Chen Xiang-mei, Chen Yi-ping, Chen Yi-pu
Department of Nephrology, General Hospital of PLA, Beijing 100853.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004 Feb;24(2):101-5.
To study the distribution pattern of TCM Syndrome type and its relationship with renal pathology in patients with IgA nephropathy.
Apopting multicenter coordinated method, patients' TCM Syndrome type was differentiated according to their clinical manifestations, data concerning laboratory examination and renal pathology were collected to establish a database for analyzing the relationship between TCM Syndrome type and renal pathology in 286 patients.
Patients of Pi-Fei Qi-deficiency type (type 1) and both Qi-Yin deficiency type (type 2) showed rather milder pathological changes, by Lee classification, most of them belonged to grade I-III (72.3%, 70.2%); patients of Gan-Shen Yin deficiency type (type 3) had severe pathological change and majority of them belonged to grade III-IV (84.6%); and the most severe pathological change was shown in patients of Pi-Shen Yang-deficiency type (type 4), and the Lee's grade IV-V was dominant (88.0%) in them. Syndrome type of patients was significantly correlated with their Lee's grade (r = 0.26, P < 0.01). Percentage of glomerular sclerosis in patients of type 4 was higher than that in patients of the other three types. Semi-quantitative scoring upon pathological changes showed that the total, glomerular, tubulo-interstitial and vascular scores were significantly higher in patients of type 4 than in those of the other three types; those scores were higher in patients of type 3 than in type 1; the total, glomerular and vascular scores were higher in patients of type 3 than in type 2; and scores in patients of type 1 and type 2 showed insignificant difference.
Multicentric prospective study proves that the TCM Syndrome typeof patients with IgA nephropathy is significantly correlated with the grade and severity of their renal pathological changes, thus, the TCM Syndrome typing shows definite referential importance to conclude the severity of renal pathological change in patients with IgA nephropathy.
研究IgA肾病患者中医证型分布规律及其与肾脏病理的关系。
采用多中心协作方法，根据患者临床表现进行中医证型辨证，收集实验室检查及肾脏病理资料，建立数据库，分析286例患者中医证型与肾脏病理的关系。
脾肺气虚型（1型）和气阴两虚型（2型）患者病理改变相对较轻，按Lee分级，大部分属于Ⅰ - Ⅲ级（72.3%，70.2%）；肝肾阴虚型（3型）患者病理改变较重，多数属于Ⅲ - Ⅳ级（84.6%）；脾肾阳虚型（4型）患者病理改变最严重，以Lee分级Ⅳ - Ⅴ级为主（88.0%）。患者证型与Lee分级显著相关（r = 0.26，P < 0.01）。4型患者肾小球硬化百分比高于其他三型。病理改变半定量评分显示，4型患者的总分、肾小球、肾小管间质及血管评分均显著高于其他三型；3型患者评分高于1型；3型患者的总分、肾小球及血管评分高于2型；1型和2型患者评分差异无统计学意义。
多中心前瞻性研究证明，IgA肾病患者的中医证型与肾脏病理改变的分级及严重程度显著相关，因此，中医证型对判断IgA肾病患者肾脏病理改变的严重程度具有一定的参考意义。
