| Objective:To explore the distribution characteristics of TCM syndrome differentiation in Henoch Schonlein purpura nephritis,and to evaluate the clinical differences of the patients with different types of syndrome differentiation,analyze the epidemiological characteristics,find the factors that affect the prognosis,and guide the clinical diagnosis and treatment.Methods:Collect general information,TCM syndromes of patients who meet the criteria,and divide patients into groups according to syndrome differentiation.The 24 hours urine protein quantitative,e GFR,urine routine and urine red cell position were measured for each patient.The pathological results of renal puncture were statistically analyzed,and the distribution of various TCM Syndrome Types and the difference of clinical indexes between different syndrome groups were analyzed and compared,and the epidemiological and related factors were investigated and analyzed.Results:1、Among the 130 patients,54(41.6%)were male(41.6%)and 76(58.4%);the minimum age was 9 years,the maximum age was 72 years,the average age was(33.04 +16.55)years old.All the seasons could occur in winter and spring.There were 48 cases(36.9%)with definite inducement.Among them,there were 24 cases of upper respiratory tract infection(18.4%),14 cases(10.8%)were infected(mostly fish shrimps),10 cases(7.7%)were vaccinated,mosquito bites,and pollen dust exposure,and 82 cases(63.1%)were unknown causes.2、The clinical manifestations of typical purpura were all found in 130 patients,of which 116 cases(89%)were mainly extensor lower limbs,8 cases(6%)of hip rash and 4 cases(3%)of upper extremities in 28 cases(21.5% %)Patients with varying degrees of abdominal pain after onset of symptoms,of which 8 cases(6%)associated with vomiting;21 cases(16.2%)patients with joint symptoms,mostly unilateral or bilateral joint involvement.3、In the present study,pathological findings of renal biopsy was mainly gradeⅢ(81.5%),with 110 cases(84.6%)of albuminuria and hematuria,16 cases of simple proteinuria or hematuria),Proteinuria and hematuria in 4 patients(3.1%);74 patients(56.9%)showed mild proteinuria(less than 1.0g / 24h),showing moderate proteinuria(1.0-3.5g / 24h)Patients(n = 41)(31.5%),which showed 15 patients(11.6%)with nephrotic syndrome proteinuria(> 3.5g / 24h).4、The patients who entered the group were identified according to syndrome differentiation.There were 115 people(88.4%)with shenxu syndrome,113people(86.9%)with yubi syndrome,56 people(43.1%)with fengshi syndrome,27people(20.8%)with ganfeng syndrome,and 3 people(2.3%)with nidu syndrome.According to the cluster analysis of the four diagnostic and clinical indicators of patients,patients can be divided into two categories: fengshi syndrome group and non-fengshi syndrome group,of which 56 people(43.1%)fengshi syndrome group,non-fengshi group 74 People(56.9%).5、Patients were divided into fengshi syndrome group and non-fengshi syndrome group compared their clinical and pathological findings found that patients with fengshi syndrome systolic blood pressure,mean arterial pressure,24 h proteinuria in patients with non-fengshi syndrome group,and serum Ig G,serum albumin,Estimated glomerular filtration rate and creatinine clearance rate were lower than non-fengshi syndrome group,the difference was statistically significant(P<0.05).At the same time,the proportion of crescents in fengshi syndrome group was greater than that of non-fengshi syndrome group,and inflammatory cells in fengshi syndrome group,the degree of infiltration was higher than that of the non-fengshi syndrome group,and the difference was statistically significant(P<0.05).6、Kaplan-Meier survival analysis was used to analyze the prognosis of different syndrome groups.It was found that the renal function of fengshi syndrome group was lower than that of non-fengshi group.The difference was statistically significant(P=0.011);The liver function in ganfeng syndrome group was lower than that in non-ganfeng syndrome group.The difference was statistically significant(P=0.005).7、According to previous HSP differentiation criteria,the patients were divided into fengre syndrome group and non-fengre syndrome group,no significant difference in clinical indicators and prognosis was found between the two groups.Conclusion:1、The incidence of allergic purpura nephritis in winter and spring-based,clinical manifestations of diversity,with rash,abdominal pain,joint symptoms,kidney damage higher incidence.2、The glomerular pathological changes of Henoch Schonlein purpura nephritis were mainly grade III.3、Patients with Henoch-Schonlein purpura nephritis were divided into shenxu syndromes,yubi syndrome,fengshi syndrome,ganfeng syndrome,and nidu syndrome.Shenxu syndrome and yubi syndrome were the basic syndromes of rheumatoid syndrome.Fengshi syndrome is the main syndrome of the disease,and it is a key stage for timely intervention and reversal of the disease.Ganfeng syndrome is the stage of progression of the disease and has a poor prognosis.Fengre syndrome is not the main syndrome affecting the disease. |
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