488例IgA肾病中医证型与病理分级相关性分析

王今朝; 刘鹏; 何长远; 刘娜; 张佩青

文章摘要

王今朝刘鹏何长远刘娜张佩青.488例IgA肾病中医证型与病理分级相关性分析[J].实用中西医结合临床,2015,15(2):1-2,7

488例IgA肾病中医证型与病理分级相关性分析

Analysis on TCM Syndromes and Pathological Grading of 488 Patients with IgA Nephropathy

DOI：

中文关键词: IgA肾病中医证型病理分级

英文关键词: IgA nephropathy (IgAN) TCM syndromes Pathological grading

基金项目:

作者	单位
王今朝刘鹏何长远刘娜张佩青	中国中医科学院博士后；黑龙江省中医药科学院

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中文摘要:

目的：总结分析我院肾病中心IgA肾病患者中医证型和病理分级的相关性，为中西医结合规范化诊治IgA肾病提供依据。方法：收集近9年我院行肾穿刺活检的488例IgA肾病患者的中医四诊资料和病理检查资料，对中医证型和Lee氏病理分级进行分析。结果：488例IgA肾病患者主证中，阴虚证与气阴两虚证病理变化相对较轻，以Lee氏Ⅱ、Ⅲ级为主（86.2%，90.2%）；脾肾两虚证病理变化相对较重，以Lee氏Ⅲ、Ⅳ级为主（85.1%）。兼证中兼湿热者204例（41.8%），其次为兼浊毒者44例（9.0%）。488例患者中有233例主要表现为脾气虚证，并且以Lee氏Ⅱ、Ⅲ级为主（91.0%）。结论：中医辨证分型与肾脏病理分级有一定的相关性；而主要表现为脾气虚证患者占有很大比例。

英文摘要:

Objective: Analyze the correlation between TCM syndromes and pathological grading of patients with IgA nephropathy at Kidney Disease Research Center in our hospital, and to provide clinical data for the standardization of diagnosis and treatment for IgA nephropathy with integrative medicine. Methods: In 9 years, diagnostic information and pathological data of 488 cases of renal biopsy in patients with IgA nephropathy were collected and their TCM syndromes and Lee's pathological grading were analyzed and recorded. Results: The principal syndromes in the patients with IgA nephropathy included Yin deficiency and Qi and Yin deficiency didn’t show much change, their grading mostly fit in Lee's Ⅱand Ⅲ classification (86.2%, 90.2%); while pathological changes in both spleen and kidney deficiency syndromes witnessed a radical change, mostly fit in Lee's Ⅲ and Ⅳ classification (85.1%). As regards to accompanying syndromes, there were 204 cases of damp-heat syndrome and 44 cases of toxication syndrome with a percentage of 41.8% and 9.0% respectively. Among all the patients, 233 cases witnessed spleen deficiency syndrome, which fit in Lee's Ⅱ and Ⅲ classification (91.0%). Conclusions: There is a link between TCM syndrome types and renal pathology grading, which are mostly shown in a large percentage of patients with spleen deficiency syndrome.

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