Study On The Correlation Between Serum Galactose-deficient IgA1 And Sanjiao Syndrome In IgA Nephropathy

IgA nephropathy is by far the most common primary glomerular disease,with up to 1/3 of patients progressing to end-stage renal disease within 10-20 years after diagnosis.The clinical manifestations were obviously heterogeneous,most of which were asymptomatic hematuria and proteinuria,accompanied by continuous and slow progress of renal function impairment,and some patients showed aggravation of gross hematuria or microscopic hematuria and proteinuria at the same time of infection.There is no specific discussion on this disease in the classical works of Chinese medicine.At present,the understanding of this disease is generally based on the original deficiency and the real deficiency,with the positive deficiency as the foundation,the evil reality as the standard,and the syndrome of multiple deficiency and real deficiency mixed.IgA nephropathy,characterized by IgA deposition in the mesangial region of the glomerular,is an autoimmune disease mediated by the formation of pathogenic immune complex after the binding of galactose-deficient IgA1(GD-IgAl)antibodies.Studies have shown that GD-IgAl formed by the abnormal glycation of the O-junction in the hinge region of IGA 1 molecule is related to the pathogenesis and prognosis of IGAN.Therefore,retrospective and cross-sectional study methods were adopted in this study to study the correlation between serum galactose-deficient IgA1 and trijoule syndrome in IgA nephropathy.Research purpose:Based on the clinical guidelines of traditional Chinese medicine and western medicine,retrospective and cross-sectional studies were conducted to investigate whether serum GD-IgAl levels in patients with IgA nephropathy were correlated with the syndromes of upper,middle and lower trifocal syndrome,so as to provide ideas for differentiation of the syndromes of IgA nephropathy.Research methods1.A retrospective study was conducted to collect the age,gender,clinical symptoms,signs,tongue signs,pulse and other information of patients with IgA nephropathy who were hospitalized in the Department of Nephrology of Guang ’anmen Hospital and confirmed by renal biopsy from September 2012 to October 2018.The core synonyms were screened by clustering algorithm and the syndrome scoring scale was developed.2.Cross-sectional study ways,collected in November 2018 to March 2021 at the gate hospital renal medicine and hospitalization after renal puncture biopsy clear for IgA nephropathy patients age,sex,clinical symptoms,signs,tongue and pulse condition information,complete syndrome integral evaluation and into the group serum GD-IgA 1 related laboratory indicators,The correlation and difference of data in each group were analyzed.The results:A retrospective study on symptoms showed that 326 patients developed 98 kinds of symptoms with a total frequency of 1755 times.After descending order,urine foam,fatigue,waist acid,dry mouth,facial limb edema were the most frequent clinical symptoms.The main symptoms were fatigue,backache and dry mouth,and deficiency of lung,spleen and kidney qi.After symptom cluster analysis,three symptom groups were obtained.Among them,group 1 showed urinary foam,fatigue,backache,dizziness and dry mouth,which were common clinical manifestations of deficiency of liver and kidney of.lower coke in clinic.Group 2 was characterized by urine foam,fatigue,yellow urine,edema of facial limbs and cough,which were the common clinical manifestations of pyrogenic wind and heat attack on lungs.Group 3 was characterized by urine foam,dry mouth,fatigue,nocturia subfrequency and facial limb edema,which were common clinical manifestations of spleen-kidney Yang deficiency.A cross-sectional study of patients with IgA nephropathy showed that serum GD-IgA1 content was 4.2(3.71,4.63)μg/ml in the IgA nephropathy group and 2.09(1.34,2.74)μ g/ml in the MCD group.The serum GD-IgAl content in healthy group was 2.11(1.57,2.49)μg/ml.The serum GD-IgA1 content of IgA nephropathy group was significantly different from that of MCD group(P<0.01).There was significant difference in serum GD-IgAl content between IgA nephropathy group and healthy group(P<0.05).There was no significant difference in serum GD-IgA1 content between MCD group and healthy group(P=0.98).Conclusion:(1)The level of serum GD-IgA1 in IGAN patients was higher than that in MCD patients and healthy people;(2)Serum GD-IgAl content in patients with IgA nephropathy was correlated with coke deficiency syndrome in IgA nephropathy.