| Objective:To explore the TCM syndrome characteristics and syndrome type classification of primary nephrotic syndrome(PNS),and the relationship between syndrome type and general condition,pathological type and medication situation by multivariate statistical methods.It could obtain the PNS syndrome rule which is more objective and in line with the clinical situation,so as to improve the study of PNS syndrome and guide clinical practice.Methods:196 patients with PNS who met the research conditions were collected from January 2015 to December 2019 in the inpatient and outpatient department of Renal Medicine,the Second Affiliated Hospital of Fujian Traditional Chinese Medical University.The TCM syndromes relevant information was collected from 196 patients’ medical records according to the information collection form of PNS designed.Results:1.General Situation:(1)The ratio of male to female was 1.97:1.The average age was 49.54 years old.The number of patients in the three groups of young,middle-aged and old was relatively balanced.(2)The number of patients with disease course of 1~5 years were the largest.(3)In terms of pathological types,the most frequent pathology type was the MN and the least was MPGN.(4)The ratio of patients who were treated with glucocorticoids to those who were not was about1:2.1.(5)There was no significant difference in gender composition in pathological types(P>0.05).(6)There was a significant difference between PNS pathological type and age group(P<0.05).2.TCM Syndrome Classification Results:(1)According to the results of multivariate statistical analysis and under the guidance of the tutor,the TCM syndrome types of PNS were divided into two categories.The primary asthenia syndrome involved lung-spleen Qi deficiency,spleen-kidney Qi deficiency,kidney Yin deficiency,spleen-kidney Yang deficiency;The secondary excess syndrome involved water-dampness syndrome,damp-heat syndrome,damp turbidity and blood stasis syndrome.(2)There was a significant difference between the primary asthenia syndrome and the secondary excess syndrome(P<0.05).3.Correlation Between TCM Syndrome Type And Clinical Information:(1)There was no significant difference between syndrome type and the factors including gender,age group,pathological type,glucocorticoids used,and the glucocorticoids used stage(P>0.05).(2)There was a significant difference between the primary asthenia syndrome and the course of disease(P<0.05).However,there was no significant difference between the secondary excess syndrome and the course of disease(P>0.05).Conclusion:1.The pathological types of PNS varied in the distribution of different age groups.MCD was more frequent in young people,MPGN is frequent in middle age,and MN was more frequent in the elderly.2.The main lesion sites of PNS were lung,spleen and kidney.The main pathological factors were water-dampness,damp-heat,damp turbidity and blood stasis,which also involved the invasion of external pathogenic factors.The nature of the disease was the existence of asthenia in origin and excess of the symptoms.3.There were 7 types frequent TCM syndromes of PNS.The primary asthenia syndrome involved lung-spleen Qi deficiency;spleen-kidney Qi deficiency;kidney Yin deficiency;spleen-kidney Yang deficiency;The secondary excess syndrome involved water-dampness syndrome,damp-heat syndrome,damp turbidity and blood stasis syndrome.4.In Terms of Syndrome Type Distribution:(1)The most frequent type of the primary asthenia syndrome was spleen-kidney Qi deficiency,followed by spleen-kidney Yang deficiency,kidney Yin deficiency,lung-spleen Qi deficiency.Damp-heat syndrome and water-dampness syndrome were more frequent in the secondary excess syndrome.Moreover,damp turbidity and blood stasis syndrome was the least frequent.Moreover,kidney Yin deficiency was frequently combined with damp-heat syndrome.(2)In the early stage of the disease,spleen-kidney Qi deficiency was the most syndrome,followed by lung-spleen Qi deficiency.With the prolonged course of disease,the proportion of spleen-kidney Yang deficiency and kidney Yin deficiency increased,and the disease turned to spleen-kidney Yang deficiency in the later stage.5.The gender,age and glucocorticoids used situation of patients had some influence on the manifestation and evolution of PNS TCM syndrome.(1)Female and elderly patients were more likely to show spleen-kidney Yang deficiency.(2)Patients treated with glucocorticoids were more likely to develop kidney Yin deficiency and damp-heat syndrome.(3)In terms of the whole stage of glucocorticoids used,spleen-kidney Qi deficiency was more frequent in the initial period of glucocorticoids used.In the withdrawal period,kidney Yin deficiency was the most frequent,followed by spleen-kidney Qi deficiency.During the maintenance period,spleen-kidney Yang deficiency was more frequent.In addition,in terms of the secondary excess syndrome,the proportion of damp-heat syndrome showed a trend of gradual increase with the stage change of glucocorticoids used. |
