The TCM Syndromes And Kidney Organization Pathology Of The Idiopathic Membranous Nephropathy In 90 Patients

ObjectivesThe kidney biopsy pathology at the nowadays kidney disease's diagnosis, the treatment and the understanding condition evolution as well as the discussion pathogenesis's research aspect played the very vital role。This topic through 2002-2010's 90 routine kidney puncture biopsy technique was clear to Guangdong Province Chinese medicine hospital kidney internal medicine department has the idiopathic membrane nephrosis nephropathy (idiopathic membranous nephropathy, IMN) the pathological diagnosis patient's related clinical material to carry on especially compiles, discussed IMN the pathology to divide and the Chinese medicine dialectical minute inner link, was advantageous for inquire deeply IMN the Chinese medicine dialectical objective indicator, the exploration Chinese medicine card modern pathology foundation, and for microscopic dialectical provided more scientific data, as well as was the IMN Chinese medicine dialectical provides the modern pathology aspect the objective indicator。MethodsMethods a retrospective study, which is collection of general information in 90 cases patients who had been taken the renal biopsy in 2002-2010 to make a diagnosis of membranous nephropathy clearly in the Urology Department in Guangdong hospital of traditional Chinese medicine. Combined with clinical material, laboratory examination, immune pathology and the characteristics of the ultrastructural changes,to make the pathological diagnosis clearly. Then refer to the standard which had been made chronic nephritis syndrome diagnostic of TCM in both Conference which is in Nanjing, the other is in Wuxi(1996 Twelfth National Symposium on Traditional Chinese Medicine nephropathy)and the "Guiding principles for new drug clinical research of Chinese medicine (Trial) " recently issued by the State Drug Administration. Then according to the results of frequency, statistics of clinical data, pathological type and distribution of traditional Chinese medicine symptom by that 90 patients in our hospital. Application of correlation analysis of statistical methods to analyze these data, and analysis of their specific relevance of contact and internal contact。Results1. Time this group of patient good kidney biopsy's age scope in 16-74 years old (average value±standard deviation for 46.68±15.01), the IMN patient's succeeding in the imperial civil service examinations age section is 50-59 years old。And the masculine 48 examples (account for 53.3%), the feminine 42 examples (account for 46.7%), the male and female proportion is 1.14:1, the t test P<0.05, Suggest a statistically significant difference between the two。In the IMN clinical manifestation, some 57 examples (64%) the clinical manifestation is the nephrosis syndrome,9 example clinical manifestations for the chronic nephritis syndrome (10%),8 example clinical manifestations for the chronic nephritis (9%), display for the urine test exceptionally (for example albuminuria Zha Yin, hematuria Zha Yin and so on) have 13 examples (14%), other (for example chronic kidney fades, dropsy to look up because of) 3 examples (3%)。2. In this group of 90 example IMN patient, in pathology on by stages, I issue of pathological change 34 examples (37.7%),ⅡTime pathological change 50 examples (55.6%),III The pathological change 5 examples (5.6%), some 1 example is situated between theⅡ-Ⅲtime (1.1%), has not seenⅣTime pathological change. And by I issue and II issue of pathological change primarily, accounts for 93.3%。The pathology displays, besides the epidermis under the immunity compound deposition and the renal glomerulus blood capillary basilar membrane accumulation these two membrane nephrosis model's pathology damage symbol, is the membrane cell proliferation, the department membrane matrix proliferation, the tubulus renalis denaturates, the tubulus renalis to wither, the kidney mesenchymal inflammatory cell infiltration, the kidney mesenchymal fibrosis, the kidney arterial bifurcation pipe wall accumulation, the blood capillary endotheli ocytosis, the ball hardening to present the frequency to be high presents the frequency to be high。The overall looked that presents the renal glomerulus is the membrane cell and the department membrane matrix proliferation is 82 examples (91.1%) the tubulus renalis mesenchymal damage is 80 examples (88.9%), presents the blood vessel pathological change also to be many are 66 examples (73.3%), most performance for arterial bifurcation pipe wall accumulation。3. My courtyard IMN Chinese medicine card period of five days by this empty sign real diagnosis primarily, this empty card by the spleen kidney lacking in vital energy card 60 examples (66.7%) and was mad that the cloudy two empty card 18 examples (20.0%) sees, the sign real diagnosis 42 (46.7%) and wet (33.3%) sees much by the hot and damp card,84.4% patients moreover have the blood stasis card (P<0.05)。In addition, except the blood stasis card, this research the same card carries on by stages other different pathology the comparison, the demonstration not obvious difference (P>0.05)。Conclus ionHas the membrane nephrosis (idiopathic membranous nephropathy, IMN) is one of especially I courtyard adult primary renal glomerulus disease most common pathology types, is also causes the adult nephrosis syndrome the most common reason。In this group of material demonstration, this sickness disease incidence rate is in the majority by the middle and old aged masculine patient, IMN pathology change by I issue and II issue primarily; In the pathology performance, take presents the renal glomerulus is the membrane cell and the department membrane matrix proliferation, the tubulus renalis mesenchymal damage and the blood vessel pathological change (most performance as arterial bifurcation pipe wall accumulation) many。The Chinese medicine card period of five days aspect, IMN as sees take this empty sign real diagnosis, this empty and is mad cloudy take the spleen kidney lacking in vital energy two empty as often the testimony; Sign reality take hot and damp and wet as often testimony, and in the majority cards have at the same time the blood stasis card (P<0.05), and in most common I Time sumⅡIn time pathology change, I The time IMN blood stasis card comparesⅡThe time is rare, prompts the IMN patient to be by stages higher, the blood stasis card possibility is bigger。Therefore the IMN Chinese medicine dialectical between has certain relevance by stages with its pathology, therefore should pay great attention in the treatment to be good for the spleen the profit kidney, the refrigeration advantage to treat big method wet, and pours adds blood circulation removing extravasted blood。This group of material demonstrated that except the blood stasis card, this research between the same card carries on by stages other different pathology the comparison, the demonstration not obvious difference。...