A Study On The Correlation Between Distribution Of TCM Syndrome Type And Clinical Related Factors In Patients With Idiopathic Membranous Nephropathy

Objective:To observe the relationship between distribution of TCM syndrome type and clinical related factors in patients with Ⅰdiopathic membranous nephropathy provides a basis for preventing ⅠMN with TCM.Methods:280 cases Ⅰdiopathic membranous nephropathy patients were collected from nephropathy outpatient and inpatient,Guangxi TCM University first subsidiary hospital,in January 2014 to January 2017.The "Guangxi region ⅠMN questionnaire of TCM syndrome" was basis on the latest edition of the reference standard of TCM syndrome and related documents.Patients’ name,gender,age,native place,protopathy,"four diagnostic methods" in TCM and laboratory biochemical indices were recorded by using this questionnaire.According to the standard of new version "Chinese medicine new medicine clinical research guiding principles" about chronic renal failure TCM syndrome,ⅠMN was divided into deficiency syndromes(Qi-deficiency of spleen and kidney syndrome,Qi-deficiency of lung and kidney syndrome,Yang-deficiency of spleen and kidney syndrome,Yin-deficiency of liver and kidney syndrome,Qi-Yin-deficiency syndrome)and excess syndromes(wet muddy syndrome,damp-heat syndrome,damp syndrome,blood stasis syndrome).To build the database was based on those cases.Then a medical statistical analysis was made by using SPSS17.0 software.Lastly,distribution regularities of ⅠMN TCM syndrome type and the related influencing factors were discussed.Results:(1)Proportion of patients with different TCM syndrome types in all patients are Qi-deficiency of spleen and kidney syndrome(30.7%),Yang-deficiency of spleen and kidney syndrome(38.2%),Qi-deficiency of lung and kidney syndrome(10%),Yin-deficiency of liver and kidney syndrome(7.9%),Qi-Yin-deficiency syndrome(13.2%).Most patients combine with blood stasis syndrome(40%)and wet muddy syndrome(32.8%).(2)Significant difference is observed in different TCM syndrome type groups due to varying pathogenic course of duration(P<0.01).Patients with relatively shortened disease duration are mainly comprised of Qi-deficiency of spleen and kidney syndrome,Yang-deficiency of spleen and kidney syndrome,followed by Qi-deficiency of lung and kidney syndrome,Yin-deficiency of liver and kidney syndrome and Qi-Yin-deficiency syndrome which are of prolonged disease duration.(3)The commonly seen pathological stage in ⅠMN patient are of stage Ⅰ,stage Ⅰ-Ⅱ,stage Ⅱ.Qi-deficiency of spleen and kidney syndrome is predominantly observed in pathological stage Ⅰ(39.5%),stage Ⅰ-Ⅱ(30.2%),stage Ⅱ(23.3%),the ratio shown is of gradual decrement phenomenon;Yang-deficiency of spleen and kidney syndrome is mostly observed in pathological stage Ⅰ(16.8%),stage Ⅰ-Ⅱ(29.9%),stage Ⅱ(43.9%),the ratio shown is of gradual increment phenomenon;Qi-Yin-deficiency syndrome is mainly seen in pathological stage Ⅱ(27%)and stage Ⅱ-Ⅲ(37.8%).Qi-deficiency of lung and kidney syndrome and Yin-deficiency of liver and kidney syndrome are sparsely observed in all varying pathological stages.(4)The correlation between TCM syndrome type and biochemical indicators: 24 hours proteinuria level and serum creatinine level in ⅠMN patients with Yang-deficiency of spleen and kidney syndrome are predominantly higher than group with Qi-deficiency of spleen and kidney syndrome,Qi-deficiency of lung andkidney syndrome,Yin-deficiency of liver and kidney syndrome(P<0.01);serum albumin level is relatively lower in ⅠMN patients with Qi-deficiency of lung and kidney syndrome,Yin-deficiency of liver and kidney syndrome(P<0.01);serum creatinine level in ⅠMN patients with Qi-Yin deficiency is relatively higher than groups with Qi-deficiency of lung and kidney syndrome,Yin-deficiency of liver and kidney syndrome(P<0.01);however serum albumin level in ⅠMN patients with Qi-Yin deficiency is relatively lower than groups with Qi-deficiency of lung and kidney syndrome,Yin-deficiency of liver and kidney syndrome(P<0.01);serum creatinine level is relatively higher in ⅠMN patients with Qi-deficiency of spleen and kidney syndrome than that of Qi-deficiency of lung and kidney syndrome(P<0.05).Nevertheless,there is no significant difference in statistical findings,be it the total cholesterol level and the LDL cholesterol level,among the varying TCM syndrome type.Conclusions:(1)Most patients with ⅠMN have Qi-deficiency of spleen and kidney syndrome and Yang-deficiency of spleen and kidney syndrome.Most patients combine with blood stasis syndrome and wet muddy syndrome.(2)The pathological staging of ⅠMN is mainly comprised of pathological stage Ⅰ,stage Ⅰ-Ⅱ and stage Ⅱ.Among which,Qi-deficiency of spleen and kidney syndrome and Yang-deficiency of spleen and kidney syndrome are predominantly of pathological stage Ⅰ,stage Ⅰ-Ⅱ,stage Ⅱ.Of such,the ratio shown a gradual decrement in group with Qi-deficiency of spleen and kidney syndrome in pathological stage Ⅰ and stage Ⅱ,whereas ratio shown a gradual increment phenomenon in group with Yang-deficiency of spleen and kidney syndrome.Qi-Yin-deficiency syndrome are mainly observed in pathological stage Ⅱ and stage Ⅱ-Ⅲ.(3)A coherent correlation exists in between ⅠMN patients with respective TCMsyndrome type and biochemical indicators,as such 24 hours proteinuria,serum creatinine,serum albumin.