| Normalization of TCM syndromes become momentous investigative topic in medical circles along with unceasing deepening ancient traditional TCM theories, developing TCM academic construction and scientific research. Normalization and standardization are foundation of scientific research, full-grown sign of subject. Determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs is one of TCM feature. Differentiation of symptoms and signs is the precondition of determination of treatment. Determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs embody TCM individualization therapy. Chinese traditional medicine especially have diagnose syndromes, have whole view as guidance thinking, and grasp human body's functional status with it's changing laws to form a set of research theories and intervention methods for human body's complex system. Therefore, research in normalization of TCM syndromes is a imminently important topic.It's elementary process that chinese traditional medicine will transform to be objectivised and standardized scientifically.The golden diagnostic code of IgAN is pathologic diagnosis.Because cause and pathogenesis of IgAN are not be completely identified, Western medicine doesn't have specific therapy to IgAN. Medical practice can prove that TCM have prevalent therapy in nephronia. The syndromes of IgAN is deeply studied in TCM domain. However, multitude TCM clinical researchers have different views to observe and kow IgAN. There is short of unified TCM diagnostic code meanwhile. It leads to various and non-specific recognition for IgAN clinic syndromes. There isn't have many research for innovative therapy in TCM literatures about IgAN. If you want to search for TCM innovative therapy in IgAN,you should first study TCM cause and pathogenesis and their changing laws and clinical syndromes.The normal quantization research for TCM syndromes is emerged by crossing many subjects. It has occupied starting stage. Because the information of TCM four diagnostic methods has fuzzy feature, the accurate nature and specification of syndromes diagnostic code are hard to unify. If the essence of modularization thoughts and fuzzy mathematics can be comprehended and handled, it will have great application value on accumulating expertise of TCM and sharing knowledge to try modeling the course of the TCM differentiation and establishing the TCM modularize diagnostic method in the foundation of systematically arranging ancient and present data, clinic data and expertise. This topic research for making use of theories, experience and methods in Chinese traditional medicine, Western medicine, fuzzy mathematics, computer et., proposing and handling fuzzy ISODATA TCM differentiation with modularization thoughts to deal with demography,symptoms and laboratory results of 117 IgAN examples with DME . It expects to research for the laws of IgAN syndromes distribution.Objective: (1) To summarize the development course of syndromes research and the current researching situation. (2)To summarize the knowledge and the new researching development on IgA nephropathy of TCM. (3)By illustrating the basic TCM theory of branch and root, asthenia and sthenia, asthenia accompanied with sthenia on IgA nephropathy from microcosmic and macroscopical point of view by handling the diagnostic method of TCM syndromes with fuzzy ISODATA and modularization thoughts to discuss the distribution and changing laws of TCM syndromes in IgA nephropathy. (4)To research for the correlation between the distribution of TCM syndromes, clinic symptoms and the pathologic damage, laboratory results to guide the clinic diagnosis and treatment.Method:(1)Literature study: to summarize and assess the development course of TCM syndromes and the researching situation of both TCM and western medicine on IgA nephropathy.(2)Study on the distribution of TCM patterns and their changing laws:â‘ There are 189 TCM symptoms and 111 tongue demonstration and pulse tracing in cross-sectional study table of IgA nephropathy case.It has 300 TCM symptoms in all. We did frequency analysis for 300 TCM symptoms in Excel sheet, rejected the symptoms which frequency less than 10%, and selected the symptoms which frequency greater than or equal to 10% before data handling of 117 Primary IgA nephropathy cases by kidney puncture.â‘¡To simulate the thought of TCM differentiation of symptoms and signs by fuzzy ISODATA and modularization thought. Firstly, 112 symptoms of asthenia syndrome which frequency greater than or equal to 10% were clustered and recognized. Secondly, every group cases of asthenia syndrome after first stage clustering were clustered and recognized again to get corresponding sthenia syndrome. Thirdly, we searched for the distribution laws between the clustering result and the data of demography to get the distribution laws of every group characteristic symptoms corresponding asthenia syndrome, of sthenia syndrome corresponding every group asthenia syndrome. And we wanted to get the relation of differentiation of symptoms and signs development tendency among groups of primary and secondary syndromes.(3)Study on the correlation between differentiation of symptoms and signs for classification of syndrome and modern laboratory results in IgA nephropathy:â‘ To do mean-sample-hypothesis test and analysis the comparison of significance and the distribution laws between groups of analogical TCM syndrome and Western medicine laboratory results. To analysis the statistics rule between analogical TCM syndrome and demography index.â‘¡When doing filate correlation analysis and regression analysis, we made the membership degree of every group analogical TCM syndrome as independent variable. We did filate correlation analysis and regression analysis between the membership degree and clinic laboratory results to seek regularity index which can express the change of pattern of syndrome.â‘¢When doing non-filate correlation analysis and regression analysis, we transformed the membership degree of every group analogical TCM syndrome to probability value by logarithm treatment. We did non-filate correlation analysis and regression analysis between the probability value and clinic laboratory results.â‘£To make Lee patho-class in IgA nephropathy as standard, we respectively did correlation analysis between the result of Lee patho-class in 117 primary IgA nephropathy cases and every group of TCM symptoms, between the result of Lee patho-class in 117 primary IgA nephropathy cases and clinic laboratory results.Results:(1)Literature study:â‘ About TCM syndrome: In Treatise on Febrile Diseases and Medical Treasures of the Golden Chamber, there has no word about syndrome. Many scholars have done a great quantity of research and got a series of results and new definition about syndrome. Some one gained definition about syndrome with new outcome of modern research. The combination of disease and syndrome is the important pathway to normalization of syndrome. multivariate analysis is utilized in TCM research of normalization of syndrome.â‘¡About IgA nephropathy: TCM understanding: There is nocorresponding name in TCM to IgA nephropathy. Now the majority of traditional Chinese physician think IgA nephropathy belongs to the syndrome of asthenia in origin and sthenia in superficiality, asthenia accompanied with sthenia. Deficiency in origin is the basic invasion cause of IgA nephropathy. Excess caused by deficiency always leads to the syndrome of sthenia in superficiality mainly including pyretic toxicity, humid heat, stagnant blood. Pyretic toxicity, humid heat and stagnant blood become pathology cause to worsen the pathogenetic condition again. The TCM treatment in IgA nephropathy gain good curative effect. It can sum up differentiation of symptoms and signs by stages, differentiation of symptoms and signs for classification of syndrome,and private prescription. Understanding of modern medicine: Western Medicine is still not elucidate the etiopathogenisis and pathogenesy in IgA nephropathy. Most scholars think it's immune complex nephritis. The nosogenesis in IgA nephropathy is concerned with heredity and functional disorder of immune system. Now Western Medicine hasn'd had specific treatment in IgA nephropathy yet. It mainly wants to improve clinical symptom , protect renal function, and advocate that IgA nephropathy should be grouping treat on the basis of different change of kidney pathology with clinical manifestation.(2)Study on pattern of syndrome and their changing laws:â‘ We did frequency analysis for 300 TCM symptoms, rejected the symptoms which frequency less than 10%, and selected the symptoms which frequency greater than or equal to 10%. Such as gross hematuria, dry mouth which want to drink, micro-pulse, debilitation, chilly and cold limbs, achi-ng pain in waist and knee, lumbago, tired mind, sallow complexion, multitude dream, indentation in margin of the tongue, dizziness, gloomy complexion, gastric cavity to be inf-lated, tired limbs, night sweat, cold hands and feet.â‘¡We simulate the thought of TCM differentiation of symptoms and signs by fuzzy ISODATA and modularization thought to do data processing with the symptoms which frequency greater than or equal to 10%. By comparing different accommodation degree S to definite the optimization clustering number which is 5, we selected 5 group similar syndromes according to the calculation of the maximum membership degree and the secondary membership degree. The 5 group similar syndromes are syndrome of deficiency of kidney-QI and spleen-QI, syndrome of deficiency of both vital energy and yin, syndrome of hepatic and renal yin deficiency, deficiency syndrome of both YIN and YANG, and syndrome of asdthenic splenonephro-yang. Deficiency in origin mainly has syndrome of hepatic and renal yin deficiency, deficiency syndrome of both YIN and YANG, syndrome of deficiency of both vital energy and yin. State of evil domination mainly has syndrome of endoretention of damp heat and internal resistanceof phlegmatic hygrosis. With the growth of age, the percentage of syndrome of deficiency of kidney-QI and spleen-QI offer in downtrend, and syndrome of asdthenic splenonephro-yang is upgraded.â‘¢When doing multiple linear regression between TCM syndromes and clinic symptoms, the definition of value Y is more scientific and reasonable on the basis of clustering the syndromes of 117 IgA nephropathy cases by fuzzy mathematics, thoughts of modularization and fuzzy ISODATA.(3)Study on the correlation between differentiation of symptoms and signs for classification of syndrome and modern laboratory results in IgA nephropathy:â‘ Different laboratory results (including blood pressure, blood routine, urine routine, function of liver and kidney, blood biochemistry, immune globulin and complement and pathology index ) have their significant difference in every group TCM syndromes(P<0.05).â‘¡Results of the correlation between differentiation of symptoms and signs for classification of syndrome and modern laboratory results in IgA nephropathy: If the grade of pathologic diagnosis is more higher and the condition of pathology is more severer, the possibility which patient is diagnosed syndrome of deficiency of kidney-QI and spleen-QI is smaller. If the grade of pathologic diagnosis is more higher, the condition of pathology is more severer and the grade of RBC in urine routine, the possibility which patient is diagnosed syndrome of deficiency of both vital energy and yin is bigger. If the condition of pathology is more severer, blood pressure is more higher, thrombin clotting time is more shorter and the value of IgM is more smaller, the possibility which patient is diagnosed syndrome of hepatic and renal yin deficiency is bigger. If the grade of pathologic diagnosis is more higher, the condition of pathology is more severer, the value of RBC and Hgb in blood routine are more smaller, the value of Scr is smaller,the possibility which patient is diagnosed syndrome of deficiency syndrome of both YIN and YANG is bigger. The regression analysis between differentiation of symptoms and signs for classification of syndrome and modern laboratory results in IgA nephropathy shows that 5 group of syndromes are closely contact with the condition of pathology.â‘¢Every group of TCM syndromes in IgA nephropathy has significant difference in Lee patho-class of IgA nephropathy(P<0.05). The results of correlation between differentiation of symptoms and signs for classification of syndrome and Lee patho-class of IgA nephropathy show that Lee patho-class is directly correlated with syndrome of deficiency syndrome of both YIN and YANG and syndrome of deficiency of both vital energy and yin, and inversely correlated with syndrome of deficiency of kidney-QI and spleen-QI.Conclusion:â‘ This topic used multicentre on-the-spot investigation, firstly gained the TCM pattern of syndrome in 117 IgA nephropathy cases in the condition of non-anthropogenic intervention with fuzzy ISODATA and thoughts of modularization. At two point of views in TCM syndrome and symptome, it investigated the distribution laws of TCM syndrome in IgA nephropathy, and got the distribution feature that deficiency in origin mainly has syndrome of hepatic and renal yin deficiency, deficiency syndrome of both YIN and YANG, syndrome of deficiency of both vital energy and yin, and state of evil domination mainly has syndrome of endoretention of damp heat and internal resistanceof phlegmatic hygrosis.â‘¡The clustering analytical method of fuzzy ISODATA grasps the concept which is fuzzy by grasping the membership degree.It can effectually solve the problem that TCM syndrome is classified by either-or rigidity classification scheme and clinic TCM symptoms can show up in different syndromes. It can achieve the purpose of anastomosing the though of determination of treatment based in pathogenesis obtained throu-gh differentiation of symptoms and signs in maximal degree.â‘¢Results of the correlation between differentiation of symptoms and signs for classification of syndrome and modern laboratory results in IgA nephropathy. It shows 5 groups of TCM syndromes are respectively correlated with different laboratory results, and closely contact with the condition of pathology of kidney puncture. If the pathology grade of Lee in IgA nephropathy is more higher, the probability of deficiency syndrome of both YIN and YANG is bigger, the probability of syndrome of deficiency of kidney-QI and spleen-QI is smaller.
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