Interrelated Study Between TCM Syndromes And Renal Pathology In Lupus Nephritis

Objective:To explore the relationship between Traditional Chinese Medicine(TCM) syndromes and renal histopathological changes in Lupus Nephritis(LN),and then provide objective evidence for microcosmic differentiation of TCM syndromes,which is beneficial to guide us for the diagnosis and treatment of LN with Integrated Traditional Chinese and Western Medicine.Method:Collected 125 cases of LN patients,who were hospitalized department of nephrology in Fuzhou General Hospital of Nanjing Military Command,and differentiated the TCM syndromes within three days before or after the renal biopsy.And we classified the renal biopsy specimens via pathological staining and calculated the scores of activity index(AI) and chronicity index(CI),then recorded the clinical manifestation,laboratory index and SLE-DAI, analyzed the correlation between TCM syndromes and the above data.Result:1 Among all the 125 cases of LN,12 cases were with Latent Nephritis(9.6%) and 12 cases were with Rapidly Progressive Nephritis(9.6%),72 cases were with Nephritic Syndome (57.6%),29 cases were with Chronic Nephritis(23.2%).Among the classification by the TCM main syndromes,41 cases were in yin asthenia generating intrinsic heat(32.8%),which was most often seen.There were 27 cases in asdthenic splenonephro-yang(21.6%),28 cases in hepatic and renal yin deficiency(22.4%),17 cases in deficiency of both vital energy and yin(13.6%),12 cases in asdthenic splenonephro-Qi(9.6%).According to the statistical analysis,there was no statistical difference between the types of TCM main syndromes and western medical clinic classification in LN(P＞0.05).2 Among the 125 cases of LN,there were 81 cases(64.8%) in typeⅣof the renal tissue pathological types,and the next one was typeⅤ,taking 28.8%,of which 19 cases(15.2%) were the pure typeⅤ,8 cases(6.4%) were in the type ofⅤ+Ⅲ,9 cases(7.2%) were in the type ofⅤ+Ⅳ.And there were 3 cases(2.4%) in typeⅡ,5 cases(4.0%) in typeⅢ.But there were no typeⅠand typeⅥcase in the renal tissue pathological types.For the asdthenic splenonephro-Qi in TCM main syndromes,the most frequent pathological type was typeⅤ, and the other four TCM main syndromes were most often seen in typeⅣof the pathological type.The TCM accompanying symptoms were mainly manifested as toxic-heat syndrome, which amounted 43 cases(34.4%).And there had 20 cases(16.0%) in liquid turbid syndrome and damp-heat syndrome,respectively.There were 15 cases(12.0%) in syndrome of blood stasis and 18 cases(14.4%) without the TCM accompanying syndromes.According to the statistical analysis,there was no statistical difference between dialectical groups of TCM (including main and accompanying symptoms) and renal pathological types(P＞0.05).3 Among the 125 patients of LN,there were 86 patients whose pathogenetic condition were severe activities(SLE-DAI≥15)(68.8%).Only 1 patient(0.8%) without lupus activities (SLE-DAI≤4),who was belonged to the asdthenic splenonephro-yang.The statistic analysis reaults showed that the SLE-DAI sores of asdthenic splenonephro-Qi got the lowest scores, which was obviously less than the SLE-DAI scores of hepatic and renal yin deficiency and Yin asthenia generating intrinsic heat(P＜0.05).There were no statistical difference of the lupus activity scores among other types(P＞0.05).4 Among the 125 cases of LN,the AI of asdthenic splenonephro-Qi was obviously less than that of the other four types(P＜0.05);the AI of asdthenic splenonephro-yang was obviously more than that of Yin asthenia generating intrinsic heat(P＜0.01);the CI of asdthenic splenonephro-Qi was obviously less than that of asdthenic splenonephro-yang and Yin asthenia generating intrinsic heat(P＜0.05);the CI of asdthenic splenonephro-yang was obviously more than that of deficiency of both vital energy and yin(P＜0.05);the AI,CI of asdthenic splenonephro-yang were obviously more than that of hepatic and renal yin deficiency,there were no statistical difference among other types both of the AI and CI(P＞0.05).Conclusion:1 SLE-DAI,AI,CI are correlated with the TCM syndromes in Lupus Nephritis;2 Neither western medical clinic classification nor renal tissue pathological types has the correlation with TCM syndromes in Lupus Nephritis.