Adult Primary Nephrotic Syndrome Tcm Syndrome And Renal Pathology, And Clinical And Biochemical Indicators Of The Relationship

Objective:To discuss the relevance of syndrome type of traditional Chinesemedicine with pathlogic of renal, blood biochemistry and the urinecorrelate inspection in the patients of 47 cases adults primary nephroticsyndrome with normal to compensate renal function.Methods:1.56 cases of adult PNS with normal to compensate renal function confirmedby t- he clinical diagnosis, and by renal needle biopsy were from theWuhan first hospital kidney internal department from November of 2003to June of 2006.2. Removes 9 cases who are not conform to the selected standard, 7 casesare incomcomplete for the clinical data, 2 cases are smaller than 10for the kidney puncture pathology in glomerulus number.3.47 cases of PNS who can be researched were divided into four typesaccording to TCM syndrome differentiation: deficiency of lung-kidney qitype, deficiency of spleen kidneyyang type, deficiency of liver-kidneyyin type, deficiency of both qi and yin type.4. Carries on the pathology type classification of 47 cases of PNS, andgrade the pathological change, renal tubule pathological change, thekidney total pathological change.5. Observe blood biochemistry target: Alb,TC,TG,HGB,IgA,IgM,IgG,C3,C4,BUN,Scr,Ccr; The urine examines target: 24 hours urines proteinsquota,urinates NAG, Lys.6. Analyzes distributed characteristic of syndrome type of TCM, thepathology classification in 47 cases adult PNS.7. Compared with the relevance between syndrome type of TCM and thepathology classification, glomerulus change grades, renal tubule change grades, total grades of renal change, blood biochemistry, Theurine examines target in 47 PNS with normal to compensate renal function.Result:1. the distribution of syndrome type of TCM in 47 cases PNS: deficiencyof spleen kidney yang 26 examples (55.3%), deficiency of lung-kidney qi11 examples(23.4%), deficiency of liver-kidney yin 6 examples (12.8%), deficiency of bothqi and yin 4 examples (8.5%). The case of liver-kidney yin type anddeficiency of both qi and yin type are less, loses statistic significance, therefore only deficiency of lung-kidney qi type, deficiencyof spleen kidney yang type carries on statistics analysis.2. the distribution of pathology type in 47 PNS: the MsPGN 36examples(76.6%), the MN 7 examples (14.9%) theFSGS 2 examples (4.3%), MPGN and NCD each are 1 example (accounts for 2.1%).3. The comparison of renal needle biopsy grades of glomerulus changebetween deficiency of lung-kidney qi type and deficiency of spleen kidneyyang type: deficiency of lung-kidney qi type have lower glomerularbasement membrane graeds than deficiency of spleen kidney yang type, there is significant difference (p＜0.05), but there is no significantdifference (P＞0.05)between the two syndrome types in the grades ofmesangial cell proliferation, membrane matrix increase width, theglomerulus and Bowmans capsule adhesion, the glomerulus harden, theglomerulus capillary loop narrow.4. The comparison of renal tubule changes between deficiency of lung-kid-ney qi type and deficiency of spleen kidney yang type: the deficiencyof lung-kidney qi type have higher grades than deficiency of spleenkidney yang type in tubule ectasia, but have lower grades in renal tubuledenaturation, have significant difference (p＜0.05), but there is no significant difference (P＞0.05) between the two syndrome types in thegrades of tubular atrophy, tubular necrosis, interstitial fibrosisin, interstitial inflammatory infliltration.5. The comparison of deficiency of lung-kidney qi type and deficiency ofspleen kidney yang type in the total scores of glomerulus change, totalscores renal tubule, total scores of kidney, do not have significantdifference (p＞0.05).6. The comparison of deficiency of lung-kidney qi type and deficiency ofspleen kidneyyang type in blood biochemistry: deficiency of lung-kidneyqi type have more density than deficiency of spleen kidney yang type(p＜0.05), but there is no significant difference (P＞0.05) in blood TC,TG,HGB,IgA,IgM,C3,C4.7. The comparison of deficiency of lung-kidney qi type and deficiency ofspleen kidney yang type in kidney funcation: there is no significantdifference (P＞0.05) in Scr,BUN,UA,Ccrbetween the two syndrome types.8. The comparison of deficiency of lung-kidney qi type and deficiency ofspleen kidney yang type in 24hu-TP,NAG,Lys: there is no significantdifference (P＞0.05).Conclusion:1. The deficiency of spleen kidney yang type is the most syndrome typeof TCM in adult PNS with normal to compensate Kidney function.2. The MsPGN is the most renal needle biopsy pathology type in adult PNSwith normal to compensate Kidney function.3. The deficiency of lung-kidney qi type have less glomerular basementmembrane thickness than deficiency of spleen kidney yang type in adultPNS with normal to compensate Kidney function.4. The deficiency of lung-kidney qi type have serious change in tubuleectasia than deficiency of spleen kidney yang type, but slighter change in renal tubule denaturation than it in adult PNS with normal tocompensate Kidney function.5. The deficiency of lung-kidney qi type have higher blood plasma Alb, IgG than deficiency of spleen kidneyyang type in adult PNS with normalto compensate kidney function.6. There is no difference in blood plasma TC,TG,HGB,IgA,IgM,C3,C4,renal function between the deficiency of lung-kidney qi type and thedeficiency of spleen kidney yang type in adult PNS with normal tocompensate Kidney function.7. There is no difference in 24hu-TP,NAG,Lys between the deficiencyof lung-kidney qi type and the deficiency of spleen kidney yang type inadult PNS with normal to compensate Kidney function.8. The pathology and the blood biochemistry target prompt, the deficiencyof spleen kidney yang type is heavier than the deficiency of lung-kidneyqi type in adult PNS with normal to compensate Kidney function.