A Preliminary Study On TCM Constitution Types Of Idiopathic Membranous Nephropathy In Some Class A Hospitals In Kunming City

Objective:In this study,by detecting the serum anti-PLA2 R antibody titer level of patients with idiopathic membranous nephropathy in some Class A hospitals of Kunming City,the correlation between patients with idiopathic membranous nephropathy whose serum anti-PLA2 R antibody results were positive and traditional Chinese medicine constitution was initially discussed,so as to find new ideas and methods for the prevention and treatment of idiopathic membranous nephropathy from the perspective of TCM.It provides a new theoretical basis for the early prevention,individualized treatment and delay of disease progression of idiopathic membrane nephropathy by regulating constitution,and provides individualized constitution intervention program according to the results of constitution classification.Methods:A total of 129 patients diagnosed with idiopathic membranous nephropathy through percutaneous renal biopsy and pathology were collected from the First People’s Hospital of Yunnan Province and Yunnan Hospital of Traditional Chinese Medicine from November2021 to December 2022.Secondary factors were excluded and serum anti-PLA2 R antibody test results were positive.2.Under the guidance of professional personnel,129 patients were filled in the TCM Constitution Classification and Identification Form,and the TCM Constitution Identification Software Professional Version 3.0,produced by Yanhuang Dongfang(Beijing)Health Technology Co.,Ltd.was used to identify the TCM constitution types of patients;3.General,laboratory and pathological data of 129 patients were collected.SPSS 25.0 software was used to analyze the correlation between different body types of patients and age,gender,serum anti-PLA2 R antibody concentration level,pathological stage,plasma albumin,serum creatinine,blood uric acid,blood urea nitrogen,24-hour urinary protein,etc.Results:1.The composition ratio of TCM constitution types of 129 IMN patients with serum anti-PLA2 R antibody positive was as follows from high to low: There were 32 cases(24.8%)of Qi-deficiency quality,27 cases(20.9%)of Yang deficiency quality,19 cases(14.7%)of Yin deficiency quality,16 cases(12.4%)of damp-heat quality,11 cases(8.5%)of phlegm-dampness quality and blood-stasis quality,6 cases(4.7%)of calm quality,4cases(3.1%)of Qi-stagnation quality and 3 cases(2.3%)of characteristic quality.Among the 8 types of biased constitution,Qi deficiency and Yang deficiency are the most common.2.The serum anti-PLA2 R antibody titer level of IMN patients with Yang deficiency and Qi deficiency was significantly higher than that of Qi stagnation and Pinghe,and the difference between Qi stagnation and qi deficiency was statistically significant(P < 0.001).3.There were 42 cases of stage I,69 cases of stage II and 18 cases of stage III renal pathological stage in IMN patients with serum anti-PLA2 R antibody positive.The types of TCM constitutions in stage I are mainly Yin deficiency and blood stasis;in stage II,Qi deficiency,Yang deficiency and damp-heat;in stage III,Yang deficiency and Qi deficiency are mainly;among all types of constitutions,phase II contains the most types.There was statistical significance in the distribution of body type among different pathological stages(P<0.05).4.Pairwise comparison of body mass index(BMI)values of TCM constitution type in IMN patients with serum anti-PLA2 R antibody positive showed that the BMI value of damp-heat type was the largest,followed by phlegm-dampness type,and Yin deficiency type was the smallest,with statistical significance between groups(P < 0.001).5.There was no significant difference in serum creatinine,serum uric acid,blood urea nitrogen,total cholesterol and serum Ig A,Ig G and Ig M in IMN patients with positive serum anti-PLA2 R antibody among different TCM constitution types(P>0.05).Quantitative comparison of plasma albumin,triglyceride and 24-hour urinary protein among different types of TCM constitution showed statistically significant differences between groups(P < 0.001).Conclusion:1.The types of TCM constitution of IMN patients with serum anti-PLA2 R antibody positive are mainly Qi deficiency and Yang deficiency,followed by Yin deficiency and damp-heat,while qi stagnation and characteristic quality are rare.2.TCM constitution type of IMN patients with serum anti-PLA2 R antibody positive has certain correlation with different age segments,serum anti-PLA2 R antibody titer level and pathological stage.3.TCM constitution type of IMN patients with serum anti-PLA2 R antibody positive was also correlated with BMI,plasma albumin,triglyceride and 24-hour urinary protein quantity.