Retrospective Analysis Of TCM Syndrome Distribution And Pathological Staging Of Idiopathic Membranous Nephropathy

Objective:To explore the relationship between the distribution of TCM syndromes and the regularity of renal pathological stages in patients with idiopathic membranous nephropathy,and hope that this study can optimize the diagnosis and treatment plan of idiopathic membranous nephropathy,in order to provide reference for the clinical effect and prognosis evaluation of the treatment of integrated traditional Chinese and Western medicine in the future.Materials and methods:The data were collected through retrospective analysis(in line with the Napai standard).The data were recorded in 150 patients with idiopathic membranous nephropathy diagnosed by renal biopsy in the Department of Nephrology of Heilongjiang Provincial Hospital of traditional Chinese medicine and the First Affiliated Hospital of Heilongjiang University of traditional Chinese medicine from march2020 to march2022.According to the basic situation of the patients,the four diagnostic information of traditional Chinese medicine,pathological reports,clinical physical and chemical data and other information,Statistical investigation,analysis and research were carried out on the patient’s condition,and spss26.0medical statistical software was used to explore the distribution of TCM Syndrome Types and pathological staging rules of the disease,and to compare the differences between each syndrome type and clinical biochemical indicators.The comparison results by chi square test,rank sum test,analysis of variance and other methods showed that p<0.05 was statistically significant.Result:1.General information: 150 IMN patients,89 males and 61 females,with a sex ratio of1.46:1;The average age of the patients was 43.21 ± 10.18 years old,and the patients aged 40~ 49 had the highest prevalence;The number of male and female patients aged from 40 to 49 was higher;The course of disease is mostly 0 ~ 1 year,accounting for 93 cases(62.0%)2.Distribution of TCM syndrome types: in this deficiency syndrome,spleen and kidney qi deficiency syndrome is the most distributed,and the rest are spleen and kidney yang deficiency syndrome,Qi and yin deficiency syndrome,lung and kidney qi deficiency syndrome,liver and kidney yin deficiency syndrome from high to low;The syndrome of dampness and heat is the most common syndrome,and the rest are blood stasis syndrome,water dampness syndrome and dampness turbidity syndrome.There was no statistical significance between this deficiency syndrome and standard excess syndrome(p>0.05).3.TCM Syndrome Types and epidemiology: in TCM syndrome types,except for liver and kidney yin deficiency,the rest of this deficiency and standard syndrome are mostly male;In this deficiency syndrome,spleen and kidney qi deficiency syndrome was more common in both men and women,and damp heat syndrome was more common in both men and women in standard syndrome.There was no statistical significance between TCM Syndrome Types and gender distribution(p>0.05);In TCM syndrome types,the highest average age of this deficiency syndrome and liver kidney yin deficiency syndrome is 44.67 ± 8.04 years old,and the rest are lung kidney qi deficiency syndrome,spleen kidney qi deficiency syndrome,Qi Yin deficiency syndrome and spleen kidney yang deficiency syndrome from high to low.In standard syndrome types,the average age from high to low is blood stasis syndrome,damp heat syndrome,water dampness syndrome and dampness turbidity syndrome,and the highest age of blood stasis syndrome is 44.91 ± 7.93 years old.There is no statistical significance between TCM Syndrome Types and age distribution(p>0.05);TCM syndrome type The longest average course of Qi Yin deficiency in this deficiency syndrome was 44 months.After test,p<0.05,that is,there was a statistical difference between this deficiency syndrome and the course distribution.The longest average course of water dampness syndrome and blood stasis syndrome in the standard syndrome was 12 months,and there was no statistical difference between the standard syndrome and the course distribution(p>0.05).4.The relationship between TCM Syndrome Types and clinical biochemical indexes: the24-hour urinary protein of Qi Yin deficiency syndrome is higher than that of spleen kidney qi deficiency syndrome,and the 24-hour urinary protein of blood stasis syndrome is higher than that of damp heat syndrome;The plasma albumin of Qi Yin deficiency syndrome was lower than that of spleen kidney qi deficiency syndrome;The serum creatinine level of dampness turbidity syndrome was higher than that of water dampness syndrome,blood stasis syndrome and damp heat syndrome;The total cholesterol level of blood stasis syndrome was higher than that of water dampness syndrome,and the difference was statistically significant (p<0.05),and there was no statistical significance among the other groups.5.The relationship between TCM Syndrome Types and pathological stages: the distribution of pathological stages in 150 patients was mainly stage I and II,and the distribution of stage II in this deficiency syndrome was the most,accounting for 72 cases(48%);In the standard syndrome,the dehumidification turbidity syndrome was mainly stage I,and the rest were mainly stage II.There was no statistical difference in the distribution of pathological stages among the syndrome types(p>0.05).6.The relationship between TCM Syndrome Types and histopathological damage: there was statistical significance in the distribution of glomerular sclerosis(p<0.05),and there was significant difference in the distribution of glomerular sclerosis and renal tubular atrophy(p<0.05).There was no statistical significance between renal interstitial fibrosis,thickening of renal arteriole wall and TCM syndrome types(p>0.05).Conclusion:1.The spleen and kidney qi deficiency syndrome is the main type of this deficiency syndrome,followed by the spleen and kidney yang deficiency syndrome.The syndrome of dampness heat is the main syndrome,followed by the syndrome of blood stasis.2.The 24-hour urinary protein in the Qi Yin deficiency group was higher than that in the spleen kidney qi deficiency group,and the 24-hour urinary protein in the blood stasis group was higher than that in the damp heat group;The plasma albumin of Qi Yin deficiency group was lower than that of spleen kidney qi deficiency group;The serum creatinine of the dampness turbid syndrome group was higher than that of the water dampness syndrome group,blood stasis syndrome group and damp heat syndrome group;The total cholesterol of blood stasis syndrome group was significantly higher than that of water dampness syndrome group.3.The distribution of renal pathological stages was the most in phase II,and there was no statistical significance between TCM Syndrome Types and renal pathological stages.4.There was statistical significance in the distribution of standard syndrome,glomerul osclerosis and renal tubular atrophy.