Analysis Of Correlation Between Syndrome-Type In Tcm And Pathology Type In Children With Frequent Relapse Nephrotic Syndrome

Objective: To investigate the relationship between syndrome-type in traditional Chinese medicine(TCM) and renal pathology type in children with frequent relapse nephrotic syndrome(FRNS) , and meanwhile to provide objective indexes and theoretical bases for clinical treatment based on the differentiation of symptoms of TCM, efficacy and prognosis of FRNS, then to increase remission rate , to reduce relapse rate and to lessen side effects.Methods: Fifty patients with a diagnosis of FRNS were divided into type of Yin deficiency of liver and kidney, type of Yang deficiency of spleen and kidney, type of Wetness-heat accumulating in the interior, type of Kidneyasthenia and blood stasis and type of Qi-Yin deficiency according to symptoms differentiation of TCM. All patients were taken percutaneous renal biopsies. And their renal pathomorphology was observed by light microscope, immunofluorescence and electron microscope. Related experimental indexes were examined in all patients. Therapeutic methods of western medicine integrated TCM were used and curative effects and relapse rate in 0.5,1.0,1.5a were observed .Statistical analysis was performed by SPSS10.05 system software.Results: In the group the symptoms showed mostly type of Yin deficiency of liver and kidney (16/50) and type of Yang deficiency of spleen and kidney (12/50). And type of Wetness-heat accumulating in the interior, type of Kidneyasthenia and blood stasis and type of Qi-Yin deficiency were minorities. There were 38 children with simple type NS and 12 children with nephritic type NS in the group. Butthere was no significant difference between clinical type and syndrome-type in TCM(P>0.05).The most common pathologies were mesangioprolierative glomerulon-ephritis(MsPGN)( 17/50), MsPGN combined focal segmental glomerulosclerosis(FSG S)(13/50), IgA nephropathy(IgAN)( 12/50) and IgM nephropathy (IgMN) (4/50). IgMN, membranous nephropathy (MN), membranoprolierative glomerulonephritis (MPGN) and focal glomerulonephritis(FGN) were minorities. The patients with MsPGN presented mainly type of Yin deficiency of liver and kidney (9/17). The patients with MsPGN+FSGS presented mainly type of Yin deficiency of liver and kidney (4/13), type of Yang deficiency of spleen and kidney (4/13) and type of Kidney asthenia and blood stasis (4/13) respectively. IgAN presented mainly type of Wetness-heat accumulating in the interior (5/12) and IgMN presented mainly type of Yang deficiency of spleen and kidney (2/4). There was a significant positive correlation between MsPGN and type of Yin deficiency of liver and kidney (r=0.938, P<0.05) ,as well as between IgAN and type of Wetness-heat accumulating in the interior (r=0.895, P<0.05). There was no significant correlation among other syndrome-types and pathology types(P>0.05). The difference in therapeutic effects of syndrome-types was significant (P<0.05). Type of Kidneyasthenia and blood stasis and type of Wetness-heat accumulating in the interior had the same efficacy(88.89%), while the efficacy of type of Yang deficiency of spleen and kidney was the least(41.67%). Compared with type of Yang deficiency of spleen and kidney, there was significant difference between type of Yin deficiency of liver and kidney, type of Wetness-heat accumulating in the interior and type of Kidneyasthenia and blood stasis respectively(P<0.05). The relapse rate of type of Kidneyasthenia and blood stasis was 11.11% (in 0.5a),22.22%(in 1.0a) and 33.33%(in 1.5a) respectively, and was the lowest among all syndrome-types. Type of Yang deficiency of spleen and kidney had the highest relapse rate(50% in 0.5a, 66.67% in 1.0a and 83.33% in 1.5a). The two types above mentioned had significant difference in relapse rate in 1.5a(P<0.05).Conclusion: 1. Type of Yin deficiency of liver and kidney and type of Yang deficiency of spleenand kidney were the most common types followed by type of Wetness-heat accumulating in the interior, type of Kidneyasthenia and blood stasis and type of Qi-Yin deficiency.2.