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[1016例IgA肾病患者中医证候多中心流行病学调查及其相关因素分析]

[A multi-centeric epidemiological survey on TCM syndrome in 1016 patients with IgA nephropathy and analysis of its relevant factors].

作者信息

Chen Xiang-Mei, Chen Yi-Ping, Li Ping

机构信息

Department of Nephrology, General Hospital of PLA, Beijing (100853).

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Mar;26(3):197-201.

Abstract

OBJECTIVE

To investigate the distribution pattern of TCM syndrome in patients with IgA nephropathy and its relationship with the main clinical prognostic indexes to provide a basis for the standardization of integrative medicine in diagnosis and treatment of IgA nephropathy.

METHODS

Multi-centeric epidemiological field survey was adopted to collect the materials of 1016 IgA nephropathic patients, including demography, TCM syndrome and laboratory findings, for exploring the distribution pattern of TCM syndrome of IgA nephropathy patients.

RESULTS

Probability of over 10% could be found in the TCM syndromes as yin deficiency, qi deficiency, yang deficiency, damp-heat and blood stasis syndrome, the highest (41.5%) was found in qi-yin deficiency syndrome and the lowest (8.1%) in yang deficiency of Pi and Shen. Along with the increasing of age, the percentage of patients with Pi-Fei qi asthenia syndrome descended while those with Pi-Shen yang asthenia ascended. In the accompanying syndromes, damp-heat syndrome and blood stasis syndrome, with the proportion of 32.6% and 28.9% respectively, were the most frequently encountered. The levels of 24 h urinary protein, serum creatinine and urea nitrogen in patients with Pi-Fei qi asthenia syndrome, qi-yin deficiency syndrome and Gan-Shen yin asthenia syndrome were significantly lower than those in patients with Pi-Shen yang asthenia syndrome, respectively (P < 0.05), while the blood pressure in patients with Pi-Fei qi asthenia syndrome, and qi-yin deficiency syndrome were significantly lower than that in patients with Gan-Shen yin asthenia syndrome and Pi-Shen yang asthenia syndrome (P<0.01).

CONCLUSION

Qi-asthenia and yin deficiency is the principal clinical manifestation of IgA nephropathy. TCM syndrome types are closely related with the prognostic indexes as urine protein, hypertension, renal lesion, etc.

摘要

目的

探讨IgA肾病患者中医证候分布规律及其与主要临床预后指标的关系,为IgA肾病中西医结合规范化诊疗提供依据。

方法

采用多中心流行病学现场调查方法,收集1016例IgA肾病患者的人口学、中医证候及实验室检查等资料,探讨IgA肾病患者中医证候分布规律。

结果

IgA肾病患者中,阴虚证、气虚证、阳虚证、湿热证、血瘀证等中医证候出现概率超过10%,其中气阴两虚证出现比例最高(41.5%),脾肾阳气虚证出现比例最低(8.1%)。随着年龄增加,肺脾气虚证患者比例下降,脾肾阳气虚证患者比例上升。兼夹证中,湿热证和血瘀证最为常见,比例分别为32.6%和28.9%。肺脾气虚证、气阴两虚证、肝肾阴虚证患者24 h尿蛋白、血肌酐、尿素氮水平分别显著低于脾肾阳气虚证患者(P<0.05),肺脾气虚证和气阴两虚证患者血压显著低于肝肾阴虚证和脾肾阳气虚证患者(P<0.01)。

结论

气虚、阴虚是IgA肾病的主要临床表现。中医证型与尿蛋白、高血压、肾脏病变等预后指标密切相关。

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