Analysis Of Clinical Characteristics Of Tongue And Eye Diagnosis In Patients With Primary Nephrotic Syndrome

Objective: To observe the clinical characters of tongue diagnosis and eye diagnosis in patients with primary nephrotic syndrome(PNS),and to explore the relationship between pathological types of kidney syndrome,tongue diagnosis,eye diagnosis,and TCM syndrome types and eye diagnosis.It provides some reference value in the comprehensive diagnosis of primary kidney disease.Methods: A cross-sectional study was used.Patients with PNS admitted to the ward and outpatient department of Ruikang Hospital of Guangxi University of Traditional Chinese Medicine from January 2019 to December2019 were selected as the research subjects.A total of 138 cases were screened according to the standard,and the general information of the patients,TCM syndrome type,pathological type,tongue picture and eye picture were collected.The analysis of the data is mainly to explore the relationship between pathological types of primary nephrotic syndrome,tongue diagnosis,eye diagnosis and syndrome differentiation and eye diagnosis.Results:1.General situation of PNS patients: Among 138 PNS patients,81 were male(58.69%)and 57 were female(41.31%).The male to female ratio was approximately 1.42: 1.Among all patients,the youngest was 14 years old and the oldest was 81 years old,with an average age of 37.23 ± 18.00 years.Among them,21 patients(15.21%)were 14-18 years old;the largest number was 18-35 years old,with 52 cases(37.68%);44-year-old patients aged 36-59(31.88%);and 21 cases(15.21%)were over 60 years old.2.The overall distribution of PNS pathological types and TCM syndrome types: 46 cases of membranous nephropathy(MN)are the most common,accounting for 33.33%,followed by 34 cases of minimally diseased nephropathy(MCD),accounting for 24.63%.Mesangial proliferative nephritis((Ms PGN)23 cases,accounting for 16.67%,19 cases of membranous proliferative nephritis(MPGN),accounting for 13.76%,16 cases of focal segmental glomerulosclerosis(FSGS)are rare,accounting for11.59%.Among the TCM syndrome types,65 cases are most common with spleen-kidney yang deficiency syndrome,accounting for 47.1%,31 cases with Feng Shui flooding syndrome,accounting for 22.46%,23 cases with damp heat accumulation syndrome,accounting for 16.67%,11 cases with kidney collateral obstruction syndrome,accounting for 7.97%,and 8 cases with liver and kidney yin deficiency syndrome,accounting for 5.79%.3.Overall tongue distribution of PNS: In the overall tongue color distribution,pale tongues and red tongues are the most common,and the silk tongue is the least.In the overall moss color distribution,white moss is the most common,yellow moss is the second,gray and black moss is the least;in the overall moss distribution,the thin moss is the most common,the thin slippery moss is the second,the thick slippery moss is the least.4.Tongue distribution of PNS pathological types: red tongue and thin white moss tongue are most common in FSGS and Ms PGN,light red tongue and thin white moss tongue is most common in MCD,pale white tongue and thin white moss tongue is most common in MN,and light red tongue and thin White greasy moss tongue is most common in MPGN.(1)Tongue color: Red tongue is most common in FSGS and Ms PGN.Among them,the proportion of red tongue in FSGS is more than 50%;the incidence of light red tongue in MCD and MPGN is significantly higher than in other groups;light tongue is most common in MN.Tongue tongue is the rarest of all pathological types.There were differences in tongue color distribution among PNS pathological types(P <0.05).(2)Moss color: White moss is most common in all pathological types.Except for Ms PGN,the incidence of white moss in other pathological types is more than 50%;FSGS and Ms PGN yellow moss are higher than other groups.The gray-black moss was the rarest in all groups.There was no difference in the distribution of moss color among PNS pathological types(P> 0.05).(3)Moss: FSGS and MCD moss is mainly thin moss,followed by thin moss,with the least thick moss.MN and Ms PGN are most common with thin moss,followed by thick moss,and the least mossy;The characteristics of MPGN moss are that thin moss is more common,followed by thin moss,and thick moss is the least common.The difference in moss distribution among PNS pathological types was statistically significant(P <0.05).5.Distribution of overall visual scores of PNS patients: Among the visual diagnosis scoring groups,the highest score was 10-13,with a total of 77 cases,accounting for 55.8%;less than 10 scores,with a total of 47 cases,accounting for 34.1%;greater than 13 was the least,Only 13 cases accounted for 10.1%.There was no significant difference in the distribution of visual diagnosis scores for each pathological type(P> 0.05).There was a significant statistical difference in the distribution of visual diagnosis scores of each TCM syndrome type(P <0.01)6.Comparison of PNS pathological types and visual inspection scores:Ms PGN had the highest score(11.05 ± 1.28 points),and MCD had the lowest score(9.52 ± 1.88 points).There was a difference in visual examination scores between MCD and FSGS,MN,and Ms PGN(P <0.05);there was a difference in visual examination scores between MPGN and MN,Ms PGN(P<0.05).There was no significant difference in visual examination scores among the other groups(P> 0.05).7.Comparison of various PNS TCM syndrome types with visual examination scores: the kidney stagnation syndrome score was the highest(11.91 ± 1.97points),and the Feng Shui flooding syndrome score was the lowest(9.55 ±1.89 points).There was a difference in visual examination scores between kidney stasis syndrome and Fengshui flooding syndrome,liver and kidney yin deficiency syndrome,and spleen and kidney yang deficiency syndrome(P<0.05);dampness and heat accumulation conclusion syndrome had Fengshui flooding syndrome and Fengshui flooding syndrome.Difference(P <0.05).There was a significant difference in visual examination scores between the groups(P <0.01).Conclusion:1.The tongue and eye images of PNS pathological types are different.Red tongue and thin white moss tongue are most common in FSGS and Ms PGN,light red tongue and thin white moss tongue are most common in MCD,pale white tongue and thin white moss tongue are most common in MN,and light red tongue and thin White greasy moss tongue are most common in MPGN.It means that tongue and eye diagnosis are of great significance to the clinical diagnosis of nephrotic syndrome,or it can provide a certain reference value for clinical diagnosis of pathological classification of PNS.2.There is a significant correlation between PNS TCM syndrome types and visual inspection scores.Eye diagnosis is an important part of TCM diagnosis.It enriches the content of eye diagnosis and provides a more powerful basis for more accurate TCM syndrome differentiation.