Anca Associated Vasculitis Of Tcm Syndrome Observation

ANCA (Anti-neutrophil cytoplasmic antibodies) are a group of autoantibodies against antigens in the cytoplasm of neutrophil granulocytes and monocytes. Accordingly, AAV (ANCA-associated vasculitis) are diseases caused by vasculitis in which ANCA can be detected in the blood comprising MPA (microscopic polyangiitis), Churg-Strauss syndrome (CSS)and GPA (granulomatosis with polyangiitis). Up to now, certain progress has been made by western medical science on such aspects as etiology and pathogenesis of ANCA, relation of ANCA and AAV by lab examinations, nexus of GPA and MPA, clinical significance on the pathological classification of ANCA, and treatment on AAV. While western medicine still comes some disadvantages on ANCA especially on treatment of it for various study shows that overmedicalization of AAV has becoming key factors causing death. On the perspective of TCM differenciation, AAV Often impairs Lung and Kidney following manifold clinical manifestations esp. non-specified ones. Correspondingly, no TCM name has been put forward to by our ancestors to match AAV because its manifestation varies in the light of different western medical systems even though it can somewhat be categorized "blood-bi", kind of arthromyodynia in close relation with blood deficiency. As a result, TCM comprehension of AAV is still insufficient regardless of its etiology, pathogenesis treatments by differeciation and clinical data. These shortcomings in both western medicine and TCM on AAV, however, direct us the way forward. As is known that systemization of TCM type of syndrome is imminent, we hope that defined TCM syndromes of AAV can make a guidance in clinics so as to exploit the advantage of TCM herbal to an extent.1. Objective:1. To dig out major syndrome of AAV, so as to ascertain its main TCM syndrome.Ⅱ. To find out the key TCM symptom that affects whole development and sequel of AAV.2. MethodA Total number of61cases are collected screening from April.2004to April,2012of patients diagnosed as AAV in Guanganmen hospital and No.1hospital of Beijing University. All patients receive relevant clinical examinations. After their own TCM symptoms are collected, they are calculated by BVAS(Birmingham Vasculities Activity Scoring). Classification of patients in the group is on the basis of EUVAS standards while cases with pathogenical reports are classified according to Berden’s classification standard of morphological distribution on ANCA-associated nephritis. Subsequently, scores of patients with different TCM symptoms are made in the light of TCM symptom Scoring standard.3.ResultMain TCM syndroms in this subject turn to be deficiency of both vital energy and humor(55.7%), Yin deficiency(26.2%), deficiency of both Yin-humor and Yang-energy(9.8%), Yang deficiency(4.9%), and deficiency of vital energy(3.3%) from greatest to least while accompaniing TCM syndroms are blood-stasis(70.5%), phlegm-dampness obstruction(52.6%), dampness obstruction(42.6%), dampness-heat obstruction(26.2%), cold-dampness impeding(11.5%) and heat-toxic stasis(6.6%) from greatest to least. In addition,a marked correlation is examined between BVAS and data from TCM symptom scoring table.(r=0.627P=0.00<0.05) and we further conclude:1.Increase of BVAS correlates with rises of scoring on lung and kidney system-two sub-items in TCM symptom scoring table.2Increase of BVAS and TCM symptom scoring correlate with rises of proportions these two branches take.3. Great statistical significance shows between TCM symptom scoring of dampness-obstruction syndrome and non-dampness-obstruction syndrome while scoring of dampness-obstruction syndrome overwhelms other syndromes (P=0.003<0.05T=3.151)4.Conclusion:I. There is a correlation between BVAS and TCM symptom scoring, testifying that TCM symptoms can be a reflection of activity of AAV.Ⅱ. TCM symptom scoring in the Lung and Kidney system weigh much in the judgment of severity of AW on the perspective of both absolute value they take and proportions they occupy.Ⅲ Existence of Dampness-obstruction syndrome might be a key factor influencing development and outcome of AAV patients, while an in-depth investigation is needed.