）,dampness（61.6%）,blood deficiency（40.2%）,qi stagnation（33.0%）,phlegm（15.2%）,indicating that the syndrome elements of the disease are mainly qi deficiency and yin deficiency,which are closely related to yang deficiency and dampness,and are related to blood deficiency,qi stagnation and phlegm.In terms of syndrome-element combination,there are 6 types of disease-position syndrome-element combination,with 2 and 3 disease-position syndromeelement combinations being the most common,accounting for 35.7%and 32.1%respectively.There were 8 types of combinations of disease-related syndromes and elements,with 3 and 4 combinations of disease-related syndromes and elements,accounting for 28.6%and 29.5%,respectively.3.The relationship between the distribution of syndrome elements and rheumatism syndrome was analyzed,and no statistical significance was found（P>0.05）.Among them,the relationship with kidney,spleen,lung,skin and surface is more closely than that of non-rheumatism group;disease syndrome elements are mainly distributed in qi deficiency,yin deficiency,yang deficiency,dampness,blood deficiency,qi stagnation,phlegm,qi deficiency,and the relationship between syndrome elements of various diseases is more closely than that of nonrheumatism group.4.The relationship between the distribution of syndrome elements and various factors was analyzed,and it was found that the urine podocyte positive group（30 cases）and the urine podocyte negative group（43 case）had statistical significance in the distribution of wet syndrome（P<0.05）;hormone group（74 cases）and the non-hormone group（38 cases）had statistical significance in the distribution of spleen syndrome（P<0.05）,and in the distribution of yang deficiency syndrome（P<0.01）.There was no statistical significance in the distribution of syndrome elements in CKD stage,hypertension,hematuria and proteinuria（P>0.05）.5.The relationship between the distribution of syndrome elements and Oxford pathological classification was analyzed,and it was found that the distribution of endocapillary hypercellularity（E）was statistically different in the distribution of Qi deficiency syndrom（P<0.05）,atrophy or interstitial fibrosis（T）had statistical difference in the distribution of yang deficiency syndrome（P<0.05）.Mesangial hypercellularity score（M0/M1）,segmental glomerulosclerosis（S）,cellular crescents and the percentage of crescent（C）had no statistical significance in the distribution of syndrome factors（P>0.05）.Conclusion A study of 112 IgA nephropathy patients with CKD stage 1-3 draws the following conclusions:1.The ratio of male to female patients is 1.04:1,and the majority of patients are aged 35-44.2.IgA nephropathy has 10 disease-site syndrome elements and 14 disease-related syndrome elements.Disease location syndromes include kidney,spleen,liver,lung,skin,surface,heart,large intestine,stomach,and bones,among which kidney,spleen,and liver are more numerous.Syndrome elements of disease include qi deficiency,yin deficiency,yang deficiency,dampness,blood deficiency,qi stagnation,phlegm,insufficiency,blood stasis,cold,hyperactivity of yang,external wind,deficiency of essence,and stagnation of water,among which qi deficiency,yin deficiency,yang deficiency The number of virtual and wet cases is large.There are 6 types of disease-position syndrome-element combinations,with 2 and 3 disease-position syndromeelement combinations being the most common.There are 8 types of combinations of diseaserelated syndromes and elements,most of which are 3 or 4 disease-related syndromes.3.IgA nephropathy urine podocyte positive group is closely related to dampness syndrome;hormone group is closely related to spleen syndrome and yang deficiency syndrome.4.Pathological Oxford classification:endocapillary hypercellularity（E）is correlated with Qi deficiency syndrome,atrophy or interstitial fibrosis（T）are correlated with Yang deficiency syndrome.