| Objective:To analyze the characteristics of idiopathic membranous nephropathy of stage Ⅰand Ⅱ in Inner Mongolia and the distribution of TCM syndrome types,as well as their correlation with serum anti-PLA2 R antibody and other laboratory indexes,so as to combine TCM syndrome types with Western objective indexes and provide scientific basis for clinical syndrome differentiation and treatment.Methods:A total of 180 patients diagnosed with stage Ⅰ and Ⅱ idiopathic membranous nephropathy by menstrual kidney biopsy from January 2020 to December 2022 were collected from the Hospital of Traditional Chinese Medicine of Inner Mongolia Autonomous Region.Patients’ general information,clinical manifestations,information of TCM four diagnoses,and laboratory indicators were recorded,and TCM syndrome type questionnaire was filled in to determine TCM syndrome type.spss26.0 statistical software was used to process and analyze the data,and the correlation between TCM syndrome type and clinical indicators was discussed.Results:1.General information: Among 180 patients with stage Ⅰ and Ⅱ idiopathic membranous nephropathy,there were 109 males and 71 females,with a sex ratio of 1.54:1;The average age was 51.77±12.34 years old,and the middle-aged and elderly patients(41～70 years old)were mostly,accounting for 75.00%;The course of disease was 0～3 months,accounting for35.56%,and 70.01% of the patients were within 1 year.2.Distribution of TCM syndrome types: the deficiency of spleen and kidney and qi was the most common(80 cases,49.08%),followed by deficiency of spleen and kidney Yang(33cases,20.25%),deficiency of lung and kidney qi(19 cases,11.66%),deficiency of qi and Yin(18 cases,11.04%),deficiency of liver and kidney Yin(13 cases,7.98%);The standard evidence was mainly water-dampness syndrome(90 cases,56.60%),followed by damp-heat syndrome(36 cases,22.64%),damp-turbidity syndrome(17 cases,10.69%)and blood-stasis syndrome(16 cases,10.06%).There was no significant difference in the distribution of TCM syndromes(P > 0.05).3.Correlation between TCM syndrome types and general conditions: there was no statistical significance in gender and course of disease among TCM syndrome types(P >0.05);In terms of age,in standard demonstration,the age of patients with dampness-heat syndrome was higher than that of patients with dampness-turbidity syndrome,the difference was statistically significant(P < 0.05).In terms of CKD staging,the patients with water-dampness syndrome,damp-heat syndrome and blood-stasis syndrome were the most in CKD1 stage,while the patients with moist-turbidity syndrome were the most in CKD3 stage and above,the difference was statistically significant(P < 0.05).4.Correlation between TCM syndrome types and laboratory indexes: there was no statistical significance in 24-hour urinary protein quantity,plasma albumin,total cholesterol,low density lipoprotein,blood urea nitrogen and blood uric acid levels among TCM syndrome types(P > 0.05).In standard demonstration,the triglyceride level in damp heat syndrome was higher than that in water dampness syndrome,the difference was statistically significant(P <0.05),and the blood creatinine in patients with wet turbidity syndrome was higher than that in water dampness syndrome,damp heat syndrome and blood stasis syndrome,the difference was statistically significant(P < 0.05).5.Serum anti-PLA2 R antibodies: Among the 180 patients,115 cases were positive for serum anti-PLA2 R antibodies,accounting for 63.89%,and 65 cases were negative for serum anti-PLA2 r antibodies,accounting for 36.11%.The ratio of positive and negative antibodies was about 2.05.1.There were no significant differences in gender,age,disease course and CKD stage between serum anti-PLA2 R antibody positive group and antibody negative group(P >0.05).Compared with the antibody-negative group,the 24-hour urinary protein quantity,total cholesterol,low density lipoprotein and blood creatinine levels in the antibody-positive group were higher,while the plasma albumin level was lower,with statistical significance(P< 0.05).6.Correlation between TCM syndrome type and serum anti-PLA2 R antibody: there was no statistical significance in antibody positive rate of patients with ben-deficiency syndrome(P>0.05);The positive rate of antibody in standard demonstration patients from high to low was damp heat syndrome,wet turbidity syndrome,blood stasis syndrome and water dampness syndrome,and the difference was statistically significant(P < 0.05).In serum anti-PLA2 R antibody positive group,the antibody concentration of ben-deficiency syndrome from high to low was lung and kidney qi deficiency syndrome,liver and kidney Yin deficiency syndrome,spleen and kidney Yang deficiency syndrome,spleen and kidney qi deficiency syndrome,qi and Yin deficiency syndrome,and the difference was not statistically significant(P > 0.05).From high to low,the positive antibody concentration was classified as damp turbidity syndrome,blood stasis syndrome,damp heat syndrome and water dampness syndrome,with no statistical significance(P > 0.05).Conclusion:1.The distribution of TCM syndrome types of IMN: deficiency of spleen and kidney >deficiency of spleen and kidney Yang > deficiency of lung and kidney > deficiency of qi and Yin > deficiency of liver and kidney Yin.Deficiency of spleen and kidney is the main syndrome of deficiency of deficiency of liver and kidney;The standard demonstration was water-dampness syndrome > damp-heat syndrome > moisture-turbidity syndrome >blood-stasis syndrome,and the standard demonstration was mainly water-dampness syndrome.2.The age,CKD stage,triglyceride level,serum creatinine level,serum anti-PLA2 R antibody positive rate of IMN patients may be correlated with the distribution of syndrome types in the standard demonstration.3.Compared with the antibody negative group,the 24-hour urinary protein quantity,total cholesterol,low density lipoprotein and blood creatinine levels in the serum anti-PLA2 R antibody positive group were higher,while the plasma albumin level was lower,with statistical significance(P < 0.05). |
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