| IgA nephropathy(IgAN) is a chronic glomerular disease which pathological diagnosis is clear and definite , and traditional Chinese medicine (TCM) has been proved good effects on IgAN at present , but TCM still exists some limitations to IgAN , such as no uniform method for symptom differentiation.In this study the data such as laboratory and pathological tests have been collected from 124 IgAN patients who had been diagnosed by renal biopsy in our hospital from Feb. 2002 to Jan. 2003. We analyze the data with symptom differentiation of TCM and try to find out a general rule to IgAN.Out of 516 patients with renal diseases, 162 patients were diagnosed as IgAN by renal biopsy, but 124 IgAN patients were analyzed in this study. According to the theory of TCM, the clinical manifestation, tongue and pulse had been observed. The laboratory tests include the amount of proteinuria, urinary routine test, serum creatinine, urea nitrogen, total proteins, albumin and immunoglobulin, endogenous creatinine clearance rate, osmotic pressure of urine and so on. The degree of pathological changes were calculated by Lee's pathology hierarchical and Katafuchi's pathology integral.The 124 IgAN patients were divided into four type according to symptom differentiation of TCM: 1) deficiency of spleen-qi and lung-qi, 2) deficiency of liver-yin and kidney-yin, 3) deficiency of qi and yin , 4) deficiency of spleen-yang and kidney-yang.The study demonstrated:1 The higher frequency symptoms of TCM are : Shortness of breath and fatigue, relative weakness in the loins and knees, be susceptible to the cold, spontaneous perspiration, dry mouth and not want drinking water, angina , burning dysphoria with feverish sensation in chest, palms and soles , sallow complexion, dizziness and tinnitus , chilly sensation and the cold limbs .Symptoms of the deficiency of qi and yin appears frequency.2 The amount of proteinuria in 24 hours: That in 64% of deficiency of spleen-yang and kidney-yang patients is more than 2 gram proteinuria per 24 hours, while over 75% patients in other three types show lower proteinuria. Serum albumin in 73% deficiency of spleen-yang and kidney-yang patients is lower than 40g/L, and that in 30%~50% patients from other the three types is lower than 40g/L. The majority ( 64% - 91% ) deficiency of spleen-yang and kidney-yang patientsshow unusual renal function, and most patients in other three types is normal. The osmotic pressure of urine in 55% patients of deficiency of spleen-yang and kidney-yang is lower than 400mOsm/L, and that in majority ( 87%-97% ) of other three types patients is more than 400mOsm/L. The statistical analysis revealed that the differences between deficiency of spleen-yang and kidney-yang and other tree types are significant (P<0.05, P<0.01 respectively). Most of deficiency of spleen-qi and lung-qi patients were the pathology I - II grade on Lee's pathology hierarchical. Most of deficiency of liver-yin and kidney-yin or deficiency of both qi and yin patients were the pathology II - III grade on Lee's pathology hierarchical, whereas all of deficiency of spleen and kidney yang patients were above the pathology HI grade on Lee's pathology hierarchical. This difference is dealt with the significance as a result of the statistics ( P=0.037 ) . The lowst Katafuchi's integral is the deficiency of spleen-qi and lung-qi patiens , next is deficiency of both qi and yin patients, and then is deficiency of liver-yin and kidney-yin patients ,and the highest is insufficiency of both the spleen and the kidney patients. Discovered by statistics ,there is significance difference of Katafuchi's integral between patients of insufficiency of both the spleen and the kidney and other three types.3 On the age , patients of deficiency of spleen-qi and lung-qi are younger than that of deficiency of both qi and yin and insufficiency of both the spleen and the kidney , and deal with significance difference through the statistics.Conclusion :1 Deficiency of the vital-qi is the key cause of I... |
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